A.Vogel Liver Gallbladder Drops Ingredients & Drug Interactions
by Bioforce
What is this page for?
First and foremost: checking A.Vogel Liver Gallbladder Drops against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
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.
Check Your Meds Against A.Vogel Liver Gallbladder Drops by Bioforce
Ask about any prescription or over-the-counter medication and we check it for interactions with A.Vogel Liver Gallbladder Drops by Bioforce — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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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.
What’s inside
Full disclosure
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 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.
How safe is it?
Well-documented data
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.
Meds to double-check
Moderate interaction found
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.
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
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 |
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
| Ingredient | Amount | % DV |
|---|---|---|
| Milk Thistle (seed) extract | 147 mg | -- |
| Boldo (leaves) extract | 32 mg | -- |
| Globe Artichoke (aerial part) (fresh) extract | 211 mg | -- |
| Dandelion (entire plant) (fresh) extract | 55 mg | -- |
| Peppermint (leaves) (fresh) extract | 14 mg | -- |
Other ingredients: Alcohol 62% v/v
Tap any ingredient to jump to its full detail below.
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
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
A.Vogel Liver Gallbladder Drops by Bioforce label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)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 with954 drugs
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 & interactionsBoldo (leaves) extract
Interacts with482 drugs
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 & interactionsGlobe Artichoke (aerial part) (fresh) extract
Interacts with363 drugs
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 & interactionsDandelion (entire plant) (fresh) extract
Interacts with457 drugs
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 & interactionsPeppermint (leaves) (fresh) extract
Interacts with796 drugs
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 & interactionsOther (inactive) ingredients: Alcohol 62% v/v. These complete the product’s ingredient list but are not active constituents.
A.Vogel Liver Gallbladder Drops by Bioforce Drug Interactions
HelloPharmacist Interaction Report
A.Vogel Liver Gallbladder Drops by Bioforce contains five herbal extracts, and several of them interact with medications.
Altogether, these interactions span 1,311 individual medications.
Read the full breakdown — every affected drug type, severity by severity
The most serious interactions involve milk thistle, which moderately interacts with antidiabetes drugs—because milk thistle can lower blood sugar, combining it with diabetes medications raises your risk of low blood sugar (hypoglycemia). Milk thistle also moderately affects how your liver processes a wide range of drugs, including blood thinners like warfarin, ledipasvir (a hepatitis C drug), sofosbuvir, morphine, and drugs that rely on glucuronidation for clearance.
Boldo, another ingredient, moderately interacts with blood thinners and antiplatelet drugs (increasing bleeding risk), drugs that suppress the immune system like tacrolimus, lithium, and drugs that harm the liver. Globe artichoke moderately affects antidiabetes and antihypertensive drugs, as well as certain enzyme-metabolized medications.
Dandelion moderately interacts with blood thinners, antidiabetes drugs, lithium, potassium-sparing diuretics, fluoroquinolone antibiotics, and glucuronidated drugs. Peppermint has moderate interactions with several enzyme-metabolized drugs and cyclosporine, plus a minor interaction with CYP1A2 substrates.
If you take any prescription medication, especially blood thinners, diabetes drugs, lithium, or immunosuppressants, run your exact medications through the checker on this page before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against A.Vogel Liver Gallbladder Drops?
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.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in A.Vogel Liver Gallbladder Drops interact with 1,310 drugs. Click any drug to see the details.
5 of the 5 ingredients in A.Vogel Liver Gallbladder Drops interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle (seed) extract Peppermint (leaves) (fresh) extract Boldo (leaves) extract Dandelion (entire plant) (fresh) extract Globe Artichoke (aerial part) (fresh) extract
Anacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Anacaulase-bcdb interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with A.Vogel Liver Gallbladder Drops — through 3 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Anagrelide interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Anagrelide interactionPeppermint (leaves) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Anagrelide interactionAnidulafunginEraxis
How Anidulafungin interacts with A.Vogel Liver Gallbladder Drops — through 1 ingredient. Tap an ingredient for the detail:
Boldo (leaves) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking boldo with hepatotoxic drugs might increase the risk of hepatic injury and disease.
Read the full Boldo (leaves) Extract + Anidulafungin interactionAnisindioneMiradon
How Anisindione interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Anisindione interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Anisindione interactionAntidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
How Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interacts with A.Vogel Liver Gallbladder Drops — through 3 ingredients. Tap an ingredient for the detail:
Globe Artichoke (aerial Part) (fresh) ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Read the full Globe Artichoke (aerial Part) (fresh) Extract + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionDandelion (entire Plant) (fresh) ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Read the full Dandelion (entire Plant) (fresh) Extract + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionMilk Thistle (seed) ExtractP-glycoprotein Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates.
Read the full Milk Thistle (seed) Extract + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Antithrombin Iii interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Antithrombin Iii interactionApalutamideErleada
How Apalutamide interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Apalutamide interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Apalutamide interactionApixabanEliquis
How Apixaban interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Apixaban interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Apixaban interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Apixaban interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Apixaban interactionApomorphineAPO-go, APO-go Pen, APO-go PFS, Apokyn, Uprima
How Apomorphine interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion (entire Plant) (fresh) Extract + Apomorphine interactionMilk Thistle (seed) ExtractP-glycoprotein Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates.
Read the full Milk Thistle (seed) Extract + Apomorphine interactionApomorphine HydrochlorideKynmobi
How Apomorphine Hydrochloride interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle (seed) ExtractGlucuronidated Drugs, P-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle (seed) Extract + Apomorphine Hydrochloride interactionDandelion (entire Plant) (fresh) ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion (entire Plant) (fresh) Extract + Apomorphine Hydrochloride interactionApremilastOtezla
How Apremilast interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Apremilast interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aprepitant interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aprepitant interactionAprobarbital, Butabarbital, PhenobarbitalTriple Barbital
How Aprobarbital, Butabarbital, Phenobarbital interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Globe Artichoke (aerial Part) (fresh) ExtractCytochrome P450 2b6 (cyp2b6) Substrates Moderate
Interaction Summary
Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2B6.
Read the full Globe Artichoke (aerial Part) (fresh) Extract + Aprobarbital, Butabarbital, Phenobarbital interactionMilk Thistle (seed) ExtractCytochrome P450 2b6 (cyp2b6) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might inhibit CYP2B6.
Read the full Milk Thistle (seed) Extract + Aprobarbital, Butabarbital, Phenobarbital interactionAprocitentanTryvio
How Aprocitentan interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Globe Artichoke (aerial Part) (fresh) ExtractAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Globe Artichoke (aerial Part) (fresh) Extract + Aprocitentan interactionBoldo (leaves) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking boldo with hepatotoxic drugs might increase the risk of hepatic injury and disease.
Read the full Boldo (leaves) Extract + Aprocitentan interactionArgatrobanArgatroban
How Argatroban interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Argatroban interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Argatroban interactionAripiprazoleAbilify, Abilify Maintena, Abilify Mycite
How Aripiprazole interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aripiprazole interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aripiprazole interactionAripiprazole LauroxilAristada, Aristada Initio Kit
How Aripiprazole Lauroxil interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aripiprazole Lauroxil interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aripiprazole Lauroxil interactionArmodafinilNuvigil
How Armodafinil interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Armodafinil interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Armodafinil interactionAsenapineSaphris, Secuado
How Asenapine interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion (entire Plant) (fresh) Extract + Asenapine interactionPeppermint (leaves) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Asenapine interactionAsparaginase Erwinia Chrysanthemi (recombinant)-rywnRylaze
How Asparaginase Erwinia Chrysanthemi (recombinant)-rywn interacts with A.Vogel Liver Gallbladder Drops — through 1 ingredient. Tap an ingredient for the detail:
Boldo (leaves) ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking boldo with hepatotoxic drugs might increase the risk of hepatic injury and disease.
Read the full Boldo (leaves) Extract + Asparaginase Erwinia Chrysanthemi (recombinant)-rywn interactionAspirinAngettes 75, ASA, Asaphen, Aspirin, Caprin, Cartia +8 more
How Aspirin interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAspirin, ButalbitalAxotal
How Aspirin, Butalbital interacts with A.Vogel Liver Gallbladder Drops — through 2 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Butalbital interactionDandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Butalbital interactionAspirin, Butalbital, CaffeineFiorinal
How Aspirin, Butalbital, Caffeine interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Butalbital, Caffeine interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Butalbital, Caffeine interactionPeppermint (leaves) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Butalbital, Caffeine interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Butalbital, Caffeine interactionAspirin, Butalbital, Caffeine, Codeine PhosphateFiorinal w/ Codeine
How Aspirin, Butalbital, Caffeine, Codeine Phosphate interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionDandelion (entire Plant) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Butalbital, Caffeine, Codeine Phosphate interactionAspirin, Butalbital, Caffeine, PhenacetinMarnal
How Aspirin, Butalbital, Caffeine, Phenacetin interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Butalbital, Caffeine, Phenacetin interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Butalbital, Caffeine, Phenacetin interactionDandelion (entire Plant) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Butalbital, Caffeine, Phenacetin interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Butalbital, Caffeine, Phenacetin interactionAspirin, CaffeineAnacin
How Aspirin, Caffeine interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Caffeine interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Caffeine interactionPeppermint (leaves) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Caffeine interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Caffeine interactionAspirin, Caffeine, Codeine PhosphateAnacin w/ Codeine
How Aspirin, Caffeine, Codeine Phosphate interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Boldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Caffeine, Codeine Phosphate interactionDandelion (entire Plant) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Caffeine, Codeine Phosphate interactionPeppermint (leaves) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Caffeine, Codeine Phosphate interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Caffeine, Codeine Phosphate interactionAspirin, Caffeine, Dihydrocodeine BitartrateSynalgos DC
How Aspirin, Caffeine, Dihydrocodeine Bitartrate interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Peppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionDandelion (entire Plant) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Caffeine, Dihydrocodeine Bitartrate interactionAspirin, Caffeine, Dover's PwdAcedoval, Dovacet
How Aspirin, Caffeine, Dover's Pwd interacts with A.Vogel Liver Gallbladder Drops — through 4 ingredients. Tap an ingredient for the detail:
Dandelion (entire Plant) (fresh) ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion (entire Plant) (fresh) Extract + Aspirin, Caffeine, Dover's Pwd interactionPeppermint (leaves) (fresh) ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Read the full Peppermint (leaves) (fresh) Extract + Aspirin, Caffeine, Dover's Pwd interactionBoldo (leaves) ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Boldo (leaves) Extract + Aspirin, Caffeine, Dover's Pwd interactionMilk Thistle (seed) ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle (seed) Extract + Aspirin, Caffeine, Dover's Pwd interactionEach 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) extract
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Peppermint (leaves) (fresh) extract
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.
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.
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.
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.
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.
Boldo (leaves) extract
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.
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.
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.
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.
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.
Dandelion (entire plant) (fresh) extract
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.
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.
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.
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.
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.
Potassium-Sparing Diuretics
Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.
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.
Globe Artichoke (aerial part) (fresh) extract
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.
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.
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.
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.
Brand information
Manufacturer and brand details for A.Vogel Liver Gallbladder Drops, from the product label.
A.Vogel Liver Gallbladder Drops by Bioforce: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
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.
Milk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph → Herb & supplement monographBoldo
Interacts with 482 drugsBoldo is a South American shrub whose leaves are traditionally used for digestive and gallbladder complaints, but good human evidence is very limited. The leaves and oil contain ascaridole,...
Read the full Boldo monograph → Herb & supplement monographArtichoke
Interacts with 363 drugsArtichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, though the evidence is modest. It is not a...
Read the full Artichoke monograph → Herb & supplement monographDandelion
Interacts with 457 drugsDandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...
Read the full Dandelion monograph → Herb & supplement monographPeppermint
Interacts with 796 drugsPeppermint is a popular herb with the best evidence supporting enteric-coated peppermint oil for easing IBS symptoms. It is generally well tolerated for most adults, but it can cause heartbu...
Read the full Peppermint monograph →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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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
- Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol 1989;9:105-13. PubMed
- Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.g
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