Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Liv Complex Ingredients & Drug Interactions

by Genestra Brands

Liv Complex label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Liv Complex against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Liv Complex is a dietary supplement by Genestra Brands with 6 active ingredients. Its ingredients are commonly taken for high cholesterol, indigestion and heartburn, constipation and bloating.Based on those ingredients, 1,287 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle (Silybum marianum) fruit std. extract, Dandelion (Taraxacum officinale) root extract, Rosemary (Rosmarinus officinalis) leaf extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Liv Complex by Genestra Brands

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

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HelloPharmacist Scorecard of Liv Complex by Genestra Brands

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

From our pharmacy team — supplement deep dive

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

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 6 of its 6 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Liv Complex contains six active ingredients. The main ones are globe artichoke leaf extract, milk thistle fruit extract, dandelion root extract, bupleurum root extract, fringe tree stem bark extract, and rosemary leaf extract.

These are combined in one capsule with inactive ingredients (cellulose, hypromellose, and silica) that serve as fillers and the capsule material.

Does it work?

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

There isn't enough reliable clinical evidence to rate this product's ingredients for its stated purpose.

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

The evidence for this product's ingredients is mixed. Artichoke is possibly effective for high cholesterol (hyperlipidemia) and indigestion (dyspepsia), but evidence for nonalcoholic fatty liver disease is insufficient.

Milk thistle is possibly effective for type 2 diabetes, though evidence for other uses — including liver disease, allergic rhinitis, and mushroom poisoning — is insufficient. Dandelion, bupleurum, fringe tree, and rosemary have insufficient evidence for their listed uses in our data.

Rosemary is possibly effective for memory, but evidence for cognitive decline is insufficient. Because most of the ingredients lack solid evidence for specific conditions, talk with your pharmacist about what you're hoping this formula will do.

The evidence, ingredient by ingredient Artichoke Milk Thistle Dandelion Bupleurum Fringetree Rosemary

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Artichoke and milk thistle are generally well tolerated, though they may cause abdominal discomfort, diarrhea, flatulence, or nausea in some people. Dandelion is also generally well tolerated but may cause diarrhea, heartburn, or stomach upset.

Bupleurum has very limited safety data and has been linked in rare cases to lung and liver problems when used in combination products. Fringe tree has very limited human safety data; use it only under professional guidance.

Rosemary is safe in food amounts, but concentrated extracts require caution. Allergic reactions — including anaphylaxis — are rare but have been reported with artichoke, milk thistle, and dandelion, especially in people sensitive to ragweed and related plants (Asteraceae/Compositae family).

During pregnancy, artichoke and bupleurum should be avoided due to insufficient safety data. Milk thistle and dandelion have not been well studied in pregnancy, so caution is advised — talk with your doctor.

Rosemary in food amounts is likely fine, but large medicinal doses should be avoided. During breastfeeding, artichoke and bupleurum should be avoided.

Milk thistle, dandelion, and fringe tree have insufficient safety data, so caution or avoidance is advised. Rosemary in food amounts is likely okay, but data on medicinal doses are lacking.

Side effects, ingredient by ingredient Artichoke Milk Thistle Dandelion Bupleurum Fringetree Rosemary

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

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

Why this rating?
  • 5 of the 6 matched ingredients can interact with medications — Milk Thistle, Rosemary, Bupleurum, Dandelion, Artichoke.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,288 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Liv Complex, double-check these medication types with your pharmacist: anticoagulants and antiplatelet drugs (blood thinners like warfarin and aspirin) — Moderate risk of increased bleeding; antidiabetes drugs (insulin, metformin, sulfonylureas) — Moderate risk of low blood sugar; drugs metabolized by CYP2C19, CYP2B6, or CYP1A2 enzymes — Moderate risk of altered drug levels; potassium-sparing diuretics — Moderate risk of high potassium; lithium — Moderate risk of increased lithium levels; and antivirals like ledipasvir, sofosbuvir, or immunosuppressants like sirolimus — Moderate risk of altered effects. Quinolone antibiotics may have reduced absorption.

Morphine levels may be affected unpredictably.

Check your own medication Run your meds through the checker above

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.

Liv Complex is a multi-ingredient herbal formula with some evidence for liver and digestive support, particularly artichoke for cholesterol and indigestion. However, if you take blood thinners, diabetes medications, lithium, or antivirals like ledipasvir or sofosbuvir, you need to check your exact medications before starting it.

If you're pregnant, breastfeeding, or have liver or lung problems, talk with your pharmacist or doctor first.

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

Assessment coverage: 6 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 25, 2016.

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

At a glance

General information

Key facts about Liv Complex, straight from the product label.

Brand Genestra Brands
Barcode (UPC) 88319613430
Net contents 90 Vegetable Capsule(s)
Market status On market
Date entered into DSLD Jan 25, 2016
DSLD ID 56055
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Liv Complex by Genestra Brands, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
90
UPC/BARCODE
88319613430
IngredientAmount% DV
Globe Artichoke (Cynara scolymus) leaf extract175 mg--
Milk Thistle (Silybum marianum) fruit std. extract125 mg--
Dandelion (Taraxacum officinale) root extract100 mg--
Bupleurum (Bupleurum chinense) root extract60 mg--
Fringe Tree (Chionanthus virginicus) stem bark extract30 mg--
Rosemary (Rosmarinus officinalis) leaf extract10 mg--

Other ingredients: Cellulose, Hypromellose, Silica

Tap any ingredient to jump to its full detail below.

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

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

Precautions

Risk Information: If you are pregnant or breastfeeding; if you are allergic to plants of the Asteraceae/Compositae/Daisy family; or if you have a bowel or bile duct obstruction, gallstones, liver or gall bladder disorders, do not use.

Risk Information: If you are pregnant or breastfeeding; if you are allergic to plants of the Asteraceae/Compositae/Daisy family; or if you have a bowel or bile duct obstruction, gallstones, liver or gall bladder disorders, do not use.

Discontinue use if you develop symptoms of liver trouble. Bupleurum can cause sedation; use caution when taking other sedatives and operating a vehicle or hazardous machinery. Hypersensitivity to globe artichoke and milk thistle has been known to occur; in which case, discontinue use.

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

Formulation

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

Ideal for vegans.

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

Storage

Store in a cool, dry place.

General

V2.0 567

FDA Statement of Identity

HERBAL SUPPLEMENT

Seals/Symbols

Seroyal

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

See for yourself

Liv Complex by Genestra Brands label

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

Liv Complex label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Liv Complex by Genestra Brands

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container90 Amounts shown are per serving.

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

Globe Artichoke (Cynara scolymus) leaf extract

Interacts with
363 drugs
175 mg per serving

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

Globe Artichoke (Cynara scolymus) leaf extract monograph & interactions

Milk Thistle (Silybum marianum) fruit std. extract

Interacts with
954 drugs
125 mg per serving Form: Silymarin

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 (Silybum marianum) fruit std. extract monograph & interactions

Dandelion (Taraxacum officinale) root extract

Interacts with
457 drugs
100 mg per serving

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

Dandelion (Taraxacum officinale) root extract monograph & interactions

Bupleurum (Bupleurum chinense) root extract

Interacts with
327 drugs
60 mg per serving

Bupleurum (Chai Hu) is a root used in traditional Chinese medicine, usually as part of multi-herb formulas, for liver, digestive, and fever-related co...

Bupleurum (Bupleurum chinense) root extract monograph & interactions

Fringe Tree (Chionanthus virginicus) stem bark extract

No known
interactions
30 mg per serving

Fringetree is a North American shrub whose root and stem bark have long been used in traditional herbal medicine, mainly for liver, gallbladder, and d...

Fringe Tree (Chionanthus virginicus) stem bark extract monograph & interactions

Rosemary (Rosmarinus officinalis) leaf extract

Interacts with
372 drugs
10 mg per serving

Rosemary is a fragrant Mediterranean herb that is safe and flavorful in normal food amounts. Some early research suggests possible benefits for memory...

Rosemary (Rosmarinus officinalis) leaf extract monograph & interactions

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

Interaction report

Liv Complex by Genestra Brands Drug Interactions

Want to check YOUR meds against Liv Complex?

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

 Go to the checker
1,287Drugs
812 Moderate 475 Minor

Ingredients driving the most interactions

Milk Thistle (Silybum marianum) fruit std. extract 954
Dandelion (Taraxacum officinale) root extract 457
Rosemary (Rosmarinus officinalis) leaf extract 372
Globe Artichoke (Cynara scolymus) leaf extract 363
Bupleurum (Bupleurum chinense) root extract 327

Individual Drug Interactions

The ingredients in Liv Complex interact with 1,287 drugs. Click any drug to see the details.

5 of the 6 ingredients in Liv Complex interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle (Silybum marianum) fruit std. extract Dandelion (Taraxacum officinale) root extract Rosemary (Rosmarinus officinalis) leaf extract Globe Artichoke (Cynara scolymus) leaf extract Bupleurum (Bupleurum chinense) root extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Liv Complex 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 (Silybum marianum) fruit std. extract17 drug types · 954 drugs

Antidiabetes Drugs

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

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

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

Likelihood Possible Evidence D
Glucuronidated Drugs

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

Likelihood Possible Evidence D
Ledipasvir

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

Likelihood Possible Evidence D
Morphine

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

Likelihood Possible Evidence D
Raloxifene (Evista)

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

Likelihood Possible Evidence D
Sirolimus (Rapamune)

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

Likelihood Possible Evidence B
Sofosbuvir (Solvaldi)

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

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

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

Likelihood Possible Evidence D
Warfarin (Coumadin)

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

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

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

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

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

Likelihood Unlikely Evidence D
Estrogens

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

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

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

Likelihood Unlikely Evidence D
Indinavir (Crixivan)

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

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

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

Likelihood Possible Evidence D
P-Glycoprotein Substrates

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

Likelihood Unlikely Evidence B
Milk Thistle (Silybum marianum) fruit std. extract full monograph & interactions

Dandelion (Taraxacum officinale) root extract7 drug types · 457 drugs

Anticoagulant/Antiplatelet Drugs

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

Likelihood Possible Evidence D
Antidiabetes Drugs

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

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

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

Likelihood Possible Evidence D
Glucuronidated Drugs

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

Likelihood Possible Evidence D
Lithium

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

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

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

Likelihood Possible Evidence D
Quinolone Antibiotics

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

Likelihood Possible Evidence D
Dandelion (Taraxacum officinale) root extract full monograph & interactions

Rosemary (Rosmarinus officinalis) leaf extract6 drug types · 372 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, rosemary may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research suggests that rosemary inhibits platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, taking rosemary with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that rosemary extract can decrease blood glucose levels in diabetic models. However, research in humans is conflicting. Although rosemary powder decreased blood glucose levels in healthy adults, no change in blood glucose levels was seen in adults with type 2 diabetes, most of whom were taking antidiabetes drugs.

Likelihood Possible Evidence B
Aspirin

Theoretically, rosemary might have additive effects with salicylate-containing drugs such as aspirin.
Rosemary is reported to contain salicylates.

Likelihood Possible Evidence D
Choline Magnesium Trisalicylate (Trilisate)

Theoretically, rosemary might have additive effects with salicylate-containing drugs such as choline magnesium trisalicylate.
Rosemary is reported to contain salicylate.

Likelihood Possible Evidence D
Salsalate (Disalcid)

Theoretically, rosemary might have additive effects with salicylate-containing drugs such as salsalate.
Rosemary is reported to contain salicylate.

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

Theoretically, rosemary might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that rosemary induces CYP1A2 enzymes. This effect has not been reported in humans.

Likelihood Unlikely Evidence D
Rosemary (Rosmarinus officinalis) leaf extract full monograph & interactions

Globe Artichoke (Cynara scolymus) leaf extract4 drug types · 363 drugs

Antidiabetes Drugs

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

Likelihood Possible Evidence D
Antihypertensive Drugs

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

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

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

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

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

Likelihood Possible Evidence D
Globe Artichoke (Cynara scolymus) leaf extract full monograph & interactions

Bupleurum (Bupleurum chinense) root extract3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, bupleurum might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research suggests that saikosaponins, constituents of bupleurum, can inhibit platelet aggregation.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, bupleurum might decrease the effects of antidiabetes drugs.
Animal research suggests that saikosaponins, constituents of bupleurum, can increase blood glucose.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, bupleurum might decrease the effects of immunosuppressants.
In vitro and animal research suggests that bupleurum might stimulate immune function.

Likelihood Possible Evidence D
Bupleurum (Bupleurum chinense) root extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Liv Complex, from the product label.

Genestra Brands

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

Liv Complex by Genestra Brands: Common Questions

Does Liv Complex by Genestra Brands interact with any medications?
Yes. Based on its ingredients, Liv Complex has a known interaction with 1,287 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Liv Complex contains 6 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is Liv Complex safe to take if I'm pregnant?
No — artichoke and bupleurum should be avoided during pregnancy due to insufficient safety data. Milk thistle and dandelion haven't been well studied in pregnancy either, so caution is advised. Rosemary in food amounts is likely okay, but large medicinal doses should be avoided. Please talk with your doctor or pharmacist for personalized advice.
Can I take this while breastfeeding?
Artichoke and bupleurum should be avoided while breastfeeding. Milk thistle, dandelion, and fringe tree have insufficient safety data, so caution or avoidance is recommended. Rosemary in food amounts is likely okay, but there isn't enough data on medicinal doses. Talk with your pharmacist or doctor before using it.
What does artichoke in this formula do?
Artichoke is possibly effective for high cholesterol and indigestion. Studies show it can modestly reduce cholesterol levels and help with digestive discomfort, though the effects are modest.
Does this product have any common side effects?
The most common side effects are mild and gastrointestinal — abdominal discomfort, diarrhea, flatulence, nausea, and heartburn. These don't occur at higher rates than placebo in most people. Allergic reactions, including anaphylaxis, are rare but have been reported, especially in people sensitive to ragweed and related plants.
Can Liv Complex help with liver disease?
Artichoke and milk thistle are traditionally used for liver support, but the evidence for nonalcoholic fatty liver disease (NAFLD) is insufficient in our data. If you have a liver condition, work with your doctor on a treatment plan — don't rely on this supplement alone.
What is fringe tree in this formula for?
Fringe tree is included in the formula, but we have very limited effectiveness data for it. It's traditionally used in herbal medicine, but human evidence is scarce. Use it only under professional guidance.

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.

Liv Complex label
Go deeper

The Full Monographs Behind Liv Complex’s Ingredients

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

Herb & supplement monograph

Artichoke

Interacts with 363 drugs

Artichoke leaf extract is a generally well-tolerated supplement that may have a mild cholesterol-lowering effect and is often used for indigestion, though the evidence is modest. It is not a...

Read the full Artichoke monograph → Herb & supplement monograph

Milk Thistle

Interacts with 954 drugs

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

Read the full Milk Thistle monograph → Herb & supplement monograph

Dandelion

Interacts with 457 drugs

Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...

Read the full Dandelion monograph → Herb & supplement monograph

Bupleurum

Interacts with 327 drugs

Bupleurum (Chai Hu) is a root used in traditional Chinese medicine, usually as part of multi-herb formulas, for liver, digestive, and fever-related complaints. High-quality human evidence fo...

Read the full Bupleurum monograph → Herb & supplement monograph

Fringetree

Fringetree is a North American shrub whose root and stem bark have long been used in traditional herbal medicine, mainly for liver, gallbladder, and digestive complaints. There is very littl...

Read the full Fringetree monograph → Herb & supplement monograph

Rosemary

Interacts with 372 drugs

Rosemary is a fragrant Mediterranean herb that is safe and flavorful in normal food amounts. Some early research suggests possible benefits for memory, mood, and hair growth, but the evidenc...

Read the full Rosemary monograph →
Sources

Sources & How We Checked

Liv Complex's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 151 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.

Artichoke 16 references
  1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  2. Walker AF, Middleton RW, Petrowicz O. Artichoke leaf extract reduces symptoms of irritable bowel syndrome in a post-marketing surveillance study. Phytother Res 2001;15:58-61. PubMed
  3. Pittler MH, White AR, Stevinson C, Ernst E. Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial. CMAJ 2003;169:1269-73.
  4. Romano, C., Ferrara, A., and Falagiani, P. A case of allergy to globe artichoke and other clinical cases of rare food allergy. J Investig.Allergol.Clin Immunol. 2000;10(2):102-104.
  5. Miralles, J. C., Garcia-Sells, J., Bartolome, B., and Negro, J. M. Occupational rhinitis and bronchial asthma due to artichoke (Cynara scolymus). Ann Allergy Asthma Immunol. 2003;91(1):92-95. PubMed
  6. Franck, P., Moneret-Vautrin, D. A., Morisset, M., Kanny, G., Megret-Gabeaux, M. L., and Olivier, J. L. Anaphylactic reaction to inulin: first identification of specific IgEs to an inulin protein compound. Int Arch Allergy Immunol 2005;136(2):155-158. PubMed
  7. Meding, B. Allergic contact dermatitis from artichoke, Cynara scolymus. Contact Dermatitis 1983;9(4):314.
  8. Quirce, S., Tabar, A. I., Olaguibel, J. M., and Cuevas, M. Occupational contact urticaria syndrome caused by globe artichoke (Cynara scolymus). J Allergy Clin Immunol. 1996;97(2):710-711. PubMed
  9. Held C. Von der 1. Deutsche-Ungarischen Phytopharmakon-Konferenz, Budapest, 20. November 1991. Z Klin Med 1992;47:92-93.
  10. Barrat E, Zaïr Y, Ogier N, et al. A combined natural supplement lowers LDL cholesterol in subjects with moderate untreated hypercholesterolemia: a randomized placebo-controlled trial. Int J Food Sci Nutr. 2013;64(7):882-9. PubMed
  11. Huber R, Müller M, Naumann J, Schenk T, Lüdtke R. Artichoke leave extract for chronic hepatitis C - a pilot study. Phytomedicine. 2009 Sep;16(9):801-4. PubMed
  12. Caputo F, Barranco R, Bonsignore A, Fraternali Orcioni G, Ventura F. A rare case of fatal bowel obstruction secondary to a colonic bezoar. Am J Forensic Med Pathol. 2018;39(1):38-40. PubMed
  13. Elsebai MF, Abass K, Hakkola J, Atawia AR, Farag MA. The wild Egyptian artichoke as a promising functional food for the treatment of hepatitis C virus as revealed via UPLC-MS and clinical trials. Food Funct. 2016;7(7):3006-16. PubMed
  14. Moradi M, Sohrabi G, Golbidi M, et al. Effects of artichoke on blood pressure: a systematic review and meta-analysis. Complement Ther Med 2021;57:102668. PubMed
  15. Jalili C, Moradi S, Babaei A, et al. Effects of Cynara scolymus L. on glycemic indices: a systematic review and meta-analysis of randomized clinical trials. Complement Ther Med 2020;52:102496. PubMed
  16. Gallo R, Oddenino G, Trave I, Gasparini G, Guadagno A, Parodi A. Contact sensitivity to sesquiterpene lactone mix and artichoke in a patient with severe recurrent dermatitis: A puzzling case. Contact Dermatitis 2023;88(2):156-158. PubMed

See these in context on the Artichoke monograph →

Milk Thistle 69 references
  1. Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol 1989;9:105-13. PubMed
  2. Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.g
  3. Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, et al. Inhibitory effects of silibinin on cytochrome P-450 enzymes in human liver microsomes. Pharmacol Toxicol 2000;86:250-6. PubMed
  4. Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug Metab Dispos 2000;28:1270-3. DOI
  5. Kim DH, Jin YH, Park JB, Kobashi K. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull 1994;17:443-5. PubMed
  6. Pares A, Planas R, Torres M, et al. Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial. J Hepatol 1998;28:615-21. PubMed
  7. Piscitelli SC, Formentini E, Burstein AH, et al. Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers. Pharmacotherapy 2002;22:551-6. PubMed
  8. Boerth J, Strong KM. The clinical utility of milk thistle (Silybum marianum) in cirrhosis of the liver. J Herb Pharmacother 2002;2:11-7.
  9. Tanamly MD, Tadros F, Labeeb S, et al. Randomised double-blinded trial evaluating silymarin for chronic hepatitis C in an Egyptian village: study description and 12-month results. Dig Liver Dis 2004;36:752-9. PubMed
  10. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
  11. Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 2006;20;1036-9.
  12. Deng JW, Shon JH, Shin HJ, et al. Effect of silymarin supplement on the pharmacokinetics of rosuvastatin. Pharm Res 2008;25:1807-14. PubMed
  13. Kim CS, Choi SJ, Park CY, et al. Effects of silybinin on the pharmacokinetics of tamoxifen and its active metabolite, 4-hydroxytamoxifen in rats. Anticancer Res 2010;30:79-85.
  14. Sridar C, Goosen TC, Kent UM, et al. Silybin inactivates cytochromes P450 3A4 and 2C9 and inhibits major hepatic glucuronosyltransferases. Drug Metab Dispos 2004;32:587-94. PubMed
  15. van Erp NP, Baker SD, Zhao M, et al. Effect of milk thistle (Silybum marianum) on the pharmacokinetics of irinotecan. Clin Cancer Res 2005;11:7800-6.
  16. Budzinski JW, Trudeau VL, Drouin CE, et al. Modulation of human cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) in Caco-2 cell monolayers by selected commercial-source milk thistle and goldenseal products. Can J Physiol Pharmacol 2007;85:966-78.
  17. Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011;25:21-7. PubMed
  18. Jiao Z, Shi XJ, Li ZD, et al. Population pharmacokinetics of sirolimus in de novo Chinese adult renal transplant patients. Br.J.Clin.Pharmacol. 2009;68(1):47-60.
  19. Gurley, B. J., Barone, G. W., Williams, D. K., Carrier, J., Breen, P., Yates, C. R., Song, P. F., Hubbard, M. A., Tong, Y., and Cheboyina, S. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin phar
  20. Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. PubMed
  21. Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. PubMed
  22. Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
  23. Hussain, S. A. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J.Med.Food 2007;10(3):543-547. PubMed
  24. El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally, M., Mikhail, N., Hashem, M., Mousa, A., Aboul-Fotouh, A., El-Kassas, M., Esmat, G., and Strickland, G. T. A randomized controlled trial to assess the safety and effic
  25. Gharagozloo, M., Moayedi, B., Zakerinia, M., Hamidi, M., Karimi, M., Maracy, M., and Amirghofran, Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam.Clin.Pharmaco
  26. Ladas, E. J., Kroll, D. J., Oberlies, N. H., Cheng, B., Ndao, D. H., Rheingold, S. R., and Kelly, K. M. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL PubMed
  27. Sayyah, M., Boostani, H., Pakseresht, S., and Malayeri, A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog.Neuropsychopharmacol.Biol.Psychiatry 3-17-2010;34(2):362-365. PubMed
  28. Flaig, T. W., Glode, M., Gustafson, D., van, Bokhoven A., Tao, Y., Wilson, S., Su, L. J., Li, Y., Harrison, G., Agarwal, R., Crawford, E. D., Lucia, M. S., and Pollak, M. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients w
  29. Ramirez-Santos, A., Perez-Bustillo, A., Gonzalez-Sixto, B., Suarez-Amor, O., and Rodriguez-Prieto, M. A. [Acute generalized exanthematous pustulosis due to milk thistle (Silybum marianum) tea]. Actas Dermosifiliogr. 2011;102(9):744-745. DOI
  30. Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med 2012;52(9):1658-65. PubMed
  31. Yakoot, M. and Salem, A. Spirulina platensis versus silymarin in the treatment of chronic hepatitis C virus infection. A pilot randomized, comparative clinical trial. BMC.Gastroenterol. 2012;12:32. PubMed
  32. Fallahzadeh, M. K., Dormanesh, B., Sagheb, M. M., Roozbeh, J., Vessal, G., Pakfetrat, M., Daneshbod, Y., Kamali-Sarvestani, E., and Lankarani, K. B. Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic
  33. Fried, M. W., Navarro, V. J., Afdhal, N., Belle, S. H., Wahed, A. S., Hawke, R. L., Doo, E., Meyers, C. M., and Reddy, K. R. Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon t
  34. Fallah Huseini, H., Larijani, B., Fakhrzadeh, H., Rajabi Pour, B., Akhondzadeh, S., Toliat, T., and Heshmat, R. The clinical trial of Silybum Marianum seed extract (Silymarin) on type II diabetic patients with hyperlipidemia. Iran J.Diabetes Lipid Disord
  35. Mironets VI, Krasovskaia EA, and Polishchuk II. [A case of urticaria during Carsil treatment]. Vrach Delo 1990;7:86-87.
  36. Velussi M, Cernigoi AM, Viezzoli L, and et al. Silymarin reduces hyperinsulinemia, malondialdehyde levels, and daily insulin need in cirrhotic diabetic patients. Curr Ther Res 1993;53(5):533-545. DOI
  37. Marcelli R, Bizzoni P, Conte D, and et al. Randomized controlled study of the efficacy and tolerability of a short course of IdB 1016 in the treatment of chronic persistent hepatitis. Eur Bull Drug Res 1992;1(3):131-135.
  38. Vailati A, Aristia L, Sozze E, and et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia 1993;64(3):219-228.
  39. Marena C and Lampertico M. Preliminary clinical development of silipide: a new complex of silybin in toxic liver disorders. Planta Med 1991;57(2):A124-A125. DOI
  40. Grungreiff K, Albrecht M, and Strenge-Hesse A. Benefit of medicinal liver therapy in general practice. Med Welt 1995;46:222-227.
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  42. Schuppan D, Strosser W, Burkard G, and et al. Influence of Legalon(TM) 140 on the metabolism of collagen in patients with chronic liver disease--Review by measurement of PIIINP-values. Zeitschrift fur Allgemeinmedizin 1998;74:577-584.
  43. Studlar M. Die Behandlung chronischer Leberkrankungen mit Silymarin und B-Vitaminen. Therapiewoche 1985;35:3375-3378.
  44. Anon. Adverse reaction: milk thistle-associated toxicity. Nurse Drug Alert 1999;23(7):51.
  45. Gufford BT, Chen G, Vergara AG, et al. Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction. Drug Metab Dispos. 2015;43(9):1353-9. PubMed
  46. El-Shitany NA, Hegazy S, El-Desoky K. Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinylestradiol in ovariectomized rats. Phytomedicine. 2010;17(2):116-25. PubMed
  47. Seidlová-Wuttke D, Becker T, Christoffel V, Jarry H, Wuttke W. Silymarin is a selective estrogen receptor beta (ERbeta) agonist and has estrogenic effects in the metaphysis of the femur but no or antiestrogenic effects in the uterus of ovariectomized (ovx
  48. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  49. 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
  50. 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
  51. 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
  52. 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
  53. Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:8 PubMed
  54. 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
  55. 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
  56. Ebrahimpour-Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M. Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A T
  57. Lash DB, Ward S. CYP2C9-mediated warfarin and milk thistle interaction. J Clin Pharm Ther. 2019. PubMed
  58. 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
  59. 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
  60. 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
  61. 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
  62. 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
  63. 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
  64. 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
  65. 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
  66. 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
  67. 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
  68. 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
  69. 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

See these in context on the Milk Thistle monograph →

Dandelion 27 references
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  3. Hussain Z, Waheed A, Qureshi RA, et al. The effect of medicinal plants of Islamabad and Murree region of Pakistan on insulin secretion from INS-1 cells. Phytother Res 2004;18:73-7. PubMed
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See these in context on the Bupleurum monograph →

Fringetree 2 references
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  2. Herbs and Supplements — MedlinePlus Source

See these in context on the Fringetree monograph →

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See these in context on the Rosemary monograph →

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

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