A 76-year-old white European woman on long-term phenprocoumon therapy with an international normalised ratio (INR) within the therapeutic range began using ginger (not specified) products. Several weeks later, she developed an elevated INR up to 10 and epistaxis. The INR returned to the normal range after ginger was stopped and vitamin K1 was given. An objective causality assessment revealed that an adverse drug event as a result of the phenprocoumon and ginger interaction was probable.