What Medications Should Not Be Taken With Hyaluronic Acid? A Comprehensive Guide

October 6, 2025 •

4 min read

While hyaluronic acid is a widely used ingredient found in countless skincare products, supplements, and medical treatments, its injectable forms require careful consideration of drug interactions. This guide explores what medications should not be taken with hyaluronic acid depending on the method of administration, from injections to oral supplements and topical products.

Quick Summary

This guide provides detailed information on medications and substances to avoid when using hyaluronic acid in injectable, oral, or topical forms. It covers risks associated with blood thinners, certain skincare actives, and potential contraindications based on medical history.

Key Points

Blood Thinners and Injections: Stop blood-thinning medications and certain supplements (like fish oil, vitamin E, ginkgo biloba) prior to hyaluronic acid injections to reduce bruising and bleeding risk.
HA Form Matters: Interactions depend on whether hyaluronic acid is injected, taken orally, or applied topically. Injections carry the highest risk profile for drug interactions.
Skincare Combos: Avoid mixing topical hyaluronic acid with potent chemical exfoliants like AHAs, BHAs, and benzoyl peroxide to prevent skin irritation and excessive dryness.
Oral HA Safety: Oral hyaluronic acid supplements have fewer reported significant interactions, but patients with a history of cancer or on diabetes medication should consult a doctor.
Medical Contraindications: Bleeding disorders, active infections, and hypersensitivity to HA are contraindications for injections. Pregnancy, breastfeeding, and radiation therapy require caution with various forms of HA.
Disinfectant Alert: Disinfectants containing quaternary ammonium salts should not be used at the site of HA injections, as they can render the treatment ineffective.

Hyaluronic acid (HA) is a natural substance found in the body that helps to retain moisture, lubricate joints, and provide structure to the skin. Its applications are widespread, from cosmetic dermal fillers and joint injections for osteoarthritis to oral supplements and topical skincare products. However, the risk profile for interactions varies significantly depending on how the HA is administered.

Hyaluronic Acid Injections and Medication Precautions

For injectable forms of hyaluronic acid, which are used for both cosmetic and therapeutic purposes, certain medications can increase the risk of side effects. The primary concern is localized bleeding, swelling, and bruising at the injection site.

Blood Thinners and NSAIDs

Patients undergoing injections for dermal fillers or joint pain should be aware of a heightened risk of bleeding and bruising if they are taking blood-thinning medications. These products can impair the blood's clotting ability. Healthcare providers often advise stopping certain medications temporarily before a procedure to mitigate this risk.

Common blood thinners and NSAIDs to watch for:

Oral anticoagulants: Warfarin, Eliquis (apixaban).
Antiplatelets: Aspirin, Clopidogrel.
NSAIDs: Ibuprofen, Naproxen.

Corticosteroids

While some studies have shown benefits in co-injecting corticosteroids and HA for conditions like osteoarthritis, a distinction must be made for dermal fillers. Oral or topical corticosteroids can cause skin thinning, which may weaken the injection site and affect the filler's longevity and result. Furthermore, prolonged corticosteroid use has been linked to negative effects on cartilage in vitro, potentially counteracting the benefits of HA in joints.

Immunosuppressants

Patients on immunosuppressant medication for systemic illnesses should exercise caution with HA injections, as these drugs can weaken the immune system and increase the risk of infection at the injection site. Examples include Methotrexate and Cyclosporine.

Vasodilators

Certain medications that dilate blood vessels, such as some blood pressure medications, can increase swelling and bruising with injections. This is due to increased blood flow to the injection area. Examples include Oral minoxidil and Hydralazine.

Incompatible Disinfectants

It is critical that disinfectants containing quaternary ammonium salts (e.g., benzalkonium chloride) are not used to prepare the injection site. These chemicals can inactivate hyaluronic acid, preventing the injection from working properly.

Oral Hyaluronic Acid Supplements and Interactions

When taken as an oral supplement, hyaluronic acid is generally considered to have a low risk of significant drug interactions. Unlike injections, it does not carry the same concerns for localized bleeding or infection risks. However, some sources suggest awareness, especially for specific conditions and populations.

Diabetes Medications: Some reports suggest potential awareness is needed, as HA is involved in metabolic pathways that affect insulin resistance. A healthcare professional should be consulted.
Cancer History: Oral hyaluronic acid supplements are sometimes advised against in patients with a history of cancer due to HA's potential role in cell proliferation. This does not typically apply to injectable HA.

Topical Skincare Ingredients to Avoid with Hyaluronic Acid

Combining hyaluronic acid with certain potent skincare actives can lead to irritation or reduced effectiveness. While HA is generally compatible, caution should be exercised, especially for sensitive skin types.

Chemical Exfoliants

Combining strong acids can lead to over-exfoliation and irritation. Using AHAs (alpha hydroxy acids) and BHAs (beta hydroxy acids) simultaneously with HA may cause excessive dryness.

Other Potent Actives

Benzoyl Peroxide: A common acne treatment, its drying effects can counteract HA's hydrating benefits.
Vitamin C: Can be safely used with HA, but some sensitive individuals may experience irritation. The main concern lies with pH incompatibility potentially reducing effectiveness, depending on the formulation.
Retinol/Salicylic Acid: Using retinol or salicylic acid with HA could increase the risk of dryness or irritation, particularly for sensitive skin.

To minimize risks, consider using these potent ingredients and hyaluronic acid at different times of the day (e.g., one in the morning, one in the evening).

Medications and Supplements to Avoid with Hyaluronic Acid


Type of Hyaluronic Acid	Medications/Substances to Avoid	Reason for Caution/Interaction
Injectable (Fillers, Joints)	Blood Thinners (Warfarin, Eliquis)	Increased risk of bleeding, bruising, and hematoma at injection site.
	NSAIDs (Ibuprofen, Naproxen)	Increased bleeding and bruising risk.
	Corticosteroids	May cause skin thinning (fillers) or affect cartilage (joints).
	Immunosuppressants	Increased risk of infection at the injection site.
	Vasodilators	May increase swelling and bruising.
	Quaternary Ammonium Salts (e.g., Benzalkonium chloride)	Can inactivate HA on contact; found in some disinfectants.
	Herbal Supplements (Ginkgo, Vitamin E)	Increase risk of bleeding and bruising.
Oral Supplements	Some Diabetes Medications	Potential involvement in metabolic pathways; consult a doctor.
	Some Chemotherapy Drugs	Caution advised; consult a doctor.
	Oral for Cancer History	Potential link to cell proliferation.
Topical (Skincare)	AHAs & BHAs	Can cause irritation and excessive dryness.
	Benzoyl Peroxide	Drying effect can counteract hydration.
	Vitamin C	Potential pH incompatibility and irritation for sensitive skin.
	Niacinamide & Salicylic Acid	Potential for irritation and dryness, especially if sensitive.

Important Medical Considerations

Beyond drug interactions, certain medical conditions are contraindicated with hyaluronic acid, particularly in injectable forms.

Bleeding Disorders: Intra-articular injections are generally contraindicated in patients with bleeding disorders or those on high-risk antithrombotic medications.
Allergies: Hypersensitivity to hyaluronic acid or components of the formulation is a direct contraindication for injections.
Infections: Infections near the planned injection site or a septic joint are contraindications.
Pregnancy and Breastfeeding: The use of HA injections is typically avoided during pregnancy and breastfeeding due to insufficient safety data.
Radiation Therapy: Studies have shown that applying topical HA during radiation therapy might increase the risk of skin complications.

Conclusion

Understanding what medications should not be taken with hyaluronic acid is essential for safety, but the context of administration is key. While oral and topical forms generally have limited systemic interaction concerns, injections carry a higher risk of adverse effects with blood thinners, certain supplements, and other medications. Always consult a healthcare provider or a board-certified dermatologist before starting any new treatment, especially if you take other medications or have underlying health conditions. Your provider can offer personalized advice based on your full medical history to ensure a safe and effective outcome. For general information on hyaluronic acid, you can visit the NIH National Library of Medicine.

Frequently Asked Questions

While oral hyaluronic acid supplements are generally considered safe with a low risk of significant interactions, you should always consult your doctor before starting them, especially if you take medications for diabetes or have a history of cancer.

Taking a blood thinner like warfarin or an NSAID like ibuprofen before a hyaluronic acid injection increases your risk of bleeding, swelling, and bruising at the injection site. Your healthcare provider will likely advise you to stop these medications for a period before the procedure.

Yes, but with caution. To avoid potential dryness and irritation, especially if you have sensitive skin, consider using retinol and hyaluronic acid at different times of the day (e.g., retinol at night and HA in the morning).

Yes, avoid disinfectants that contain quaternary ammonium salts, such as benzalkonium chloride, at the injection site. These chemicals can inactivate hyaluronic acid and prevent the treatment from working.

Yes, many healthcare providers recommend temporarily stopping supplements known to increase bleeding, such as fish oil, vitamin E, ginkgo biloba, and St. John's wort, for about one to two weeks before a dermal filler injection.

No, applying topical hyaluronic acid to the skin while undergoing radiation therapy is not recommended. Studies have shown it may increase the risk of skin complications like dermatitis.

Hyaluronic acid injections are generally avoided during pregnancy and breastfeeding due to a lack of sufficient safety data for these specific groups. Always consult your doctor before any treatment.