LactationBlend Ingredients & Drug Interactions
by Vitanica
What is this page for?
First and foremost: checking LactationBlend 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
LactationBlend is a dietary supplement by Vitanica with 11 active ingredients. Its ingredients are commonly taken for liver health and protection, hepatitis, cirrhosis.Based on those ingredients, 1,337 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle Seed Extract, Hops, Fennel. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against LactationBlend by Vitanica
Ask about any prescription or over-the-counter medication and we check it for interactions with LactationBlend by Vitanica — 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 LactationBlend by Vitanica
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
LactationBlend contains 11 active herbal ingredients: milk thistle seed extract, hops, nettle, fennel, red raspberry, borage seed oil, blessed thistle, chaste tree, oat straw, fenugreek seed extract, and vervain. These are combined in capsule form with two inactive ingredients (hydroxypropyl methylcellulose and water) that serve as the capsule material.
Each ingredient is traditionally used to support lactation or milk supply. Milk thistle, nettle, blessed thistle, and fenugreek are classic galactagogues—herbs long used to encourage milk production—while red raspberry and chaste tree address hormonal balance, borage seed oil provides omega-3 fatty acids, oat straw offers nutritional support, and hops and fennel round out the blend with additional traditional benefits.
Does it work?
Insufficient evidence
The evidence for this product as a whole is not established in the data we hold. However, several individual ingredients have been studied: milk thistle is possibly effective for type 2 diabetes, fennel is possibly effective for menstrual cramps (dysmenorrhea), oat straw is likely effective for high cholesterol and heart disease, chaste tree is possibly effective for PMS and breast pain (mastalgia), and fenugreek seed is possibly effective for sexual dysfunction and diabetes.
Hops, nettle, red raspberry, borage, blessed thistle, and vervain either lack sufficient evidence or show no effectiveness for their traditional uses in the available data. The product's overall role in supporting lactation specifically is not rated in our data.
How safe is it?
Well-documented data
Milk thistle, hops, nettle, fennel, red raspberry, borage seed oil, blessed thistle, chaste tree, and fenugreek are generally well tolerated by most adults at typical doses. Common side effects are mild and gastrointestinal—bloating, diarrhea, nausea, abdominal discomfort, and flatulence.
Rare serious effects include allergic reactions (milk thistle and fenugreek can cause anaphylaxis) and liver injury (reported with nettle and borage containing hepatotoxic alkaloids). Blessed thistle and oat straw can cause nausea and vomiting at high doses.
During pregnancy, the safety profile is mixed and concerning: milk thistle, hops, nettle, fennel, borage, blessed thistle, chaste tree, and fenugreek are all rated unsafe or possibly unsafe for pregnancy due to limited data and theoretical effects on the uterus or hormones. Red raspberry is rated possibly safe to likely safe if used in late pregnancy only with provider guidance, and oat straw is likely safe as a food.
During breastfeeding, hops and borage are rated unsafe, nettle and fenugreek are rated unsafe to caution, blessed thistle and chaste tree are rated unsafe, red raspberry safety is unknown, and oat straw is likely safe as food. Milk thistle's breastfeeding safety is caution.
Do not assume any ingredient in this product is safe for you personally during pregnancy or breastfeeding—talk with your doctor or pharmacist about your individual situation before taking it.
Meds to double-check
Moderate interaction found
Before starting LactationBlend, check with your doctor or pharmacist if you take blood thinners (warfarin, clopidogrel, other anticoagulants or antiplatelet drugs), diabetes medications or insulin, sedative or anti-anxiety drugs, birth control pills or hormone replacement therapy, antipsychotic or dopamine-related medications (metoclopramide, antipsychotics, dopamine agonists), blood pressure medications (especially metoprolol), theophylline, H2-blockers or proton pump inhibitors, phenytoin, sildenafil, or ciprofloxacin. These represent the Moderate-severity interactions documented in this product's ingredients.
Altogether, these interactions span 1,338 individual medications.
The bottom line
Scorecard at a glanceFully disclosed formula with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
LactationBlend is a multi-ingredient herbal formula traditionally used to support lactation, and most of its ingredients are generally well tolerated. However, it carries numerous theoretical Moderate drug interactions across multiple medication classes—most notably with blood thinners, diabetes drugs, sedatives, birth control, and hormone therapy.
If you take any prescription medication, check your exact drugs against this product using the interaction tool below before you start. This product is not recommended during pregnancy or breastfeeding without a conversation with your doctor or pharmacist, given the mixed safety data and the traditional concerns about some ingredients' effects on the uterus and hormones.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 10 of 11 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 22, 2024.
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 LactationBlend, straight from the product label.
| Brand | Vitanica |
|---|---|
| Barcode (UPC) | 708118021909 |
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 22, 2024 |
| DSLD ID | 302794 |
| Product type | Botanical With Nutrients |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Women (not pregnant or lactating), Adult Female (18 - 50 Years), Lactating, Gluten Free |
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 LactationBlend by Vitanica, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Milk Thistle Seed Extract | 20 mg | -- |
| Hops | 45 mg | -- |
| Nettle | 70 mg | -- |
| Fennel | 100 mg | -- |
| Red Raspberry | 40 mg | -- |
| Borage Seed Oil | 35 mg | -- |
| Blessed Thistle | 70 mg | -- |
| Chaste Tree | 75 mg | -- |
| Oat Straw | 45 mg | -- |
| Fenugreek Seed Extract | 50 mg | -- |
| Vervain | 70 mg | -- |
Other ingredients: Hydroxypropyl Methylcellulose, Water
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Formulated by Dr. Tori Hudson, a Naturopathic Physician specializing in women's natural health.
Formulation
LactationBlend provides the benefit of centuries of experience with lactation supporting herbs and modern clinical research to naturally promote healthy lactation while nursing.
This product contains no: preservatives, binders, artificial colorings or flavorings, sugars, lactose, salt, wheat, gluten, soybeans, milk derivatives, egg, peanuts, tree nuts, fish or shellfish.
Nursing support
LactationBlend is suitable for vegetarians and vegans.
Suggested/Recommended/Usage/Directions
Suggested use: One (1) to two (2) capsules up to twice daily, or as directed by your health care practitioner.
Precautions
Avoid use of this product during pregnancy. Caution if taking prescription hypoglycemic medications.
Tamper resistant: Please do not use if safety seal is broken or missing.
Keep in a cool, dry place out of reach of children.
Storage
Keep in a cool, dry place out of reach of children.
FDA Statement of Identity
Dietary Supplement
FDA Disclaimer Statement
This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
LactationBlend by Vitanica 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 LactationBlend by Vitanica
These are the 11 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Milk Thistle Seed Extract
Interacts with954 drugs
Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin....
Milk Thistle Seed Extract monograph & interactionsHops
Interacts with863 drugs
Hops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They ar...
Hops monograph & interactionsNettle
Interacts with164 drugs
Stinging nettle is a common plant used as food and in traditional medicine, most often for prostate symptoms, allergies, and joint pain. The evidence...
Nettle monograph & interactionsFennel
Interacts with740 drugs
Fennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some sm...
Fennel monograph & interactionsRed Raspberry
Interacts with135 drugs
Red raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific eviden...
Red Raspberry monograph & interactionsBorage Seed Oil
Interacts with226 drugs
Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arth...
Borage Seed Oil 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 & interactionsChaste Tree
Interacts with121 drugs
Vitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS sympto...
Chaste Tree monograph & interactionsOat Straw
Interacts with86 drugs
Oats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a f...
Oat Straw monograph & interactionsFenugreek Seed Extract
Interacts with389 drugs
Fenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. So...
Fenugreek Seed Extract monograph & interactionsVervain
Other (inactive) ingredients: Hydroxypropyl Methylcellulose, Water. These complete the product’s ingredient list but are not active constituents.
LactationBlend by Vitanica Drug Interactions
HelloPharmacist Interaction Report
Vitanica's LactationBlend contains 11 ingredients, and through its milk thistle, hops, nettle, fennel, red raspberry, borage seed oil, blessed thistle, chaste tree, oat straw, and fenugreek seed extract, it interacts with a substantial number of medications.
The most serious interaction is a theoretical Moderate risk: milk thistle may inhibit a liver enzyme (CYP2B6) that metabolizes certain drugs, potentially increasing their levels and effects.
Read the full breakdown — every affected drug type, severity by severity
Milk thistle poses Moderate interactions with blood thinners like warfarin, diabetes drugs, morphine, and several other medication classes by altering how your liver processes them. Hops may cause additive sedation with sedative drugs (Moderate) and theoretically interfere with hormone therapy and birth control (Moderate), though its effect on some liver enzyme substrates appears to be Minor.
Nettle carries Moderate risks with diabetes drugs, diuretics, lithium, and blood thinners due to its vitamin K content and diuretic properties.
Fennel poses Moderate concerns with birth control, hormone therapy, blood thinners, and several other drug classes through its hormone-like constituents and enzyme effects. Red raspberry leaf theoretically increases bleeding risk with anticoagulants (Moderate) and may lower blood sugar dangerously with insulin (Moderate).
Borage seed oil carries Moderate risks with blood thinners and antipsychotic drugs. Chaste tree may interfere with dopamine-related drugs and hormone therapies (all Moderate).
Blessed thistle and oat straw pose Minor and Moderate risks, respectively, with acid-reducing and diabetes drugs. Fenugreek seed extract has extensive Moderate interactions with blood thinners, diabetes drugs, blood pressure medications, and several others.
One ingredient, vervain, we could not check—no interaction data is on file for it. Use the search tool below to verify your exact medications against these ingredients.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against LactationBlend?
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 LactationBlend interact with 1,337 drugs. Click any drug to see the details.
10 of the 11 ingredients in LactationBlend interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle Seed Extract Hops Fennel Fenugreek Seed Extract Borage Seed Oil Nettle Red Raspberry Chaste Tree Oat Straw Blessed Thistle
Ado-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Ado-trastuzumab Emtansine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Ado-trastuzumab Emtansine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Ado-trastuzumab Emtansine interactionAbciximabReoPro
How Abciximab interacts with LactationBlend — through 4 ingredients. Tap an ingredient for the detail:
Fenugreek Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek Seed Extract + Abciximab interactionFennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Abciximab interactionBorage Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Seed Oil + Abciximab interactionRed RaspberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Red Raspberry + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Abemaciclib interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abemaciclib interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Abemaciclib interactionAbiraterone
How Abiraterone interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Abiraterone interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Abiraterone interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Abiraterone Acetate interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Abiraterone Acetate interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with LactationBlend — through 5 ingredients. Tap an ingredient for the detail:
Red RaspberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Red Raspberry + Abrocitinib interactionFennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Abrocitinib interactionBorage Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Seed Oil + Abrocitinib interactionFenugreek Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek Seed Extract + Abrocitinib interactionMilk Thistle Seed ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle Seed Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acalabrutinib interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acalabrutinib interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with LactationBlend — through 4 ingredients. Tap an ingredient for the detail:
NettleAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Read the full Nettle + Acarbose interactionFenugreek Seed ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Read the full Fenugreek Seed Extract + Acarbose interactionOat StrawAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Read the full Oat Straw + Acarbose interactionMilk Thistle Seed ExtractAntidiabetes Drugs Moderate
Interaction Summary
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Read the full Milk Thistle Seed Extract + Acarbose interactionAcenocoumarolSintrom
How Acenocoumarol interacts with LactationBlend — through 4 ingredients. Tap an ingredient for the detail:
Fenugreek Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek Seed Extract + Acenocoumarol interactionFennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Acenocoumarol interactionBorage Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Seed Oil + Acenocoumarol interactionRed RaspberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Red Raspberry + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
HopsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acepromazine interactionChaste TreeAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, vitex agnus-castus could interfere with the activity of antipsychotic drugs.
Read the full Chaste Tree + Acepromazine interactionBorage Seed OilPhenothiazines Moderate
Interaction Summary
Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Read the full Borage Seed Oil + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with LactationBlend — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with LactationBlend — through 6 ingredients. Tap an ingredient for the detail:
Borage Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Seed Oil + Acetaminophen, Aspirin interactionFennelAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Fennel + Acetaminophen, Aspirin interactionFenugreek Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek Seed Extract + Acetaminophen, Aspirin interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Aspirin interactionRed RaspberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Red Raspberry + Acetaminophen, Aspirin interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with LactationBlend — through 6 ingredients. Tap an ingredient for the detail:
Red RaspberryAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Read the full Red Raspberry + Acetaminophen, Aspirin, Caffeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Aspirin, Caffeine interactionMilk Thistle Seed ExtractCytochrome 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 Seed Extract + Acetaminophen, Aspirin, Caffeine interactionFenugreek Seed ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Fenugreek Seed Extract + Acetaminophen, Aspirin, Caffeine interactionBorage Seed OilAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Borage Seed Oil + Acetaminophen, Aspirin, Caffeine interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with LactationBlend — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with LactationBlend — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Butalbital, Caffeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Butalbital, Caffeine interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
HopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Butalbital, Caffeine, Codeine interactionMilk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with LactationBlend — through 2 ingredients. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Butalbital, Codeine interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with LactationBlend — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMilk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + 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 LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractCytochrome 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 Seed Extract + Acetaminophen, Caffeine, Codeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Caffeine, Codeine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Caffeine, Codeine, Salicylamide interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Caffeine, Codeine, Salicylamide interactionMilk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractCytochrome 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 Seed Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Caffeine, Dihydrocodeine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Caffeine, Isometheptene interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Caffeine, Isometheptene interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with LactationBlend — through 4 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Caffeine, Pyrilamine interactionNettleDiuretic Drugs Moderate
Interaction Summary
Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
Read the full Nettle + Acetaminophen, Caffeine, Pyrilamine interactionMilk Thistle Seed ExtractCytochrome 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 Seed Extract + Acetaminophen, Caffeine, Pyrilamine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionMilk Thistle Seed ExtractCytochrome 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 Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionFennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with LactationBlend — through 3 ingredients. Tap an ingredient for the detail:
FennelCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
Read the full Fennel + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionMilk Thistle Seed ExtractGlucuronidated 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 Seed Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in LactationBlend with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Milk Thistle Seed Extract
Antidiabetes Drugs
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.
Glucuronidated Drugs
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.
Ledipasvir
Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.
Morphine
Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.
Raloxifene (Evista)
Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.
Sirolimus (Rapamune)
Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.
Sofosbuvir (Solvaldi)
Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.
Tamoxifen (Nolvadex)
Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.
Warfarin (Coumadin)
Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.
Estrogens
Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.
Indinavir (Crixivan)
Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
P-Glycoprotein Substrates
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.
Hops
Cns Depressants
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative effects.
Estrogens
Theoretically, concomitant use of large amounts of hops might interfere with hormone replacement therapy due to competition for estrogen receptors.
In vitro research suggests that certain hops constituents can competitively bind to estrogen receptors. However, most hops extracts contain very small amounts of these constituents.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
Fennel
Anticoagulant/Antiplatelet Drugs
Theoretically, fennel might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Animal research suggests that fennel oil has antithrombotic and antiplatelet effects.
Ciprofloxacin (Cipro)
Theoretically, fennel might decrease the levels and clinical effects of ciprofloxacin.
Animal research shows that fennel reduces ciprofloxacin bioavailability by nearly 50%, possibly due to the metal cations such as calcium, iron, and magnesium contained in fennel. This study also found that fennel increased tissue distribution and slowed elimination of ciprofloxacin.
Contraceptive Drugs
Theoretically, taking large amounts of fennel might decrease the effects of contraceptive drugs due to competition for estrogen receptors.
Some constituents of fennel have estrogenic activity.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, fennel might increase levels of drugs metabolized by CYP3A4.
In vitro research suggests that fennel inhibits CYP3A4 enzyme activity. This effect has not been reported in humans.
Estrogens
Theoretically, taking large amounts of fennel might interfere with hormone replacement therapy due to competition for estrogen receptors.
Some constituents of fennel have estrogenic activity.
Tamoxifen (Nolvadex)
Theoretically, taking large amounts of fennel might decrease the antiestrogenic effect of tamoxifen.
Some constituents of fennel have estrogenic activity, which may interfere with the antiestrogenic activity of tamoxifen.
Fenugreek Seed Extract
Anticoagulant/Antiplatelet Drugs
Theoretically, fenugreek might have additive effects when used with anticoagulant or antiplatelet drugs.
Some of the constituents in fenugreek have antiplatelet effects in animal and in vitro research. However, common fenugreek products might not contain sufficient concentrations of these constituents for clinical effects. A clinical study in patients with coronary artery disease or diabetes shows that taking fenugreek seed powder 2.5 grams twice daily for 3 months does not affect platelet aggregation, fibrinolytic activity, or fibrinogen levels .
Antidiabetes Drugs
Theoretically, fenugreek seed might have additive hypoglycemic effects when used with antidiabetes drugs.
Clinical research shows that fenugreek seed can reduce fasting blood glucose and 2-hour postprandial glucose levels in adults with type 2 diabetes.
Clopidogrel (Plavix)
Theoretically, fenugreek seed might alter the clinical effects of clopidogrel by inhibiting its conversion to the active form.
Animal research shows that fenugreek seed 200 mg/kg daily for 14 days increases the maximum serum concentration of clopidogrel by 21%. It is unclear how this affects the pharmacokinetics of the active metabolite of clopidogrel; however, this study found that concomitant use of fenugreek seed and clopidogrel prolonged bleeding time by an additional 11%.
Metoprolol (Toprol)
Theoretically, fenugreek seed might have additive hypotensive effects when used with metoprolol.
Animal research shows that fenugreek seed 300 mg/kg daily for 2 weeks decreases systolic and diastolic blood pressure by 9% and 11%, respectively, when administered alone, and by 15% and 22%, respectively, when given with metoprolol 10 mg/kg.
Phenytoin (Dilantin)
Theoretically, fenugreek might decrease plasma levels of phenytoin.
Animal research shows that taking fenugreek seeds for 1 week decreases maximum concentrations and the area under the curve of a single dose of phenytoin by 44% and 72%, respectively. This seems to be related to increased clearance. So far, this interaction has not been reported in humans.
Sildenafil (Viagra)
Theoretically, concurrent use of sildenafil and fenugreek might reduce levels and therapeutic effects of sildenafil.
Animal research shows that taking fenugreek seeds for 1 week reduces maximum concentrations and the area under the curve of a single dose of sildenafil by 27% and 48%, respectively. So far, this interaction has not been reported in humans.
Theophylline
Theoretically, fenugreek may reduce the levels and clinical effects of theophylline.
Animal research shows that fenugreek 50 grams daily for 7 days reduces the maximum serum concentration (Cmax) of theophylline by 28% and the area under the plasma drug concentration-time curve (AUC) by 22%.
Warfarin (Coumadin)
Theoretically, fenugreek might have additive effects with warfarin and increase the international normalized ratio (INR).
Some fenugreek constituents have antiplatelet effects, although these might not be present in concentrations that are clinically significant. In one case report, a patient taking warfarin experienced an increased INR when starting to take fenugreek in combination with boldo.
Antihypertensive Drugs
Fenugreek may also have an additive effect on blood pressure-lowering medications. Studies on animals have shown that fenugreek seed can decrease both systolic and diastolic blood pressure by up to 22% when combined with metoprolol. Therefore, it is essential to monitor your blood pressure regularly if you are taking fenugreek and metoprolol together or any other antihypertensive drugs.
Borage Seed Oil
Anticoagulant/Antiplatelet Drugs
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation. However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research.
Cytochrome P450 3A4 (Cyp3A4) Inducers
Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.
Phenothiazines
Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure. In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures.
Nettle
Antidiabetes Drugs
Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
Clinical research shows that stinging nettle might decrease blood glucose levels in patients with diabetes.
Diuretic Drugs
Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
Animal research suggests that the above ground parts and roots of stinging nettle may have a diuretic effect.
Lithium
Theoretically, stinging nettle might reduce excretion and increase levels of lithium.
Animal research suggests that stinging nettle has diuretic and natriuretic properties, which could alter the excretion of lithium. The dose of lithium might need to be decreased.
Warfarin (Coumadin)
There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Stinging nettle contains a significant amount of vitamin K. When taken in large quantities, this might interfere with the activity of warfarin.
Red Raspberry
Anticoagulant/Antiplatelet Drugs
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor. This interaction has not been reported in humans.
Insulin
Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea.
Chaste Tree
Antipsychotic Drugs
Theoretically, vitex agnus-castus could interfere with the activity of antipsychotic drugs.
Vitex agnus-castus might interfere with the action of dopamine antagonists such as antipsychotic drugs due to its dopamine agonist effects.
Contraceptive Drugs
Theoretically, vitex agnus-castus could interfere with oral contraceptives.
Vitex agnus-castus might interfere with the efficacy of oral contraceptives due to possible hormone modulating activity.
Dopamine Agonists
Theoretically, vitex agnus-castus could interfere with dopamine agonists.
Vitex agnus-castus might potentiate the actions of dopaminergic agonists due to possible dopaminergic effects.
Estrogens
Theoretically, vitex agnus-castus could interfere with the activity of estrogens.
Vitex agnus-castus has hormone modulating activity that can interfere with the efficacy of hormone replacement therapy.
Metoclopramide (Reglan)
Theoretically, dopaminergic effects of vitex agnus-castus could interfere with metoclopramide.
Vitex agnus-castus might interfere with the action of dopamine antagonists such as metoclopramide due to its possible dopaminergic effects.
Oat Straw
Antidiabetes Drugs
Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
Insulin
Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.
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 LactationBlend, from the product label.
Vitanica
See all Vitanica products- Name
- Vitanica
- Street Address
- 12401 SW Leveton Dr.
- City
- Tualatin
- State
- OR
- ZipCode
- 97062
- Web Address
- www.vitanica.com
LactationBlend by Vitanica: Common Questions
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How can one product interact with so many drugs?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind LactationBlend’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 monographHops
Interacts with 863 drugsHops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used sho...
Read the full Hops monograph → Herb & supplement monographStinging Nettle
Interacts with 164 drugsStinging nettle is a common plant used as food and in traditional medicine, most often for prostate symptoms, allergies, and joint pain. The evidence is mixed and mostly preliminary, so it i...
Read the full Stinging Nettle monograph → Herb & supplement monographFennel
Interacts with 740 drugsFennel is a Mediterranean herb widely used as a food and spice, and traditionally taken for digestive complaints, colic, and menstrual cramps. Some small studies suggest possible benefit for...
Read the full Fennel monograph → Herb & supplement monographRed Raspberry
Interacts with 135 drugsRed raspberry leaf is a traditional herbal remedy most often used as a tea in late pregnancy and for menstrual discomfort, but solid scientific evidence for these uses is limited. It is gene...
Read the full Red Raspberry monograph → Herb & supplement monographBorage
Interacts with 226 drugsBorage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arthritis with mixed results. The plant's le...
Read the full Borage 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 monographVitex Agnus-castus
Interacts with 121 drugsVitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS symptoms. It is generally well tolerated by ma...
Read the full Vitex Agnus-castus monograph → Herb & supplement monographOats
Interacts with 86 drugsOats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...
Read the full Oats monograph → Herb & supplement monographFenugreek
Interacts with 389 drugsFenugreek is a common kitchen spice that is also taken as a supplement, mainly for blood sugar, cholesterol, and to support breast milk production. Some early research is encouraging for blo...
Read the full Fenugreek monograph →Sources & How We Checked
LactationBlend'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 211 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Milk Thistle 69 references
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- 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
- Kawaguchi-Suzuki M, Frye RF, Zhu HJ, et al. The effects of milk thistle (Silybum marianum) on human cytochrome P450 activity. Drug Metab Dispos. 2014;42(10):1611-6. PubMed
- Rastegarpanah M, Malekzadeh R, Vahedi H, et al. A randomized, double blinded, placebo-controlled clinical trial of silymarin in ulcerative colitis. Chin J Integr Med. 2015;21(12):902-6. PubMed
- Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:8 PubMed
- Di Pierro F, Villanova N, Agostini F, Marzocchi R, Soverini V, Marchesini G. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control. Diabetes Metab Syndr Obes. 2012;5:213-7. PubMed
- Guarino G, Strollo F, Carbone L, et al. Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Bilybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes. J Biol Regul Homeos
- Ebrahimpour-Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M. Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A T
- Lash DB, Ward S. CYP2C9-mediated warfarin and milk thistle interaction. J Clin Pharm Ther. 2019. PubMed
- Malekshah RE, Khaleghian A. Influence of Silybum marianum on morphine addicted rats, biochemical parameters and molecular simulation studies on µ-opioid receptor. Drug Res (Stuttg). 2019;69(11):630-638. PubMed
- Soleymani S, Ayati MH, Mansourzadeh MJ, Namazi N, Zargaran A. The effects of Silymarin on the features of cardiometabolic syndrome in adults: A systematic review and meta-analysis. Phytother Res. 2022 Jan 11. doi: 10.1002/ptr.7364. PubMed
- Gamissans M, Expósito-Serrano V, López-Llunell C, Valdivieso L, Garbayo-Salmons P. Bullous pemphigoid triggered by Silybum marianum: an unexpected side effect of an herbal remedy. Int J Dermatol. 2021 Aug 7. doi: 10.1111/ijd.15822. PubMed
- Aboras SI, Korany MA, El-Yazbi AF, Ragab MAA, Abdine HH. In-depth investigation of the Silymarin effect on the pharmacokinetic parameters of sofosbuvir, GS-331007 and ledipasvir in rat plasma using LC-MS. Biomed Chromatogr 2022;36(9):e5427. PubMed
- Wattanakrai P, Nimmannitya K. A Randomized, Double-Blind, Split-Face Study of Topical Silymarin vs 2% Hydroquinone Cream in Melasmas. J Drugs Dermatol 2022;21(12):1304-1310. PubMed
- Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
- Zhang W, Zhang Y, Wen C, Jiang X, Wang L. In vitro Assessment of the Effects of Silybin on CYP2B6-mediated Metabolism. Planta Med 2023. PubMed
- Bechtold BJ, Lynch KD, Oyanna VO, et al. Rifampin- and Silymarin-Mediated Pharmacokinetic Interactions of Exogenous and Endogenous Substrates in a Transgenic OATP1B Mouse Model. Mol Pharm 2024;21(5):2284-2297. PubMed
- Mohammadi S, Asbaghi O, Afrisham R, et al. Impacts of Supplementation with Silymarin on Cardiovascular Risk Factors: A Systematic Review and Dose-Response Meta-Analysis. Antioxidants (Basel) 2024;13(4):390. PubMed
- Rustamzadeh A, Sadigh N, Vahabi Z, et al. Effects silymarin and rosuvastatin on amyloid-carriers level in dyslipidemic Alzheimer's patients: A double-blind placebo-controlled randomized clinical trial. IBRO Neurosci Rep 2024;17:108-121. PubMed
- Fatemi Shandiz A, Karimi G, Dayyani M, Hosseini S, Elyasi S. Evaluation of oral silymarin formulation efficacy in prevention of doxorubicin induced hepatotoxicity in patients with non-metastatic breast cancer. J Oncol Pharm Pract 2024. PubMed
- Duan X, Bai W, Hu J, et al. Inhibitory effect of flavonoids on multidrug and toxin extrusion protein 1 function: Implications for food/herb-drug interaction and drug-induced kidney injury. J Appl Toxicol 2024;44(9):1388-1402. PubMed
Hops 15 references
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- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med 1998;217:369-78. PubMed
- Milligan SR, Kalita JC, Heyerick A, et al. Identification of a potent phytoestrogen in hops (Humulus lupulus L.) and beer. J Clin Endocrinol Metab 1999;84:2249-52.. PubMed
- Milligan SR, Kalita JC, Pocock V, et al. The endocrine activities of 8-prenylnaringenin and related hop (Humulus lupulus L.) flavonoids. J Clin Endocrinol Metab 2000;85:4912-5.. DOI
- Henderson MC, Miranda CL, Stevens JF, et al. In vitro inhibition of human P450 enzymes by prenylated flavonoids from hops, Humulus lupulus. Xenobiotica 2000;30:235-51.. PubMed
- Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
- Skorska, C., Mackiewicz, B., Gora, A., Golec, M., and Dutkiewicz, J. Health effects of inhalation exposure to organic dust in hops farmers. Ann.Univ Mariae.Curie Sklodowska [Med] 2003;58(1):459-465.
- Schiller, H., Forster, A., Vonhoff, C., Hegger, M., Biller, A., and Winterhoff, H. Sedating effects of Humulus lupulus L. extracts. Phytomedicine. 2006;13(8):535-541. PubMed
- van Hunsel, F. P. and Kampschoer, P. [Postmenopausal bleeding and dietary supplements: a possible causal relationship with hop- and soy-containing preparations]. Ned.Tijdschr.Geneeskd. 2012;156(41):A5095.
- Fenselau, C. and Talalay, P. Is oestrogenic activity present in hops? Food Cosmet.Toxicol. 1973;11(4):597-602. PubMed
- Godnic-Cvar, J., Zuskin, E., Mustajbegovic, J., Schachter, E. N., Kanceljak, B., Macan, J., Ilic, Z., and Ebling, Z. Respiratory and immunological findings in brewery workers. Am J Ind Med 1999;35(1):68-75. DOI
- Lee KM, Jung JS, Song DK, and et al. Effects of Humulus lupulus extract on the central nervous system in mice. Planta Med 1993;59(Suppl):A691.
- Assessment report on Humulus lupulus L., flos. European Medicines Agency, 2014. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-humulus-lupulus-l-flos_en.pdf. Accessed September 29, 2021.
- van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. PubMed
Stinging Nettle 23 references
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