Fenugreek Free Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Fenugreek Free 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
Fenugreek Free is a dietary supplement by Mommy Knows Best with 5 active ingredients. Its ingredients are commonly taken for liver health and protection, hepatitis, cirrhosis.Based on those ingredients, 2,144 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Marshmallow, Milk Thistle, Goat's Rue. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Fenugreek Free by Mommy Knows Best
Ask about any prescription or over-the-counter medication and we check it for interactions with Fenugreek Free by Mommy Knows Best — 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 Fenugreek Free by Mommy Knows Best
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
Fenugreek Free contains five active ingredients: milk thistle, marshmallow, shatavari (also known as asparagus racemosus), blessed thistle, and goat's rue. These are herbal extracts traditionally used in lactation support formulas.
The product also includes inactive ingredients — a veggie capsule, microcrystalline cellulose (a filler), silicon dioxide, and vegetable magnesium stearate — to hold the capsule together and aid absorption.
Does it work?
Not established
The evidence for these ingredients is limited. Milk thistle is rated possibly effective for type 2 diabetes, though the other uses we have data for — acne, liver disease from alcohol, hay fever, gambling disorder, and amanita mushroom poisoning — all lack sufficient reliable evidence.
Marshmallow, shatavari, blessed thistle, and goat's rue have insufficient evidence for their listed uses, which include respiratory infections, muscle strength, lactation support, and wound healing. If you're considering this product for a specific health goal, talk it over with your doctor or pharmacist about whether the evidence supports it.
How safe is it?
Well-documented data
Milk thistle is generally well tolerated, though a small number of people report mild stomach upset, headache, dizziness, or sleep disturbances. Allergic reactions, though rare, can occur.
Marshmallow and shatavari are well tolerated in the short term, but human safety data are limited. Blessed thistle in small doses is often well tolerated, but higher doses can cause nausea or vomiting and may trigger allergic reactions in people sensitive to ragweed and related plants.
During pregnancy, milk thistle and marshmallow are best avoided due to insufficient safety information. Blessed thistle is likely unsafe in pregnancy — it's traditionally thought to affect the uterus and lacks reliable data.
Shatavari and goat's rue also lack established safety data in pregnancy and should be avoided unless your doctor advises otherwise. For breastfeeding, milk thistle and shatavari require caution due to limited study, blessed thistle should be used only under professional guidance, and goat's rue lacks enough data.
Talk with your doctor or pharmacist before using this product if you're pregnant or breastfeeding.
Meds to double-check
Moderate interaction found
Before taking Fenugreek Free, check with your doctor or pharmacist if you take blood thinners (anticoagulants) like warfarin or heparin, or antiplatelet drugs like aspirin or clopidogrel — milk thistle and goat's rue may increase bleeding risk. Also confirm any diabetes medications, lithium (a mood stabilizer), acid-reducing drugs like H2-blockers or PPIs, or morphine and other pain relievers.
Milk thistle's effects on how your liver and kidneys process drugs are broad; use the checker below with your exact medication list.
The bottom line
Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.
This product combines five herbal ingredients with a long history in lactation support, but the scientific evidence for them is sparse. If you take medications — especially blood thinners, diabetes drugs, lithium, acid reducers, or hepatitis C treatment — you need to check your specific prescriptions against the interaction tool on this page before starting.
Pregnancy and breastfeeding require a conversation with your own doctor or pharmacist, since safety data are limited for most of these herbs.
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 Jan 22, 2022.
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 Fenugreek Free, straight from the product label.
| Brand | Mommy Knows Best |
|---|---|
| Barcode (UPC) | 857615008507 |
| Net contents | 30 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Jan 22, 2022 |
| DSLD ID | 257859 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult Female (18 - 50 Years), Lactating |
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 Fenugreek Free by Mommy Knows Best, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Milk Thistle | 300 NP | -- |
| Marshmallow | 100 mg | -- |
| Shatavari | 100 mg | -- |
| Blessed Thistle | 800 mg | -- |
| Goat's Rue | 200 mg | -- |
Other ingredients: Veggie Capsule, Microcrystalline Cellulose, Silicon Dioxide, Vegetable Magnesium Stearate
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.
Suggested/Recommended/Usage/Directions
Suggested use: Take 1 capsule daily. For maximum effectiveness, avoid more than 1-2 oz. of liquid before and after each dose.
FDA Disclaimer Statement
These statements have bot been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
General Statements
To reorder: visit mommyknowsbest.com
Formulation
Breastfeeding Supplement For increased milk supply
Formula
Blessed and milk thistle Goat's rue herb Marshmallow root Shatavari Root
FDA Statement of Identity
Dietary Supplement
Precautions
Warning: Do not use if safety seal under the cap is missing. Do not exceed recommended serving. Consult your physician prior to using any dietary supplement.
Do not use if you are under the age of 18. Keep out of reach of children.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Fenugreek Free by Mommy Knows Best 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 Fenugreek Free by Mommy Knows Best
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container30 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
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 monograph & interactionsMarshmallow
Interacts with2,040 drugs
Marshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats,...
Marshmallow monograph & interactionsShatavari
Interacts with76 drugs
Asparagus racemosus, often called shatavari, is an Ayurvedic herb traditionally used to support women's health, digestion, and overall vitality. Human...
Shatavari monograph & interactionsBlessed Thistle
Interacts with36 drugs
Blessed thistle is a bitter herb traditionally used to stimulate appetite and ease mild digestive complaints. High-quality human studies are lacking,...
Blessed Thistle monograph & interactionsGoat's Rue
Interacts with122 drugs
Goat's rue is a traditional herb most often used by nursing parents to try to increase milk supply, and it has a historical link to diabetes research....
Goat's Rue monograph & interactionsOther (inactive) ingredients: Veggie Capsule, Microcrystalline Cellulose, Silicon Dioxide, Vegetable Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Fenugreek Free by Mommy Knows Best Drug Interactions
HelloPharmacist Interaction Report
Fenugreek Free by Mommy Knows Best contains five active ingredients, and through its milk thistle, marshmallow, shatavari, blessed thistle, and goat's rue content, it interacts with a number of medications.
The most serious interactions are with milk thistle: it may increase the blood-thinning effects of warfarin (Coumadin), a medication that prevents clots, raising your bleeding risk.
Read the full breakdown — every affected drug type, severity by severity
Milk thistle carries moderate-severity interactions with several drug categories. It may lower blood sugar (hypoglycemia) when combined with diabetes medications, and it might slow how your body clears certain pain relievers and transplant drugs like sirolimus (Rapamune).
It can also theoretically affect how your liver processes a hepatitis C medication (sofosbuvir) and may increase morphine levels in your bloodstream.
Marshmallow and shatavari both interact with lithium (a mood stabilizer) — they may reduce how your kidneys clear it, raising the risk of toxicity. Marshmallow's mucilage may also impair absorption of oral drugs if taken at the same time.
Blessed thistle may reduce the effectiveness of acid-reducing medications like H2-blockers, antacids, and proton pump inhibitors (PPIs). Goat's rue may increase bleeding risk when combined with blood thinners (anticoagulants) or antiplatelet drugs like aspirin or clopidogrel (Plavix).
Altogether, these interactions span 2,145 individual medications. Use the interaction checker below to see if your exact medications are affected before you start this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Fenugreek Free?
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 Fenugreek Free interact with 2,144 drugs. Click any drug to see the details.
5 of the 5 ingredients in Fenugreek Free interact with drugs. Each result below shows which ingredient is responsible. Marshmallow Milk Thistle Goat's Rue Shatavari Blessed Thistle
AbciximabReoPro
How Abciximab interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Goat's RueAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research suggests that goat's rue extract can inhibit platelet aggregation.
Read the full Goat's Rue + Abciximab interactionMarshmallowAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow + Abciximab interactionAbrocitinibCibinqo
How Abrocitinib interacts with Fenugreek Free — through 3 ingredients. Tap an ingredient for the detail:
Goat's RueAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research suggests that goat's rue extract can inhibit platelet aggregation.
Read the full Goat's Rue + Abrocitinib interactionMarshmallowOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Abrocitinib interactionMilk ThistleCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle + Abrocitinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleAntidiabetes Drugs Moderate
Interaction Summary
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Read the full Milk Thistle + Acarbose interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Goat's RueAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research suggests that goat's rue extract can inhibit platelet aggregation.
Read the full Goat's Rue + Acenocoumarol interactionMarshmallowAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Fenugreek Free — through 3 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Aspirin interactionGoat's RueAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research suggests that goat's rue extract can inhibit platelet aggregation.
Read the full Goat's Rue + Acetaminophen, Aspirin interactionMarshmallowOral Drugs, Anticoagulant/antiplatelet Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Fenugreek Free — through 3 ingredients. Tap an ingredient for the detail:
Goat's RueAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Laboratory research suggests that goat's rue extract can inhibit platelet aggregation.
Read the full Goat's Rue + Acetaminophen, Aspirin, Caffeine interactionMilk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Aspirin, Caffeine interactionMarshmallowAnticoagulant/antiplatelet Drugs, Oral Drugs Minor
Interaction Summary
Theoretically, marshmallow flower might have antiplatelet effects.
Read the full Marshmallow + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Caffeine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Caffeine, Codeine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Codeine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Codeine Phosphate interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Caffeine, Codeine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Codeine, Salicylamide interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Dihydrocodeine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Caffeine, Isometheptene interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Fenugreek Free — through 3 ingredients. Tap an ingredient for the detail:
ShatavariDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus racemosus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Shatavari + Acetaminophen, Caffeine, Pyrilamine interactionMilk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Pyrilamine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Phenylephrine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, Phenylephrine, SalicylamideRhinogesic, Rhinogesic JR
How Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylpropanolamineAlumadrine, Conex, Sinadrin Max Strength, Sinulin
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Phenylpropanolamine, OpiumHista-Derfule
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interacts with Fenugreek Free — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionMarshmallowOral Drugs Minor
Interaction Summary
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Read the full Marshmallow + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Opium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Fenugreek Free 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.
Marshmallow
Lithium
Theoretically, due to potential diuretic effects, marshmallow might reduce excretion and increase levels of lithium.
Marshmallow is thought to have diuretic properties. To avoid lithium toxicity, the dose of lithium might need to be decreased when used with marshmallow.
Anticoagulant/Antiplatelet Drugs
Theoretically, marshmallow flower might have antiplatelet effects.
Animal research suggests that marshmallow flower extract has antiplatelet effects. However, the root and leaf of marshmallow, not the flower, are the plant parts most commonly found in dietary supplements. Theoretically, use of marshmallow flower with anticoagulant/antiplatelet drugs can have additive effects, and might increase the risk for bleeding in some patients.
Oral Drugs
Theoretically, mucilage in marshmallow might impair absorption of oral drugs.
Marshmallow contains mucilage which can affect oral drug absorption. To avoid changes in absorption, take marshmallow 30-60 minutes after oral medications.
Milk Thistle
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.
Goat's Rue
Anticoagulant/Antiplatelet Drugs
Laboratory research suggests that goat's rue extract can inhibit platelet aggregation. Theoretically, goat's rue might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Shatavari
Diuretic Drugs
Theoretically, asparagus racemosus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Animal studies show that asparagus racemosus root has diuretic effects when used in high doses. This effect has not been reported in humans.
Lithium
Theoretically, Asparagus racemosus root could reduce excretion and increase levels of lithium.
Animal research suggests that Asparagus racemosus root has diuretic properties when used in high doses. Therefore, it might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Blessed Thistle
Antacids
Theoretically, blessed thistle might decrease the effectiveness of antacids.
There are reports that blessed thistle increases stomach acid.
H2-Blockers
Theoretically, blessed thistle might decrease the effectiveness of H2-blockers.
There are reports that blessed thistle increases stomach acid.
Proton Pump Inhibitors (Ppis)
Theoretically, blessed thistle might decrease the effectiveness of PPIs.
There are reports that blessed thistle increases stomach acid.
Brand information
Manufacturer and brand details for Fenugreek Free, from the product label.
Mommy Knows Best
See all Mommy Knows Best products- Name
- Mommy Knows Best
- Street Address
- 224 W Judd St. Suite 7B
- City
- Woodstock
- State
- IL
- ZipCode
- 60098
- Phone Number
- (800) 323-2510
- Web Address
- mommyknowsbest.com
Fenugreek Free by Mommy Knows Best: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Fenugreek Free is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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 Fenugreek Free’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 monographMarshmallow
Interacts with 2,040 drugsMarshmallow root is a traditional herb rich in soothing, gel-like fibers called mucilage, which is why it has long been used for coughs, sore throats, and stomach irritation. Evidence for th...
Read the full Marshmallow monograph → Herb & supplement monographAsparagus Racemosus
Interacts with 76 drugsAsparagus racemosus, often called shatavari, is an Ayurvedic herb traditionally used to support women's health, digestion, and overall vitality. Human evidence for most of these uses is limi...
Read the full Asparagus Racemosus monograph → Herb & supplement monographBlessed Thistle
Interacts with 36 drugsBlessed thistle is a bitter herb traditionally used to stimulate appetite and ease mild digestive complaints. High-quality human studies are lacking, so its benefits are not well proven. It...
Read the full Blessed Thistle monograph → Herb & supplement monographGoat's Rue
Interacts with 122 drugsGoat's rue is a traditional herb most often used by nursing parents to try to increase milk supply, and it has a historical link to diabetes research. Solid human evidence for either use is...
Read the full Goat's Rue monograph →Sources & How We Checked
Fenugreek Free'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 83 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
- 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
- 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
- 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
- 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
- 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
- Boerth J, Strong KM. The clinical utility of milk thistle (Silybum marianum) in cirrhosis of the liver. J Herb Pharmacother 2002;2:11-7.
- 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
- 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. .
- 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.
- Deng JW, Shon JH, Shin HJ, et al. Effect of silymarin supplement on the pharmacokinetics of rosuvastatin. Pharm Res 2008;25:1807-14. PubMed
- 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.
- 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
- 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.
- 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.
- 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
- 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.
- 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
- 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
- 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
- Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Mironets VI, Krasovskaia EA, and Polishchuk II. [A case of urticaria during Carsil treatment]. Vrach Delo 1990;7:86-87.
- 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
- 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.
- 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.
- 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
- Grungreiff K, Albrecht M, and Strenge-Hesse A. Benefit of medicinal liver therapy in general practice. Med Welt 1995;46:222-227.
- Frerick F, Kuhn U, and Strenge-Hesse A. Silymarin--ein Phytopharmakon zur Behandlung toxischen Leberschaden: Anwendungsbeobachtung bei 2169 Patienten. Kassenarzt 1990;33:36-41.
- 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.
- Studlar M. Die Behandlung chronischer Leberkrankungen mit Silymarin und B-Vitaminen. Therapiewoche 1985;35:3375-3378.
- Anon. Adverse reaction: milk thistle-associated toxicity. Nurse Drug Alert 1999;23(7):51.
- 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
- 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
- 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
- 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
- Derosa G, Romano D, D'Angelo A, Maffioli P. Berberis aristata/Silybum marianum fixed combination (Berberol(®)) effects on lipid profile in dyslipidemic patients intolerant to statins at high dosages: a randomized, placebo-controlled, clinical trial. Phyto PubMed
- Luangchosiri C, Thakkinstian A, Chitphuk S, Stitchantrakul W, Petraksa S, Sobhonslidsuk A. A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern Med. 2015;15:334. PubMed
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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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