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Dietary supplement

A.Vogel Liver Gallbladder Drops Ingredients & Drug Interactions

by Bioforce

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

A.Vogel Liver Gallbladder Drops is a dietary supplement by Bioforce with 5 active ingredients. Its ingredients are commonly taken for liver health and protection, hepatitis, cirrhosis.Based on those ingredients, 1,310 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle (seed) extract, Peppermint (leaves) (fresh) extract, Boldo (leaves) extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of A.Vogel Liver Gallbladder Drops by Bioforce

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 5 of its 5 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

A.Vogel Liver Gallbladder Drops contains five active herbal extracts: milk thistle seed extract, boldo leaf extract, globe artichoke aerial part extract, dandelion whole plant extract, and peppermint leaf extract. The product is formulated as a liquid with 62% alcohol by volume as an inactive ingredient.

These extracts are traditionally used to support liver and gallbladder function, though the strength of evidence varies by ingredient. The product is concentrated herbal material, not a simple food—so the doses and effects differ from eating these plants as culinary herbs.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Liver and gallbladder health support.
  • We looked for evidence on: Biliary disorders, Gallbladder disease, Alcohol-related liver disease, Hepatitis B, Hepatitis C, Metabolic dysfunction-associated steatotic liver disease (MASLD) — and 4 related terms.
  • The strongest evidence on file: Peppermint is rated "Possibly Effective" for Dyspepsia (Natural Medicines).
  • Also on file: Artichoke is rated "Possibly Effective" for Dyspepsia.
  • Also on file: Milk Thistle is rated "Insufficient Reliable Evidence To Rate" for Alcohol-related liver disease, Metabolic dysfunction-associated steatotic liver disease (MASLD), Dyspepsia, Hepatitis C, and more.

Evidence for these ingredients is mixed. Milk thistle is possibly effective for type 2 diabetes, but evidence for other uses (acne, alcohol-related liver disease, hay fever, gambling disorder, amanita mushroom poisoning) is insufficient.

Boldo has insufficient evidence for all uses we have data on, including gallbladder and kidney stone support. Artichoke is possibly effective for high cholesterol and indigestion, but nonalcoholic fatty liver disease is insufficient.

Dandelion has insufficient evidence for all conditions we hold data on—joint pain, tonsillitis, and swelling or pain after surgery. Peppermint is likely effective for irritable bowel syndrome and possibly effective for indigestion, nausea from chemotherapy, colon spasm, and endoscopy-related side effects.

For the liver and gallbladder support this product is marketed for, the evidence is not established in the data we hold.

The evidence, ingredient by ingredient Milk Thistle Boldo Artichoke Dandelion Peppermint

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 5 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 5 of 5.
  • General safety write-ups exist for 5 of 5.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Milk thistle, artichoke, and dandelion are generally well tolerated in most people, though quality and dosing vary by product. Boldo, however, carries real safety concerns: it contains ascaridole, a liver toxin, and cases of hepatotoxicity (liver damage) have been reported.

Peppermint oil is generally well tolerated, but concentrated oil should be used cautiously. Common side effects across these ingredients include stomach upset, diarrhea, nausea, abdominal pain, and flatulence—though these typically occur at rates similar to placebo.

Rare serious effects include allergic reactions and anaphylaxis, especially in people sensitive to the ragweed family (artichoke and dandelion). Milk thistle is best avoided in pregnancy; boldo is considered unsafe in pregnancy because it may stimulate the uterus.

Artichoke should be avoided in supplement form during pregnancy. Dandelion has limited safety data in pregnancy—talk with your doctor.

Peppermint is likely safe in pregnancy in food amounts but concentrated oil should be approved by your provider first. Safety during breastfeeding is limited or unstudied for all ingredients except peppermint, so caution is advised—discuss with your healthcare provider.

Side effects, ingredient by ingredient Milk Thistle Boldo Artichoke Dandelion Peppermint

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 5 of the 5 matched ingredients can interact with medications — Milk Thistle, Boldo, Peppermint, Dandelion, Artichoke.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,311 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your doctor or pharmacist before taking this product if you're on blood thinners (like warfarin), antidiabetes drugs, lithium, potassium-sparing diuretics, tacrolimus or other immunosuppressants, ledipasvir, sofosbuvir, morphine, fluoroquinolone antibiotics (like ciprofloxacin), or any drug that's metabolized through your liver's cytochrome P450 enzymes (CYP2B6, CYP2C19, CYP2C9, CYP3A4, CYP1A2) or glucuronidation pathways. The milk thistle and peppermint in this product are the main contributors to these interactions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product may be worth discussing with your doctor if you're interested in herbal support for liver or gallbladder health, but it's not established to work for those purposes in our data. If you take blood thinners, diabetes medications, lithium, or any immunosuppressant, you need to check your exact drugs before starting—the interaction risk is real.

Boldo's liver toxicity is a particular concern for people with existing liver disease. Talk it over with your own doctor or pharmacist before you add this to your routine.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 24, 2013.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about A.Vogel Liver Gallbladder Drops, straight from the product label.

Brand Bioforce
Barcode (UPC) 364031532306
Net contents 1.7 fl. Oz.; 50 mL
Market status On market
Date entered into DSLD Dec 24, 2013
DSLD ID 26430
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Children 4 or More Years of Age, Adult (18 - 50 Years), Children more than 1 but less than 4
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for A.Vogel Liver Gallbladder Drops by Bioforce, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
15 Drop(s)
Maximum serving Sizes:
20 Drop(s)
Servings per container
100
UPC/BARCODE
364031532306
IngredientAmount% DV
Milk Thistle (seed) extract147 mg--
Boldo (leaves) extract32 mg--
Globe Artichoke (aerial part) (fresh) extract211 mg--
Dandelion (entire plant) (fresh) extract55 mg--
Peppermint (leaves) (fresh) extract14 mg--

Other ingredients: Alcohol 62% v/v

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Cultivation with a Conscience

Best Before: Lot No.:

Making Nature Work

Fresh Herb Extract

Like Fresh Herbs in a bottle. Exclusive A.Vogel Formula Made according to Swiss Pharmaceutical Good Manufacturing Practices Standardized Tests before, during and after processing guarantee uniform quality and purity Contains organically grown herbs Special dispensing insert guarantees accurate measurement and helps prevent contamination Organic cultivation certified by Bio-Suisse

Swiss Product

Supports healthy liver and gallbladder function* Supports natural cleansing of toxins* Supports good digestion*

Bioforce uses a unique process-extracting from fresh herbs, not dried. Fresh herbs are usually harvested at their prime and processed within 24 hours before they can dry out. Special extraction process guarantees a maximum of important fresh elements inherent in each herb.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

General

96744.04 040407

FDA Statement of Identity

Dietary Supplement

Formula

Milk Thistle Complex

Seals/Symbols

PRODUCED IN ACCORDANCE WITH SWISS GOOD MANUFACTURING PRACTICES SWISS GMP Standards

Bioforce

Suggested/Recommended/Usage/Directions

Suggested Use: Adults: 15-20 drops (Children 2-12 years 5 drops) in small amount of water 3 times a day. Shake well before using.

Precautions

Safety Sealed Bottle. If ring at bottom of cap is missing or broken, do not use!

Keep out of reach of children.

Brand IP Statement(s)

(C) 2004, Bioforce AG Switzerland

See for yourself

A.Vogel Liver Gallbladder Drops by Bioforce label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in A.Vogel Liver Gallbladder Drops by Bioforce

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size15 Drop(s) Dosage formLiquid Servings per container100 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Milk Thistle (seed) extract

Interacts with
954 drugs
147 mg per serving

Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin....

Milk Thistle (seed) extract monograph & interactions

Boldo (leaves) extract

Interacts with
482 drugs
32 mg per serving

Boldo is a South American shrub whose leaves are traditionally used for digestive and gallbladder complaints, but good human evidence is very limited....

Boldo (leaves) extract monograph & interactions
211 mg per serving

Artichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, th...

Globe Artichoke (aerial part) (fresh) extract monograph & interactions
55 mg per serving

Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for thes...

Dandelion (entire plant) (fresh) extract monograph & interactions

Peppermint (leaves) (fresh) extract

Interacts with
796 drugs
14 mg per serving

Peppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated f...

Peppermint (leaves) (fresh) extract monograph & interactions

Other (inactive) ingredients: Alcohol 62% v/v. These complete the product’s ingredient list but are not active constituents.

Interaction report

A.Vogel Liver Gallbladder Drops by Bioforce Drug Interactions

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Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

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Each ingredient & the kinds of drugs it affects

For each ingredient in A.Vogel Liver Gallbladder Drops with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Milk Thistle (seed) extract17 drug types · 954 drugs

Antidiabetes Drugs

Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.

Likelihood Possible Evidence B
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.

Likelihood Possible Evidence D
Ledipasvir

Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.

Likelihood Possible Evidence D
Morphine

Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.

Likelihood Possible Evidence D
Raloxifene (Evista)

Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.

Likelihood Possible Evidence D
Sirolimus (Rapamune)

Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.

Likelihood Possible Evidence B
Sofosbuvir (Solvaldi)

Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.

Likelihood Unlikely Evidence D
Estrogens

Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.

Likelihood Possible Evidence D
Hmg-Coa Reductase Inhibitors ("Statins")

Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.

Likelihood Unlikely Evidence D
Indinavir (Crixivan)

Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.

Likelihood Unlikely Evidence B
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.

Likelihood Unlikely Evidence B

Peppermint (leaves) (fresh) extract5 drug types · 796 drugs

Cyclosporine (Neoral, Sandimmune)

Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction. An interaction between peppermint oil and cyclosporine has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, peppermint might increase the levels of CYP2C19 substrates.
In vitro research shows that peppermint oil inhibits CYP2C19. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, peppermint might increase the levels of CYP2C9 substrates.
In vitro research shows that peppermint oil inhibits CYP2C9. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate. However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, peppermint might increase the levels of CYP1A2 substrates.
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2. However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference.

Likelihood Possible Evidence B

Boldo (leaves) extract5 drug types · 482 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Animal and in vitro research shows that boldine, a constituent of boldo, has antiplatelet activity. In one case report, an adult taking a combination of boldo and fenugreek with warfarin experienced an increase in international normalized ratio (INR); however, it is unclear if this effect was due to boldo, fenugreek, the combination, or another factor.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking boldo with hepatotoxic drugs might increase the risk of hepatic injury and disease.
Boldo leaf contains ascaridole, a known liver toxin. Many cases of hepatotoxicity, including elevated liver transaminase levels and jaundice, have been reported in patients taking boldo.

Likelihood Possible Evidence D
Lithium

Theoretically, taking boldo with lithium might increase the levels and clinical effects of lithium.
Boldo is believed to have diuretic effects. Theoretically, these diuretic effects might reduce the excretion of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Tacrolimus (Prograf)

Taking boldo with tacrolimus may decrease the levels and clinical effects of tacrolimus, potentially increasing the risk of transplant rejection.
In one case report, a patient with a long-term history of stable tacrolimus levels developed subtherapeutic levels after taking boldo 300 mg twice daily orally for several weeks. Tacrolimus levels returned to normal after discontinuing boldo. However, the mechanism of this interaction is unclear.

Likelihood Possible Evidence D
Warfarin (Coumadin)

A combination of boldo and fenugreek was thought to be associated with an increased international normalized ratio (INR) in a female on warfarin. It is not clear if boldo, fenugreek, or the combination played a role in this interaction. Therefore, boldo may have additive effects with warfarin.

Likelihood Possible Evidence D

Dandelion (entire plant) (fresh) extract7 drug types · 457 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.

Likelihood Possible Evidence D
Lithium

Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.

Likelihood Possible Evidence D

Globe Artichoke (aerial part) (fresh) extract4 drug types · 363 drugs

Antidiabetes Drugs

Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
A meta-analysis of small clinical studies shows that taking artichoke leaf extract for 8-12 weeks can modestly reduce fasting plasma glucose when compared with placebo.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
A meta-analysis of small clinical studies in patients with hypertension shows that taking artichoke can reduce systolic blood pressure by around 3 mmHg and diastolic blood pressure by around 2 mmHg when compared with placebo.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2B6.
In vitro research shows that artichoke leaf extract inhibits CYP2B6 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2C19.
In vitro research shows that artichoke leaf extract inhibits CYP2C19 activity. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for A.Vogel Liver Gallbladder Drops, from the product label.

Bioforce

See all Bioforce products
Name
Bioforce AG
Street Address
CH-9325
City
Roggwil TG
Pharmacist Counseling Corner

A.Vogel Liver Gallbladder Drops by Bioforce: Common Questions

Does A.Vogel Liver Gallbladder Drops by Bioforce interact with any medications?
Yes. Based on its ingredients, A.Vogel Liver Gallbladder Drops has a known interaction with 1,310 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
A.Vogel Liver Gallbladder Drops contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on warfarin or another blood thinner?
Not without checking first. Milk thistle and boldo both may increase bleeding risk or boost warfarin's effects. A case report showed a patient's INR (a blood-clotting measure) jumped when taking a product with milk thistle. Talk to your doctor before starting this—they may need to monitor your blood work or adjust your dose.
Will this help my liver if I drink a lot or have liver disease?
We don't have evidence that this product works for alcohol-related liver disease in our data. More important: boldo contains ascaridole, a known liver toxin, and cases of liver damage have been reported with it. If you have liver disease or drink heavily, talk to your doctor before using this—it may do more harm than good.
Is it safe to take if I have type 2 diabetes?
The milk thistle in this product can lower blood sugar, so combined with your diabetes medication, it may increase the risk of low blood sugar (hypoglycemia). Artichoke and dandelion may have similar effects. If you're interested, your doctor needs to check your blood sugar more often and may adjust your diabetes medication.
Can I take this while pregnant?
Milk thistle and boldo should be avoided—milk thistle lacks enough safety data, and boldo is considered unsafe because it may stimulate the uterus. Artichoke should be avoided in supplement form. Dandelion has limited data; peppermint is likely safe in food amounts. Talk with your doctor before taking any supplement during pregnancy.
What are the most common side effects?
Stomach upset, diarrhea, nausea, abdominal pain, and flatulence are the most common. Most of these happen at rates similar to placebo. Rare but serious side effects include allergic reactions and anaphylaxis, especially if you're sensitive to ragweed or the daisy family.
Is peppermint in this product enough to help with indigestion or IBS?
Peppermint is possibly effective for indigestion and likely effective for irritable bowel syndrome, but this is a combination product at an unknown dose. The amount of peppermint and the other ingredients mixed in may or may not give you the benefit you're looking for—ask your pharmacist about whether the dose is appropriate for your need.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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The Full Monographs Behind A.Vogel Liver Gallbladder Drops’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Sources

Sources & How We Checked

A.Vogel Liver Gallbladder Drops's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 163 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Milk Thistle 69 references
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  7. Piscitelli SC, Formentini E, Burstein AH, et al. Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers. Pharmacotherapy 2002;22:551-6. PubMed
  8. Boerth J, Strong KM. The clinical utility of milk thistle (Silybum marianum) in cirrhosis of the liver. J Herb Pharmacother 2002;2:11-7.
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  11. Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 2006;20;1036-9.
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  15. van Erp NP, Baker SD, Zhao M, et al. Effect of milk thistle (Silybum marianum) on the pharmacokinetics of irinotecan. Clin Cancer Res 2005;11:7800-6.
  16. Budzinski JW, Trudeau VL, Drouin CE, et al. Modulation of human cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) in Caco-2 cell monolayers by selected commercial-source milk thistle and goldenseal products. Can J Physiol Pharmacol 2007;85:966-78.
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  20. Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. PubMed
  21. Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. PubMed
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  27. Sayyah, M., Boostani, H., Pakseresht, S., and Malayeri, A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog.Neuropsychopharmacol.Biol.Psychiatry 3-17-2010;34(2):362-365. PubMed
  28. Flaig, T. W., Glode, M., Gustafson, D., van, Bokhoven A., Tao, Y., Wilson, S., Su, L. J., Li, Y., Harrison, G., Agarwal, R., Crawford, E. D., Lucia, M. S., and Pollak, M. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients w
  29. Ramirez-Santos, A., Perez-Bustillo, A., Gonzalez-Sixto, B., Suarez-Amor, O., and Rodriguez-Prieto, M. A. [Acute generalized exanthematous pustulosis due to milk thistle (Silybum marianum) tea]. Actas Dermosifiliogr. 2011;102(9):744-745. DOI
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  44. Anon. Adverse reaction: milk thistle-associated toxicity. Nurse Drug Alert 1999;23(7):51.
  45. Gufford BT, Chen G, Vergara AG, et al. Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction. Drug Metab Dispos. 2015;43(9):1353-9. PubMed
  46. El-Shitany NA, Hegazy S, El-Desoky K. Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinylestradiol in ovariectomized rats. Phytomedicine. 2010;17(2):116-25. PubMed
  47. Seidlová-Wuttke D, Becker T, Christoffel V, Jarry H, Wuttke W. Silymarin is a selective estrogen receptor beta (ERbeta) agonist and has estrogenic effects in the metaphysis of the femur but no or antiestrogenic effects in the uterus of ovariectomized (ovx
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  53. Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:8 PubMed
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  56. Ebrahimpour-Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M. Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A T
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See these in context on the Milk Thistle monograph →

Boldo 10 references
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See these in context on the Boldo monograph →

Artichoke 16 references
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See these in context on the Artichoke monograph →

Dandelion 27 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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