Interactions on record — worth a quick check against your medications. Based on 11 of 12 ingredients. Check your meds →
Dietary supplement

Bioretic Ingredients & Drug Interactions

by Genestra Brands

Bioretic label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 30, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Bioretic 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

The interaction bottom line Most serious interaction: Moderate

Bioretic is a dietary supplement by Genestra Brands with 12 active ingredients. Its ingredients are commonly taken for water retention (diuretic), digestive upset, liver and gallbladder support.Based on those ingredients, 1,371 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle, Uva-ursi, Cubeb. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Bioretic by Genestra Brands

Ask about any prescription or over-the-counter medication and we check it for interactions with Bioretic by Genestra Brands — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Bioretic by Genestra Brands

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

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

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 12 of its 12 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Bioretic contains 12 active herbal ingredients: Dandelion, Milk Thistle, Buchu leaf extract, Uva-ursi, Cleavers, Calendula, Couch Grass, Cubeb, European Goldenrod aerial parts extract, Gravel Root, Asparagus, and Agrimony. The product also contains inactive ingredients—Hypromellose, Silica, and Cellulose—which serve as capsule material and binders.

Does it work?

Leans against
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
Leans against

The strongest graded evidence we hold for the stated purpose leans against a benefit.

Why this rating?
  • The label markets this product for: Liver and urinary tract health support.
  • We looked for evidence on: Liver disease, Hepatitis B, Hepatitis C, Nonalcoholic fatty liver disease (NAFLD), Nonalcoholic steatohepatitis (NASH), Metabolic dysfunction-associated steatotic liver disease (MASLD) — and 4 related terms.
  • The closest evidence on file: Uva Ursi is rated "Possibly Ineffective" for Urinary tract infections (UTIs) (Natural Medicines).
  • Also on file: Goldenrod is rated "Insufficient Reliable Evidence To Rate" for Kidney stones (nephrolithiasis), Urinary tract infections (UTIs).
  • Also on file: Milk Thistle is rated "Insufficient Reliable Evidence To Rate" for Alcohol-related liver disease, Metabolic dysfunction-associated steatotic liver disease (MASLD), Hepatitis C, Hepatitis B.

The evidence for these ingredients is sparse. Milk Thistle is rated Possibly Effective for type 2 diabetes.

Uva-ursi is rated Possibly Ineffective for urinary tract infections. The rest—Dandelion for joint pain and post-operative swelling, Calendula for acne and various skin conditions, Goldenrod for kidney stones and UTIs, Asparagus for acne and constipation, and Agrimony for its intended uses—all have Insufficient Reliable Evidence to rate.

In other words, we don't have solid evidence that this product works for the conditions it's marketed to treat.

The evidence, ingredient by ingredient Dandelion Milk Thistle Buchu Uva Ursi Calendula Couch Grass Cubebs Goldenrod

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 7 of the 11 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 11 of 11.
  • General safety write-ups exist for 11 of 11.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of these herbs are generally well tolerated when used short-term, but some carry real cautions. Dandelion is well tolerated as a food but supplement-strength doses are less studied and may trigger allergies or stomach upset.

Buchu contains pulegone, a liver toxin, and is best avoided in large doses. Uva-ursi is generally tolerated at low doses for short periods but can be toxic at high doses or with prolonged use; very high doses (30 grams or more) may be fatal.

Gravel Root contains hepatotoxic pyrrolizidine alkaloids and carries risk of liver and lung damage with chronic use. Common mild side effects across the product include diarrhea, nausea, stomach discomfort, and heartburn.

Allergic reactions—including rare anaphylaxis—have been reported, especially in people sensitive to plants in the ragweed family (Asteraceae/Compositae), which includes several of these herbs.

Side effects, ingredient by ingredient Dandelion Milk Thistle Buchu Uva Ursi Calendula Couch Grass Cubebs Goldenrod

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?
  • 10 of the 11 matched ingredients can interact with medications — Goldenrod, Milk Thistle, Buchu, Calendula, Asparagus, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; lithium.
  • For scale: 1,372 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.

Before taking Bioretic, double-check with your pharmacist or doctor if you take blood thinners or antiplatelet drugs (Moderate risk of bleeding), diabetes medications (Moderate risk of low blood sugar), diuretics or water pills (Moderate risk of electrolyte loss or raised lithium), lithium (Moderate risk of toxicity from raised levels), liver-broken-down drugs processed by CYP1A2, CYP2B6, CYP2C19, or CYP3A4 enzymes, glucuronidated drugs, or quinolone antibiotics like ciprofloxacin. Sedating drugs carry a Minor interaction with Calendula.

No interactions are documented for Couch Grass; Cleavers and Cubeb could not be checked.

Check your own medication Run your meds through the checker above

The bottom line

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

Bioretic is a multi-herb supplement with limited evidence for its intended uses and broad interactions with prescription medications, especially blood thinners, diabetes drugs, lithium, and several liver-processed medications. If you take any regular prescriptions—or if you take lithium or blood thinners—check with your pharmacist before starting this product.

Pregnant and breastfeeding people should avoid it: several ingredients are rated unsafe or lack safety data in those situations.

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

Assessment coverage: 11 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2016.

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 Bioretic, straight from the product label.

Brand Genestra Brands
Barcode (UPC) 88319610352
Net contents 90 Vegetable Capsule(s)
Market status On market
Date entered into DSLD Jan 25, 2016
DSLD ID 55377
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Dairy Free
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 Bioretic by Genestra Brands, 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:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
90
UPC/BARCODE
88319610352
IngredientAmount% DV
Dandelion75 mg--
Milk Thistle40 mg--
Buchu (Agathosma crenulata/serratifolia) leaf extract100 mg--
Uva-ursi50 mg--
Cleavers50 mg--
Calendula50 mg--
Couch Grass40 mg--
Cubeb50 mg--
European Goldenrod (Solidago virgaurea) aerial parts extract10 mg--
Gravel root40 mg--
Asparagus25 mg--
Agrimony25 mg--

Other ingredients: Hypromellose, Silica, Cellulose

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.
Suggested/Recommended/Usage/Directions

Recommended Adult Dose: Take one capsule daily or as recommended by your healthcare practitioner.

Precautions

Risk Information: Stop use and seek medical attention immediately if you experience dizziness, confusion, muscle weakness or pain, abnormal heart beat and/or difficulty breathing.

If you are pregnant; if you have heart disease, high or low blood pressure, bowel obstruction, diabetes, edema or liver, gall bladder or kidney disorders; if you are taking products containing diuretics; or if you are allergic to plants of the Astaracea/ Compositae/Daisy family, do not use. If you are breastfeeding, consult your healthcare practitioner prior to use.

If you are pregnant; if you have heart disease, high or low blood pressure, bowel obstruction, diabetes, edema or liver, gall bladder or kidney disorders; if you are taking products containing diuretics; or if you are allergic to plants of the Astaracea/ Compositae/Daisy family, do not use.

Discontinue use if you develop symptoms of liver trouble.

Hypersensitivity/allergy to calendula and milk thistle is known to occur; in which case, discontinue use.

Quality Assurance: Safety-sealed for your protection and for product freshness. Do not use if outer seal is missing or broken.

Formulation

Guaranteed to contain no added wheat, yeast, gluten, soy, sodium, sugar, artificial coloring or flavoring, antimicrobial preservatives, dairy or animal products.

Ideal for vegans.

The capsules are made from 100% pure vegetable sources, free of perservatives and additives.

Formula

The capsules are made from 100% pure vegetable sources, free of perservatives and additives.

Storage

Store in a cool, dry place.

General

V1.0 507

Seals/Symbols

Seroyal

FDA Statement of Identity

HERBAL SUPPLEMENT

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Bioretic by Genestra Brands label

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

Bioretic label

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)
What’s inside

The Ingredients in Bioretic by Genestra Brands

These are the 12 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container90 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.

Dandelion

Interacts with
457 drugs
75 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 monograph & interactions

Milk Thistle

Interacts with
954 drugs
40 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 monograph & interactions

Buchu (Agathosma crenulata/serratifolia) leaf extract

Interacts with
481 drugs
100 mg per serving

Buchu is a fragrant South African shrub whose leaves are traditionally used for urinary and bladder complaints and as a diuretic. Solid human studies...

Buchu (Agathosma crenulata/serratifolia) leaf extract monograph & interactions

Uva-ursi

Interacts with
803 drugs
50 mg per serving

Uva ursi is a traditional herb used mainly for urinary tract infections, and its leaves contain a compound called arbutin that may have antimicrobial...

Uva-ursi monograph & interactions

Cleavers

50 mg per serving

Calendula

Interacts with
248 drugs
50 mg per serving

Calendula is a flowering plant whose petals are used mainly in skin creams, oils, and ointments to soothe minor irritation and support wound healing....

Calendula monograph & interactions

Couch Grass

No known
interactions
40 mg per serving

Couch grass is a common lawn weed whose rhizome has long been used in traditional European herbal medicine, mainly for urinary and bladder complaints....

Couch Grass monograph & interactions

Cubeb

Interacts with
665 drugs
50 mg per serving

Cubebs are spicy, peppery berries from a vine in the pepper family that have long been used in traditional medicine for coughs, digestion, and urinary...

Cubeb monograph & interactions

European Goldenrod (Solidago virgaurea) aerial parts extract

Interacts with
75 drugs
10 mg per serving

Goldenrod is a flowering plant traditionally used as an herbal diuretic and for urinary tract health. Human evidence is limited, and while it is gener...

European Goldenrod (Solidago virgaurea) aerial parts extract monograph & interactions

Gravel root

Interacts with
88 drugs
40 mg per serving

Gravel Root is a traditional North American herb long used by herbalists for kidney stones and urinary problems, but there is very little modern scien...

Gravel root monograph & interactions

Asparagus

Interacts with
76 drugs
25 mg per serving

Asparagus is a nutritious vegetable that is safe and healthy to eat as part of a normal diet. Most of its claimed medicinal benefits, such as use as a...

Asparagus monograph & interactions

Agrimony

Interacts with
86 drugs
25 mg per serving

Agrimony is a traditional European herb rich in tannins that has long been used for sore throats, mild diarrhea, and minor skin problems. Good-quality...

Agrimony monograph & interactions

Other (inactive) ingredients: Hypromellose, Silica, Cellulose. These complete the product’s ingredient list but are not active constituents.

Interaction report

Bioretic by Genestra Brands Drug Interactions

Want to check YOUR meds against Bioretic?

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 checker
1,371Drugs
1,222 Moderate 149 Minor

Ingredients driving the most interactions

Milk Thistle 954
Uva-ursi 803
Cubeb 665
Buchu (Agathosma crenulata/serratifolia) leaf extract 481
Dandelion 457

Individual Drug Interactions

The ingredients in Bioretic interact with 1,371 drugs. Click any drug to see the details.

10 of the 12 ingredients in Bioretic interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle Uva-ursi Cubeb Buchu (Agathosma crenulata/serratifolia) leaf extract Dandelion Calendula Gravel root Agrimony Asparagus European Goldenrod (Solidago virgaurea) aerial parts extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Bioretic 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 Thistle17 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
Milk Thistle full monograph & interactions

Uva-ursi6 drug types · 803 drugs

Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, uva ursi may decrease the metabolism of CYP2C19 substrates.
In vitro, uva ursi appears to inhibit cytochrome CYP2C19. This effect has not been reported in humans.

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

Theoretically, uva ursi may decrease the metabolism of CYP3A4 substrates.
In vitro, uva ursi appears to inhibit CYP3A4. This effect has not been reported in humans.

Likelihood Possible Evidence D
Glucuronidated Drugs

Theoretically, uva ursi may increase levels of drugs metabolized by glucuronidation.
In vitro, uva ursi extract appears to strongly inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1). However, uva ursi extract does not appear to inhibit UGT1A1 in animal models. This effect has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, uva ursi may increase lithium levels, necessitating a decrease in dose.
Uva ursi may have diuretic properties. Diuretics may increase lithium reabsorption with sodium in the proximal tubule of the kidney. Theoretically, uva ursi might reduce excretion and increase levels of lithium.

Likelihood Probable Evidence D
Urinary Acidifying Agents

Effects of uva ursi in the urinary tract may be reduced by urinary acidifying agents.
Uva ursi seems to work best in alkaline urine. Theoretically, taking uva ursi with medications known to acidify the urine may decrease any effects of uva ursi on the urinary tract.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, uva ursi may alter the levels of drugs transported by P-glycoprotein.
In vitro, uva ursi appears to inhibit the multi-drug transporter protein, P-glycoprotein. This effect has not been reported in humans.

Likelihood Possible Evidence D
Uva-ursi full monograph & interactions

Cubeb4 drug types · 665 drugs

Cytochrome P450 3A4 (Cyp3A4) Substrates

Several compounds isolated from cubebs can inhibit cytochrome P450 3A4 (CYP3A4) in vitro. So far, this effect has not been reported in humans. Theoretically, cubebs might increase the effects and side effects of drugs metabolized by CYP3A4. These include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and numerous others.

Likelihood Possible Evidence D
Antacids

Theoretically, due to reports that cubebs increases stomach acid, cubebs might decrease the effectiveness of antacids.

Likelihood Possible Evidence D
H2-Blockers

Theoretically, due to reports that cubebs increases stomach acid, cubebs might decrease the effectiveness of H2-blockers. The H2 blockers include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

Theoretically, due to reports that cubebs increases stomach acid, cubebs might decrease the effectiveness of PPIs. PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).

Likelihood Possible Evidence D
Cubeb full monograph & interactions

Buchu (Agathosma crenulata/serratifolia) leaf extract3 drug types · 481 drugs

Anticoagulant/Antiplatelet Drugs

Buchu may have antiplatelet effects. Theoretically, buchu may enhance the effects of anticoagulant or antiplatelet drugs and increase the risk of bleeding in some patients. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Buchu contains pulegone, a known hepatotoxin. There is some concern that buchu may adversely affect the liver, especially when the leaf is used in large doses or the oil is ingested. Theoretically, concomitant use with hepatotoxic drugs might increase the risk of liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (Tricor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo)

Likelihood Possible Evidence D
Lithium

Buchu is thought to have diuretic properties. Theoretically, buchu might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Buchu (Agathosma crenulata/serratifolia) leaf extract full monograph & interactions

Dandelion7 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
Dandelion full monograph & interactions

Calendula1 drug type · 248 drugs

Cns Depressants

Theoretically, calendula might have additive effects when used with CNS depressants, although this appears to be unlikely.
Although some animal research has suggested that a saponoside constituent in calendula may have sedative effects, calendula has been used for over 30 years without reports of sedation in humans.

Likelihood Unlikely Evidence D
Calendula full monograph & interactions

Gravel root2 drug types · 88 drugs

Cytochrome P450 3A4 (Cyp3A4) Inducers

Hepatotoxic pyrrolizidine alkaloids (PA) are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Likelihood Possible Evidence D
Lithium

Gravel root is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, gravel root might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Gravel root full monograph & interactions

Agrimony1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking agrimony with antidiabetes drugs might increase the risk of hypoglycemia.
Agrimony has demonstrated hypoglycemic effects in animal research.

Likelihood Possible Evidence D
Agrimony full monograph & interactions

Asparagus2 drug types · 76 drugs

Diuretic Drugs

Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Animal studies show that asparagus root extracts have diuretic effects. This effect has not been reported in humans.

Likelihood Possible Evidence D
Lithium

Theoretically, asparagus root might cause diuresis, reducing lithium clearance.
Animal studies show that asparagus root extracts have diuretic effects. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

Likelihood Probable Evidence D
Asparagus full monograph & interactions

European Goldenrod (Solidago virgaurea) aerial parts extract1 drug type · 75 drugs

Diuretic Drugs

Theoretically, goldenrod might increase the effects and adverse effects of diuretic drugs.
In vitro and animal research suggests that goldenrod has diuretic effects.

Likelihood Possible Evidence D
European Goldenrod (Solidago virgaurea) aerial parts extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Bioretic, from the product label.

Genestra Brands

Name
Seroyal USA
City
Pittsburgh
State
PA
ZipCode
15275
Phone Number
1-888-737-6925
Web Address
seroyal.com
Pharmacist Counseling Corner

Bioretic by Genestra Brands: Common Questions

Does Bioretic by Genestra Brands interact with any medications?
Yes. Based on its ingredients, Bioretic has a known interaction with 1,371 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Bioretic contains 12 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 pregnant or breastfeeding?
The safety data advises against it. Buchu, Uva-ursi, Gravel Root, and Calendula are rated Likely Unsafe in pregnancy. Dandelion, Milk Thistle, Goldenrod, and Asparagus lack enough safety information in pregnancy—talk with your doctor or pharmacist. For breastfeeding, safety data are limited or absent for most ingredients; avoid it unless your healthcare provider says otherwise.
What side effects might I experience?
The most common are mild: diarrhea, nausea, stomach upset, heartburn, and bloating. Allergic reactions—including hives or, rarely, anaphylaxis—can occur, especially if you're sensitive to ragweed or related plants. At very high doses, Uva-ursi can cause serious toxicity.
Does this product actually work for what it's supposed to do?
The evidence is weak. Only Milk Thistle is rated Possibly Effective, and only for type 2 diabetes. Uva-ursi is rated Possibly Ineffective for UTIs. For most other uses this product claims, we don't have reliable evidence either way.
Should I be worried about liver damage?
Gravel Root contains pyrrolizidine alkaloids, compounds known to damage the liver and lungs with chronic use. Buchu contains pulegone, a liver toxin. Use short-term only and under medical supervision if you have any liver concerns.
Why does this product interact with so many medications?
Many of the herbs—Dandelion, Milk Thistle, Uva-ursi, and others—are processed by your liver using the same enzymes that break down prescription drugs. When a supplement inhibits or speeds up these enzymes, it can raise or lower your medication levels, changing how well your drugs work or how much you absorb.
What are Cleavers and Cubeb, and do they interact with anything?
Cleavers and Cubeb are herbal ingredients in this product, but we don't have interaction data on file for them—they weren't checked. Talk to your pharmacist if you want to know more about their effects.

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

Not sure if Bioretic is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

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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.

Bioretic label
Go deeper

The Full Monographs Behind Bioretic’s Ingredients

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

Herb & supplement monograph

Dandelion

Interacts with 457 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 these uses is very limited, so its benefits...

Read the full Dandelion monograph → Herb & supplement monograph

Milk Thistle

Interacts with 954 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. While it is generally well tolerated, th...

Read the full Milk Thistle monograph → Herb & supplement monograph

Buchu

Interacts with 481 drugs

Buchu is a fragrant South African shrub whose leaves are traditionally used for urinary and bladder complaints and as a diuretic. Solid human studies are lacking, so its benefits are largely...

Read the full Buchu monograph → Herb & supplement monograph

Uva Ursi

Interacts with 803 drugs

Uva ursi is a traditional herb used mainly for urinary tract infections, and its leaves contain a compound called arbutin that may have antimicrobial effects in the urine. Evidence in people...

Read the full Uva Ursi monograph → Herb & supplement monograph

Calendula

Interacts with 248 drugs

Calendula is a flowering plant whose petals are used mainly in skin creams, oils, and ointments to soothe minor irritation and support wound healing. Some early research is promising for ski...

Read the full Calendula monograph → Herb & supplement monograph

Couch Grass

Couch grass is a common lawn weed whose rhizome has long been used in traditional European herbal medicine, mainly for urinary and bladder complaints. High-quality human studies are lacking,...

Read the full Couch Grass monograph → Herb & supplement monograph

Cubebs

Interacts with 665 drugs

Cubebs are spicy, peppery berries from a vine in the pepper family that have long been used in traditional medicine for coughs, digestion, and urinary problems. Modern human studies are very...

Read the full Cubebs monograph → Herb & supplement monograph

Goldenrod

Interacts with 75 drugs

Goldenrod is a flowering plant traditionally used as an herbal diuretic and for urinary tract health. Human evidence is limited, and while it is generally well tolerated, people with certain...

Read the full Goldenrod monograph → Herb & supplement monograph

Gravel Root

Interacts with 88 drugs

Gravel Root is a traditional North American herb long used by herbalists for kidney stones and urinary problems, but there is very little modern scientific evidence to support these uses. Be...

Read the full Gravel Root monograph → Herb & supplement monograph

Asparagus

Interacts with 76 drugs

Asparagus is a nutritious vegetable that is safe and healthy to eat as part of a normal diet. Most of its claimed medicinal benefits, such as use as a diuretic or for urinary health, come fr...

Read the full Asparagus monograph → Herb & supplement monograph

Agrimony

Interacts with 86 drugs

Agrimony is a traditional European herb rich in tannins that has long been used for sore throats, mild diarrhea, and minor skin problems. Good-quality human studies are very limited, so its...

Read the full Agrimony monograph →
Sources

Sources & How We Checked

Bioretic'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 147 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.

Dandelion 27 references
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  2. Williams CA, Goldstone F, Greenham J. Flavonoids, cinnamic acids and coumarins from the different tissues and medicinal preparations of Taraxacum officinale. Phytochemistry 1996;42:121-7. PubMed
  3. Hussain Z, Waheed A, Qureshi RA, et al. The effect of medicinal plants of Islamabad and Murree region of Pakistan on insulin secretion from INS-1 cells. Phytother Res 2004;18:73-7. PubMed
  4. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212-7. PubMed
  5. Zhu M, Wong PY, Li RC. Effects of taraxacum mongolicum on the bioavailability and disposition of ciprofloxacin in rats. J Pharm Sci 1999;88:632-4. PubMed
  6. Jovanovic M, Mimica-Dukic N, Poljacki M, Boza P. Erythema multiforme due to contact with weeds: a recurrence after patch testing. Contact Dermatitis 2003;48:17-25. PubMed
  7. Chivato T, Juan F, Montoro A, Laguna R. Anaphylaxis induced by ingestion of a pollen compound. J Investig Allergol Clin Immunol 1996;6:208-9.
  8. Cohen SH, Yunginger JW, Rosenberg N, Fink JN. Acute allergic reaction after composite pollen ingestion. J Allergy Clin Immunol 1979;64:270-4. PubMed
  9. Lovell CR, Rowan M. Dandelion dermatitis. Contact Dermatitis 1991;25:185-8. PubMed
  10. Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. PubMed
  11. Martín-Muñoz MF, Bartolome B, Caminoa M, et al. Bee pollen: a dangerous food for allergic children. Identification of responsible allergens. Allergol Immunopathol (Madr) 2010;38:263-5. PubMed
  12. Neef H, Cilli F, Declerck PJ, et al. Platelet anti-aggregating activity of Taraxacum officinale Weber. Phytotherapy Research 1996;10:s138-s140.
  13. Cuzzolin L, Zaffani S, and Benoni G. Safety implications regarding use of phytomedicines. Eur.J Clin Pharmacol. 2006;62:37-42. PubMed
  14. Posadzki, P., Watson, L. K., and Ernst, E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12. PubMed
  15. Wakelin, S. H., Marren, P., Young, E., and Shaw, S. Compositae sensitivity and chronic hand dermatitis in a seven-year-old boy. Br J Dermatol 1997;137(2):289-291. PubMed
  16. Ingber, A. Seasonal allergic contact dermatitis from Taraxacum officinale (dandelion) in an Israeli florist. Contact Dermatitis 2000;43(1):49.
  17. Rodriguez, B., Rodriguez, A., de Barrio, M., Tornero, P., and Baeza, M. L. Asthma induced by canary food mix. Allergy Asthma Proc. 2003;24(4):265-268.
  18. Syhaieva, I. A. [Efficiency of specific immunotherapy in treatment of patients with seasonal allergic rhinitis]. Lik.Sprava. 2006;(1-2):51-53.
  19. Catania, M. A., Oteri, A., Caiello, P., Russo, A., Salvo, F., Giustini, E. S., Caputi, A. P., and Polimeni, G. Hemorrhagic cystitis induced by an herbal mixture. South.Med.J. 2010;103(1):90-92. PubMed
  20. Goksu, E., Eken, C., Karadeniz, O., and Kucukyilmaz, O. First report of hypoglycemia secondary to dandelion (Taraxacum officinale) ingestion. Am J Emerg.Med 2010;28(1):111-112. PubMed
  21. Fernandez-Gonzalez, D., Gonzalez-Parrado, Z., Vega-Maray, A. M., Valencia-Barrera, R. M., Camazon-Izquierdo, B., De, Nuntiis P., and Mandrioli, P. Platanus pollen allergen, Pla a 1: quantification in the atmosphere and influence on a sensitizing populati
  22. Liang, K. L., Su, M. C., Shiao, J. Y., Wu, S. H., Li, Y. H., and Jiang, R. S. Role of pollen allergy in Taiwanese patients with allergic rhinitis. J Formos.Med Assoc. 2010;109(12):879-885. PubMed
  23. Yang, Y., Zhao, Y., Wang, C. S., Wang, X. D., and Zhang, L. [Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis]. Zhonghua Er.Bi Yan.Hou Tou.Jing.Wai Ke Za Zhi 2011;46(11):914-920.
  24. Davies, M. G. and Kersey, P. J. Contact allergy to yarrow and dandelion. Contact Dermatitis 1986;14(4):256-257. PubMed
  25. Collins JM and Miller DR. Dandelion green bezoar following antrectomy and vagotomy - case report. J Kansas Med Soc 1966;67(6):303-304.
  26. Moriarty B, Pinney JH, Owen-Casey MP, Rustin MH, Deroide F, Laing C, Davenport A. Digital necrosis from dandelion tea. Br J Dermatol. 2013 Jul;169(1):227-30. PubMed
  27. Onal S, Timur S, Okutucu B, Zihnioglu F. Inhibition of alphaglucosidase by aqueous extracts of some potent antidiabetic medicinal herbs. Prep Biochem Biotechnol 2005;35:29-36.

See these in context on the Dandelion monograph →

Milk Thistle 69 references
  1. 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
  2. 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
  3. Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, et al. Inhibitory effects of silibinin on cytochrome P-450 enzymes in human liver microsomes. Pharmacol Toxicol 2000;86:250-6. PubMed
  4. Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug Metab Dispos 2000;28:1270-3. DOI
  5. Kim DH, Jin YH, Park JB, Kobashi K. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull 1994;17:443-5. PubMed
  6. Pares A, Planas R, Torres M, et al. Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial. J Hepatol 1998;28:615-21. PubMed
  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.
  9. Tanamly MD, Tadros F, Labeeb S, et al. Randomised double-blinded trial evaluating silymarin for chronic hepatitis C in an Egyptian village: study description and 12-month results. Dig Liver Dis 2004;36:752-9. PubMed
  10. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
  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.
  12. Deng JW, Shon JH, Shin HJ, et al. Effect of silymarin supplement on the pharmacokinetics of rosuvastatin. Pharm Res 2008;25:1807-14. PubMed
  13. Kim CS, Choi SJ, Park CY, et al. Effects of silybinin on the pharmacokinetics of tamoxifen and its active metabolite, 4-hydroxytamoxifen in rats. Anticancer Res 2010;30:79-85.
  14. Sridar C, Goosen TC, Kent UM, et al. Silybin inactivates cytochromes P450 3A4 and 2C9 and inhibits major hepatic glucuronosyltransferases. Drug Metab Dispos 2004;32:587-94. PubMed
  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.
  17. Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011;25:21-7. PubMed
  18. Jiao Z, Shi XJ, Li ZD, et al. Population pharmacokinetics of sirolimus in de novo Chinese adult renal transplant patients. Br.J.Clin.Pharmacol. 2009;68(1):47-60.
  19. Gurley, B. J., Barone, G. W., Williams, D. K., Carrier, J., Breen, P., Yates, C. R., Song, P. F., Hubbard, M. A., Tong, Y., and Cheboyina, S. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin phar
  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
  22. Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
  23. Hussain, S. A. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J.Med.Food 2007;10(3):543-547. PubMed
  24. El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally, M., Mikhail, N., Hashem, M., Mousa, A., Aboul-Fotouh, A., El-Kassas, M., Esmat, G., and Strickland, G. T. A randomized controlled trial to assess the safety and effic
  25. Gharagozloo, M., Moayedi, B., Zakerinia, M., Hamidi, M., Karimi, M., Maracy, M., and Amirghofran, Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam.Clin.Pharmaco
  26. Ladas, E. J., Kroll, D. J., Oberlies, N. H., Cheng, B., Ndao, D. H., Rheingold, S. R., and Kelly, K. M. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL PubMed
  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
  30. Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med 2012;52(9):1658-65. PubMed
  31. Yakoot, M. and Salem, A. Spirulina platensis versus silymarin in the treatment of chronic hepatitis C virus infection. A pilot randomized, comparative clinical trial. BMC.Gastroenterol. 2012;12:32. PubMed
  32. Fallahzadeh, M. K., Dormanesh, B., Sagheb, M. M., Roozbeh, J., Vessal, G., Pakfetrat, M., Daneshbod, Y., Kamali-Sarvestani, E., and Lankarani, K. B. Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic
  33. Fried, M. W., Navarro, V. J., Afdhal, N., Belle, S. H., Wahed, A. S., Hawke, R. L., Doo, E., Meyers, C. M., and Reddy, K. R. Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon t
  34. Fallah Huseini, H., Larijani, B., Fakhrzadeh, H., Rajabi Pour, B., Akhondzadeh, S., Toliat, T., and Heshmat, R. The clinical trial of Silybum Marianum seed extract (Silymarin) on type II diabetic patients with hyperlipidemia. Iran J.Diabetes Lipid Disord
  35. Mironets VI, Krasovskaia EA, and Polishchuk II. [A case of urticaria during Carsil treatment]. Vrach Delo 1990;7:86-87.
  36. Velussi M, Cernigoi AM, Viezzoli L, and et al. Silymarin reduces hyperinsulinemia, malondialdehyde levels, and daily insulin need in cirrhotic diabetic patients. Curr Ther Res 1993;53(5):533-545. DOI
  37. Marcelli R, Bizzoni P, Conte D, and et al. Randomized controlled study of the efficacy and tolerability of a short course of IdB 1016 in the treatment of chronic persistent hepatitis. Eur Bull Drug Res 1992;1(3):131-135.
  38. Vailati A, Aristia L, Sozze E, and et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia 1993;64(3):219-228.
  39. Marena C and Lampertico M. Preliminary clinical development of silipide: a new complex of silybin in toxic liver disorders. Planta Med 1991;57(2):A124-A125. DOI
  40. Grungreiff K, Albrecht M, and Strenge-Hesse A. Benefit of medicinal liver therapy in general practice. Med Welt 1995;46:222-227.
  41. Frerick F, Kuhn U, and Strenge-Hesse A. Silymarin--ein Phytopharmakon zur Behandlung toxischen Leberschaden: Anwendungsbeobachtung bei 2169 Patienten. Kassenarzt 1990;33:36-41.
  42. Schuppan D, Strosser W, Burkard G, and et al. Influence of Legalon(TM) 140 on the metabolism of collagen in patients with chronic liver disease--Review by measurement of PIIINP-values. Zeitschrift fur Allgemeinmedizin 1998;74:577-584.
  43. Studlar M. Die Behandlung chronischer Leberkrankungen mit Silymarin und B-Vitaminen. Therapiewoche 1985;35:3375-3378.
  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
  48. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
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Buchu 3 references
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Uva Ursi 8 references
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Calendula 9 references
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Cubebs 2 references
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  2. Usia T, Watabe T, Kadota S, Tezuka Y. Potent CYP3A4 inhibitory constituents of Piper cubeba. J Nat Prod 2005;68(1):64-8.

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Goldenrod 6 references
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Gravel Root 5 references
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Asparagus 14 references
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
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Agrimony 4 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gray AM, Flatt PR. Actions of the traditional anti-diabetic plant, Agrimony eupatoria (agrimony): effects on hyperglycaemia, cellular glucose metabolism and insulin secretion. Br J Nutr 1998;80:109-14.
  4. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. PubMed

See these in context on the Agrimony monograph →

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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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