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Dietary supplement

Livachol Ingredients & Drug Interactions

by MBi Nutraceuticals

Livachol label
See full label image
Capsule Category: Other Combinations
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 Livachol 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

Livachol is a dietary supplement by MBi Nutraceuticals with 7 active ingredients. Its ingredients are commonly taken for liver health and fatty liver, brain and memory support, prenatal nutrition and fetal development.Based on those ingredients, 1,202 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle, Beet, Parsley. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Livachol by MBi Nutraceuticals

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

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HelloPharmacist Scorecard of Livachol by MBi Nutraceuticals

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 Aug 20, 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 7 of its 7 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Livachol contains 7 active ingredients: choline bitartrate (a form of choline, an essential nutrient for cell function), beet (a root vegetable with nitrates and pigments), inositol (a carbohydrate important for cell signaling), watercress (a green vegetable), parsley (an herb), betaine HCl (a compound that increases stomach acid), and milk thistle (an herbal extract used for liver support). The capsules also contain inactive ingredients: rice flour, rice flour extract, magnesium stearate, and silica.

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 detoxification and health support.
  • We looked for evidence on: Alcohol-related liver disease, Chemotherapy-induced hepatotoxicity, Gallbladder disease, Hepatitis, Hepatitis B, Hepatitis C — 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 backing these ingredients is mixed. Beet shows possibly effective evidence for athletic performance and exercise-related muscle soreness.

Inositol is possibly effective for polycystic ovary syndrome (PCOS), metabolic syndrome, and preterm labor. Milk thistle appears possibly effective for diabetes.

For most other uses—choline for cognitive decline or Alzheimer's disease, inositol for anxiety or depression, watercress, parsley, and betaine HCl for various conditions—the evidence we hold is insufficient to rate them reliably. No effectiveness data is on file for watercress.

The evidence, ingredient by ingredient Choline Beet Inositol Watercress Parsley Betaine Hydrochloride Milk Thistle

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

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

Why this rating?
  • We hold adverse-effect (side-effect) data for 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Choline is well tolerated at normal doses but can cause fishy body odor, and at very high doses (over 3.5 grams daily) may trigger nausea, vomiting, diarrhea, and sweating. Beet is generally well tolerated and commonly eaten; concentrated supplements lack safety data.

Inositol commonly causes mild digestive side effects like diarrhea, gas, and nausea. Watercress is safe as a food but should not be consumed raw and wild due to parasite risk.

Parsley in food amounts is safe, but large medicinal doses can cause serious effects including hemolytic anemia and kidney problems. Betaine HCl may irritate the stomach and is unsafe for people with ulcers or gastritis.

Milk thistle is generally well tolerated, though gastrointestinal symptoms and rare allergic reactions have been reported. Regarding pregnancy: choline is likely safe; inositol is possibly safe; watercress and parsley are likely unsafe and should be avoided; betaine HCl safety is unknown, so it's best avoided; and milk thistle safety is not well established, so it's best avoided.

For breastfeeding, choline and inositol lack sufficient data—talk to your doctor before using. Watercress and parsley safety data for breastfeeding is not on file.

Betaine HCl and milk thistle safety during breastfeeding is not established.

Side effects, ingredient by ingredient Choline Beet Inositol Watercress Parsley Betaine Hydrochloride Milk Thistle

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?
  • 7 of the 7 matched ingredients can interact with medications — Milk Thistle, Inositol, Beet, Betaine Hydrochloride, Watercress, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; lithium.
  • For scale: 1,203 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.

Check with your pharmacist before taking this if you use blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel, apixaban), diabetes medications, diuretics, acid-reflux drugs (H2-blockers, antacids, proton pump inhibitors), or medications metabolized by your liver's CYP3A4 or CYP1A2 enzymes. Also check if you take lithium, morphine, sirolimus, or hepatitis C antivirals like ledipasvir or sofosbuvir.

The combination of ingredients raises the risk of interactions across many drug classes—your own pharmacist can see your complete medication list and advise whether this product is right for you.

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.

Livachol combines ingredients with mixed evidence: beet and inositol have some supporting research for specific uses, while choline, watercress, parsley, and milk thistle lack reliable evidence in our data. The product carries multiple moderate-to-minor interactions with common medications—especially blood thinners, diabetes drugs, and acid-reflux medications—so it's important to check your exact medications before starting.

If you're pregnant, breastfeeding, taking blood thinners or diabetes medications, or have stomach ulcers, talk with your doctor or pharmacist first.

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

Assessment coverage: 7 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2020.

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 Livachol, straight from the product label.

Brand MBi Nutraceuticals
Barcode (UPC) 358301206172
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Aug 23, 2020
DSLD ID 231617
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years)
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 Livachol by MBi Nutraceuticals, 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:
2 Capsule(s)
Maximum serving Sizes:
6 Capsule(s)
Servings per container
60
UPC/BARCODE
358301206172
IngredientAmount% DV
Choline Bitartrate150 mg--
Beet25 mg--
Inositol150 mg--
Watercress25 mg--
Parsley25 mg--
Betaine HCl50 mg--
Milk Thistle25 mg--

Other ingredients: Rice Flour, Rice Flour extract, Magnesium Stearate, 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.
Formula

Livachol is an all natural vitamin and herbal complex that utilizes the natural detoxifying properties of milk thistle, watercress, beets, and parsley. Turn to nature for liver detoxification.

Suggested/Recommended/Usage/Directions

Usage: Two to six capsules daily, following meals.

Precautions

Warning: Keep out of the reach of children.

If tamper resistant seals are broken do not use this product.

FDA Statement of Identity

Liver Detox Supplement

General Statements

Bringing balance back to life

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

See for yourself

Livachol by MBi Nutraceuticals label

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

Livachol 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 Livachol by MBi Nutraceuticals

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 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.

Choline Bitartrate

Interacts with
16 drugs
150 mg per serving

Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like egg...

Choline Bitartrate monograph & interactions

Beet

Interacts with
861 drugs
25 mg per serving

Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some peopl...

Beet monograph & interactions

Inositol

Interacts with
86 drugs
150 mg per serving

Inositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, m...

Inositol monograph & interactions

Watercress

Interacts with
6 drugs
25 mg per serving

Watercress is a nutrient-rich leafy green that provides vitamins A, C, and K plus minerals and antioxidant plant compounds. Eaten as a food it is gene...

Watercress monograph & interactions

Parsley

Interacts with
443 drugs
25 mg per serving

Parsley is a popular culinary herb that is safe to eat in normal food amounts and is a good source of vitamins K and C. It is traditionally used as a...

Parsley monograph & interactions

Betaine HCl

Interacts with
36 drugs
50 mg per serving

Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is l...

Betaine HCl monograph & interactions

Milk Thistle

Interacts with
954 drugs
25 mg per serving

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

Milk Thistle monograph & interactions

Other (inactive) ingredients: Rice Flour, Rice Flour extract, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Livachol by MBi Nutraceuticals Drug Interactions

Want to check YOUR meds against Livachol?

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
1,202Drugs
1,006 Moderate 196 Minor

Ingredients driving the most interactions

Milk Thistle 954
Beet 861
Parsley 443
Inositol 86
Betaine HCl 36

Individual Drug Interactions

The ingredients in Livachol interact with 1,202 drugs. Click any drug to see the details.

7 of the 7 ingredients in Livachol interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle Beet Parsley Inositol Betaine HCl Choline Bitartrate Watercress

Each ingredient & the kinds of drugs it affects

For each ingredient in Livachol with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Milk Thistle17 drug types · 954 drugs

Antidiabetes Drugs

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

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

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

Likelihood Possible Evidence D
Glucuronidated Drugs

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

Likelihood Possible Evidence D
Ledipasvir

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

Likelihood Possible Evidence D
Morphine

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

Likelihood Possible Evidence D
Raloxifene (Evista)

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

Likelihood Possible Evidence D
Sirolimus (Rapamune)

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

Likelihood Possible Evidence B
Sofosbuvir (Solvaldi)

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

Likelihood Possible Evidence D
Tamoxifen (Nolvadex)

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

Likelihood Possible Evidence D
Warfarin (Coumadin)

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

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

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

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

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

Likelihood Unlikely Evidence D
Estrogens

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

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

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

Likelihood Unlikely Evidence D
Indinavir (Crixivan)

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

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

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

Likelihood Possible Evidence D
P-Glycoprotein Substrates

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

Likelihood Unlikely Evidence B
Milk Thistle full monograph & interactions

Beet3 drug types · 861 drugs

Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, beet might increase the levels of CYP3A4 substrates.
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole.

Likelihood Possible Evidence D
Antihypertensive Drugs

Beet and beetroot contain nitrates, which can cause vasodilation, potentially leading to lower blood pressure. However, a study published in the European Journal of Clinical Nutrition using concentrated beetroot juice found no significant impact on blood pressure or heart rate in different age groups. Other small clinical studies suggest that while beet consumption might transiently lower blood pressure due to vessel dilation, there's no consistent evidence of a lasting effect. Overall, the theoretical risk of reduced blood pressure due to beet's nitrate content exists, but studies generally indicate a low and temporary impact rather than a sustained decrease.

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

Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research suggests that beet induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Beet full monograph & interactions

Parsley8 drug types · 443 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, parsley might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Animal research suggests that parsley has antiplatelet effects.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, parsley might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that parsley might decrease blood glucose. Monitor blood glucose levels closely. Dose adjustments might be necessary.

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

Theoretically, parsley might increase serum levels of CYP1A2 substrates.
Laboratory research suggests that parsley can inhibit CYP1A2.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, parsley might enhance or interfere with the effects of diuretic drugs.
Animal research suggests that parsley seed extract increases urine elimination. Parsley leaf and root might also interfere with diuretic therapy due their purported aquaretic effects.

Likelihood Possible Evidence D
Pentobarbital (Nembutal)

Theoretically, parsley might increase the duration of pentobarbital effects.
Animal research suggests that parsley juice prolongs the action of pentobarbital, perhaps by decreasing cytochrome P450 levels. It is not known if this occurs in humans or if this applies to other barbiturates or sedatives.

Likelihood Possible Evidence D
Sirolimus (Rapamune)

Theoretically, large quantities of parsley might increase sirolimus levels.
In one case report, an adult female with a history of kidney transplant presented with elevated blood sirolimus levels, approximately 4-7 times greater than previous measures, after daily consumption of a juice containing approximately 30 grams of parsley for 7 days. Sirolimus levels returned to normal a week after the parsley juice was discontinued.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, large amounts of parsley leaf and root might decrease the effects of warfarin.
Parlsey contains vitamin K.

Likelihood Possible Evidence D
Aspirin

Theoretically, aspirin might increase the severity of allergic reactions to parsley.
In one case, severe urticaria and swelling were reported after taking aspirin with parsley in an individual with a known mild parsley allergy.

Likelihood Unlikely Evidence D
Parsley full monograph & interactions

Inositol1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that inositol lowers blood glucose levels and glycated hemoglobin (HbA1c) levels in patients with diabetes.

Likelihood Possible Evidence A
Inositol full monograph & interactions

Betaine HCl3 drug types · 36 drugs

Antacids

Betaine hydrochloride increases stomach acidity and could decrease the effects of antacids.
In human research, betaine hydrochloride increases stomach acidity. Antacids are taken to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with antacids might decrease the effects of the antacids.

Likelihood Possible Evidence D
H2-Blockers

Betaine hydrochloride increases stomach acidity and could decrease the effects of H2-blockers.
In human research, betaine hydrochloride increases stomach acidity. H2-blockers are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with H2-blockers might decrease the effects of H2-blockers.

Likelihood Possible Evidence D
Proton Pump Inhibitors (Ppis)

Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.
In human research, betaine hydrochloride increases stomach acidity. PPIs are used to decrease stomach acidity. Theoretically, taking betaine hydrochloride along with PPIs might decrease the effects of PPIs

Likelihood Possible Evidence D
Betaine HCl full monograph & interactions

Choline Bitartrate1 drug type · 16 drugs

Atropine

Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.

Likelihood Possible Evidence D
Choline Bitartrate full monograph & interactions

Watercress3 drug types · 6 drugs

Chlorzoxazone (Parafon Forte, Paraflex)

Watercress might reduce the metabolism of chlorzoxazone and increase its effects and side effects. Clinical research in healthy volunteers shows that a single ingestion of watercress 50 grams increases the chlorzoxazone plasma concentration-time curve by about 56% and increases its half-life by about 53%.

Likelihood Probable Evidence B
Lithium

Watercress is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, watercress might reduce excretion and increase levels of lithium.

Likelihood Probable Evidence D
Warfarin (Coumadin)

Watercress contains vitamin K. Consuming large amounts of watercress might antagonize the anticoagulant effects of warfarin.

Likelihood Possible Evidence B
Watercress full monograph & interactions
The maker

Brand information

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

MBi Nutraceuticals

See all MBi Nutraceuticals products
Name
MBi Nutraceuticals
Street Address
211 N 1800 W
City
Lindon
State
UT
ZipCode
84042
Phone Number
801-796-8742
Pharmacist Counseling Corner

Livachol by MBi Nutraceuticals: Common Questions

Does Livachol by MBi Nutraceuticals interact with any medications?
Yes. Based on its ingredients, Livachol has a known interaction with 1,202 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Livachol contains 7 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take Livachol if I'm pregnant or breastfeeding?
Choline is likely safe in pregnancy, and inositol is possibly safe, but watercress and parsley are likely unsafe in pregnancy and should be avoided. For breastfeeding, choline and inositol lack enough data—talk with your doctor before using any of these. Betaine HCl and milk thistle safety in pregnancy and breastfeeding is not well established, so those are best avoided as well. Ask your doctor or pharmacist which ingredients, if any, are appropriate for your situation.
What are the most common side effects?
Choline can cause fishy body odor at regular doses. Inositol commonly causes mild gas, diarrhea, or nausea. Beet may turn your urine and stools red, which is harmless. Milk thistle may cause bloating, diarrhea, nausea, or indigestion—though these usually occur no more often than with placebo. Watercress and parsley in food amounts are well tolerated, but the doses in a supplement haven't been well studied.
Does this product actually work?
Evidence varies by ingredient. Beet is possibly effective for athletic performance and exercise-related muscle soreness. Inositol is possibly effective for polycystic ovary syndrome, metabolic syndrome, and preterm labor. Milk thistle is possibly effective for diabetes. For the other ingredients and conditions, reliable evidence is insufficient or missing from the data we hold.
Why does this product have so many interactions?
Livachol contains seven active ingredients, each with different effects on how your body processes medications. Milk thistle, parsley, and beet all affect liver enzymes that break down drugs, while choline, inositol, watercress, and parsley can enhance or interfere with specific medication classes. The more ingredients in a product, the higher the chance of overlapping interactions with your medications.
Is betaine HCl safe if I have acid reflux?
No. Betaine HCl increases stomach acid, so it's unsafe for people with acid reflux, ulcers, or gastritis. If you have any of these conditions, avoid this product or ask your doctor first.
What is milk thistle for?
Milk thistle is traditionally used for liver support. The evidence we hold shows it's possibly effective for diabetes, but for other liver conditions or uses, reliable evidence is insufficient. It's generally well tolerated, though gastrointestinal side effects like nausea, bloating, and diarrhea can occur.

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.

Livachol label
Go deeper

The Full Monographs Behind Livachol’s Ingredients

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

Herb & supplement monograph

Choline

Interacts with 16 drugs

Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help...

Read the full Choline monograph → Herb & supplement monograph

Beet

Interacts with 861 drugs

Beet, especially beetroot juice, is a nitrate-rich food that may modestly lower blood pressure and slightly improve exercise performance in some people. It is generally safe as a food, but s...

Read the full Beet monograph → Herb & supplement monograph

Inositol

Interacts with 86 drugs

Inositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, mood, and metabolic concerns. The stronge...

Read the full Inositol monograph → Herb & supplement monograph

Watercress

Interacts with 6 drugs

Watercress is a nutrient-rich leafy green that provides vitamins A, C, and K plus minerals and antioxidant plant compounds. Eaten as a food it is generally safe and healthy for most people,...

Read the full Watercress monograph → Herb & supplement monograph

Parsley

Interacts with 443 drugs

Parsley is a popular culinary herb that is safe to eat in normal food amounts and is a good source of vitamins K and C. It is traditionally used as a diuretic and for digestion, but solid hu...

Read the full Parsley monograph → Herb & supplement monograph

Betaine Hydrochloride

Interacts with 36 drugs

Betaine hydrochloride is a supplement used to temporarily increase stomach acid in people who may have low acid levels. Evidence for its benefits is limited and mostly based on tradition rat...

Read the full Betaine Hydrochloride 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 →
Sources

Sources & How We Checked

Livachol'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 168 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.

Choline 14 references
  1. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
  2. Cho E, Willett WC, Colditz GA, et al. Dietary choline and betaine and the risk of distal colorectal adenoma in women. J Natl Cancer Inst 2007;99:1224-31. PubMed
  3. Schmidt, C., Abicht, A., Krampfl, K., Voss, W., Stucka, R., Mildner, G., Petrova, S., Schara, U., Mortier, W., Bufler, J., Huebner, A., and Lochmuller, H. Congenital myasthenic syndrome due to a novel missense mutation in the gene encoding choline acetyl
  4. Tamminga, C., Smith, R. C., Chang, S., Haraszti, J. S., and Davis, J. M. Depression associated with oral choline. Lancet 10-23-1976;2(7991):905. PubMed
  5. Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
  6. Growdon, J. H. and Gelenberg, A. J. Choline and lecithin administration to patients with tardive dyskinesia. Trans.Am.Neurol.Assoc. 1978;103:95-99.
  7. Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318. PubMed
  8. Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
  9. Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5
  10. Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. PubMed
  11. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res. 2013;33(11):897-904. PubMed
  12. Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015;102(5): 1113-25.
  13. Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8. PubMed
  14. Food and Nutrition Board, Institute of Medicine. Choline. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington D.C.: National Academy Press; 1998:390-422.

See these in context on the Choline monograph →

Beet 14 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Clifford T, Berntzen B, Davison GW, et al. Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 2016;8. pii: E506. PubMed
  3. Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143:818-26. PubMed
  4. Clifford T, Howatson G, West DJ, Stevenson EJ. Beetroot juice is more beneficial than sodium nitrate for attenuating muscle pain after strenuous eccentric-bias exercise. Appl Physiol Nutr Metab. 2017;42(11):1185-1191. PubMed
  5. Clifford T, Bell O, West DJ, Howatson G, Stevenson EJ. The effects of beetroot juice supplementation on indices of muscle damage following eccentric exercise. Eur J Appl Physiol. 2016;116(2):353-62. PubMed
  6. Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol (1985). 2013;115(3):325-36. PubMed
  7. Garnacho-Castaño MV, Palau-Salvà G, Cuenca E, et al. Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes. J Int Soc Sports Nutr. 2018;15(1):49. PubMed
  8. Rasica L, Porcelli S, Marzorati M, et al. Ergogenic effects of beetroot juice supplementation during severe-intensity exercise in obese adolescents. Am J Physiol Regul Integr Comp Physiol. 2018;315(3):R453-R460. PubMed
  9. Henrohn D, Björkstrand K, Lundberg JO, et al. Effects of oral supplementation with nitrate-rich beetroot juice in patients with pulmonary arterial hypertension-results from BEET-PAH, an exploratory randomized, double-blind, placebo-controlled, crosso
  10. Serra-Payá N, Garnacho-Castaño MV, Sánchez-Nuño S, et al. The relationship between resistance exercise performance and ventilatory efficiency after beetroot juice intake in well-trained athletes. Nutrients 2021;13(4):1094. PubMed
  11. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  12. Hemmatinafar M, Zaremoayedi L, Koushkie Jahromi M, et al. Effect of Beetroot Juice Supplementation on Muscle Soreness and Performance Recovery after Exercise-Induced Muscle Damage in Female Volleyball Players. Nutrients 2023;15(17):3763. PubMed
  13. Lim SH, Bae S, Lee HS, Han HK, Choi CI. Effect of Betanin, the Major Pigment of Red Beetroot (Beta vulgaris L.), on the Activity of Recombinant Human Cytochrome P450 Enzymes. Pharmaceuticals (Basel) 2023;16(9):1224. PubMed
  14. Oscherwitz M, Tamayo RM, Heudebert A, Centor R. A Case of Pseudo-Hematochezia from Beet Supplement Ingestion. Am J Med 2023;136(9):e177-e178. PubMed

See these in context on the Beet monograph →

Inositol 14 references
  1. Palatnik A, Frolov K, Fux M, Benjamin J. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol 2001;21:335-9.. PubMed
  2. Allan SJ, Kavanagh GM, Herd RM, Savin JA. The effect of inositol supplements on the psoriasis of patients taking lithium: a randomized, placebo-controlled trial. Br J Dermatol 2004;150:966-9. PubMed
  3. Machado-Vieira R, Viale CI, Kapczinski F. Mania associated with an energy drink: the possible role of caffeine, taurine, and inositol. Can J Psychiatry 2001;46:454-5. PubMed
  4. Kamenov Z, Kolarov G, Gateva A, Carlomagno G, Genazzani AD. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol Endocrinol 2015;31(2):131-5. PubMed
  5. Matarrelli B, Vitacolonna E, D'Angelo M, et al. Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. J Matern Fetal Neonatal Med 2013;26(1 PubMed
  6. Mukai T, Kishi T, Matsuda Y, Iwata N. A meta-analysis of inositol for depression and anxiety disorders. Hum Psychopharmacol 2014;29(1):55-63. PubMed
  7. Farren M, Daly N, McKeating A, Kinsley B, Turner MJ, Daly S. The Prevention of Gestational Diabetes Mellitus With Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial. Diabetes Care. 2017;40(6):759-63. PubMed
  8. Zheng X, Liu Z, Zhang Y, et al. Relationship Between Myo-Inositol Supplementary and Gestational Diabetes Mellitus: A Meta-Analysis. Medicine (Baltimore). 2015;94(42):e1604. PubMed
  9. Crawford TJ, Crowther CA, Alsweiler J, Brown J. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes. Cochrane Database Syst Rev. 2015;(12):CD011507. PubMed
  10. Maurizi AR, Menduni M, Del Toro R, et al. A pilot study of D-chiro-inositol plus folic acid in overweight patients with type 1 diabetes. Acta Diabetol. 2017;54(4):361-65. PubMed
  11. Leppink EW, Redden SA, Grant JE. A double-blind, placebo-controlled study of inositol in trichotillomania. Int Clin Psychopharmacol. 2017;32(2):107-14. PubMed
  12. Lam S, Mandrekar SJ, Gesthalter Y. A Randomized Phase IIb Trial of myo-Inositol in Smokers with Bronchial Dysplasia. Cancer Prev Res (Phila). 2016;9(12):906-14.
  13. Wozniak J, Faraone SV, Chan J, et al. A randomized clinical trial of high eicosapentaenoic acid omega-3 fatty acids and inositol as monotherapy and in combination in the treatment of pediatric bipolar spectrum disorders: a pilot study. J Clin Psychiatry. PubMed
  14. Vitale SG, Corrado F, Caruso S, et al. Myo-inositol supplementation to prevent gestational diabetes in overweight non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric and neonatal outcomes - a randomized and open-label, placebo-

See these in context on the Inositol monograph →

Watercress 34 references
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. Leclercq I, Desager JP, Horsmans Y. Inhibition of chlorzoxazone metabolism, a clinical probe for CYP2E1, by a single ingestion of watercress. Clin Pharmacol Ther 1998;64:144-9. PubMed
  4. Bolton-Smith C, Price RJ, Fenton ST, et al. Compilation of a provisional UK database for the phylloquinone (vitamin K1) content of foods. Br J Nutr 2000;83:389-99.
  5. Rondelaud, D., Dreyfuss, G., Bouteille, B., and Darde, M. L. Changes in human fasciolosis in a temperate area: about some observations over a 28-year period in central France. Parasitol.Res 2000;86(9):753-757. PubMed
  6. Sanchez-Sosa, S., Rojas-Ortega, S., Reed-San Roman, G., and Torres-Santana, M. A. [Massive hepatobiliary fascioliasis]. Rev Gastroenterol.Mex. 2000;65(4):179-183.
  7. van Daele, P. L., Madretsma, G. S., and van Agtmael, M. A. [Stomach ache and fever after consumption of watercress in Turkey: fascioliasis]. Ned.Tijdschr.Geneeskd. 9-29-2001;145(39):1896-1899.
  8. Cosme, A., Ojeda, E., Cilla, G., Torrado, J., Alzate, L., Beristain, X., Orive, V., and Arenas, J. [Fasciola hepatica. study of a series of 37 patients]. Gastroenterol.Hepatol. 2001;24(8):375-380.
  9. Martinez-Bebert, K., Rodriguez-Baez, R., Pila-Perez, R., Pila-Pelaez, R., and Tamakloe, K. [Hepatic hematoma caused by fascioliasis]. Gac.Med Mex. 2002;138(3):271-274.
  10. Dreyfuss, G., Vignoles, P., Abrous, M., and Rondelaud, D. Unusual snail species involved in the transmission of Fasciola hepatica in watercress beds in central France. Parasite 2002;9(2):113-120.
  11. Christmann, M., Henrich, R., Mayer, G., and Ell, C. [Infection with fasciola hepatica causing elevated liver-enzyme results and eosinophilia - serologic and endoscopic diagnosis and therapy]. Z.Gastroenterol. 2002;40(9):801-806.
  12. Cosme, A., Ojeda, E., Poch, M., Bujanda, L., Castiella, A., and Fernandez, J. Sonographic findings of hepatic lesions in human fascioliasis. J Clin Ultrasound 2003;31(7):358-363. PubMed
  13. Sapunar, J., Latorre, R., Guerra, M., and Defilippi, C. [Clinical considerations on 2 cases of hepatic fascioliasis. Importance of the imaging examinations]. Bol.Chil.Parasitol. 1992;47(3-4):70-76.
  14. de Gorgolas, M., Torres, R., Verdejo, C., Garay, J., Robledo, A., Ponte, M. C., and Fernandez Guerrero, M. L. [Fasciola hepatica infestation. Biopathology and new diagnostic and therapeutic aspects]. Enferm.Infecc.Microbiol.Clin 1992;10(9):514-519.
  15. Carrada-Bravo, T. [Fascioliasis: diagnosis, epidemiology and treatment]. Rev Gastroenterol.Mex. 2003;68(2):135-142.
  16. Yilmaz, H. and Godekmerdan, A. Human fasciolosis in Van province, Turkey. Acta Trop. 2004;92(2):161-162.
  17. Dobrucali, A., Yigitbasi, R., Erzin, Y., Sunamak, O., Polat, E., and Yakar, H. Fasciola hepatica infestation as a very rare cause of extrahepatic cholestasis. World J Gastroenterol. 10-15-2004;10(20):3076-3077. PubMed
  18. Alvarez-Chacon, R., Garcia-Rosales, J. J., de la Cruz-Otero MC, Wong-Chio, M., Cabrera-Bravo, M., Gomez-Gomez, J. V., and Gamez-Aranda, V. [Fascioliasis in children. A study of 10 cases]. Bol.Med Hosp.Infant Mex. 1992;49(6):365-371.
  19. Mailles, A., Capek, I., Ajana, F., Schepens, C., Ilef, D., and Vaillant, V. Commercial watercress as an emerging source of fascioliasis in Northern France in 2002: results from an outbreak investigation. Epidemiol.Infect. 2006;134(5):942-945.
  20. Cruz, Lopez O., Adan, Pimentel A., Tamariz Cruz, O. J., Munoz, Lopez A., Cruz Lopez, M. C., Cruz Lopez, M. E., and Munoz, Lopez S. [Hepatic fasciolasis diagnosed in state phase]. Rev Gastroenterol Mex. 2006;71(1):59-62.
  21. el Shazly, A. M., Handousa, A. E., Youssef, M. E., Rizk, H., and Hamouda, M. M. Human fascioliasis: a parasitic health problem in Dakahlia Governorate, Egypt. J Egypt.Soc Parasitol. 1991;21(2):553-559.
  22. Cosme, A., Alzate, L., Orive, V., Recasens, M., Torrado, J., Ruiz, I., and Arenas, J. [Laparoscopic findings in liver fascioliasis. Study of 13 cases]. Rev Esp.Enferm.Dig. 1990;78(6):359-362.
  23. Diaz, J., Pina, B., Lastre, M., Rivera, L., and Perez, O. [Epidemic human fascioliasis. Cuba 1983. VI. Clinical study of 40 children in the Hospital Provincial of Sagua la Grande]. G.E.N. 1990;44(4):385-388.
  24. Borie, C., Corona, S., Garin, A., Olea, P., Salcedo, M., Perez, C., and Apt, W. [A family outbreak of acute hepatic fascioliasis]. Rev Med Chil. 1990;118(1):67-72.
  25. Diamond, S. P., Wiener, S. G., and Marks, J. G., Jr. Allergic contact dermatitis to nasturtium. Dermatol.Clin. 1990;8(1):77-80. DOI
  26. Delasalle, P., Beytout, J., Cambon, M., and Bommelaer, G. [Distomatosis: diagnosis and treatment]. Rev Prat. 1-21-1990;40(3):230-236.
  27. Rivera, J. V. and Bermudez, R. H. Radionuclide imaging of the liver in human fascioliasis. Clin Nucl.Med 1984;9(8):450-453. PubMed
  28. Croese, J., Chapman, G., and Gallagher, N. D. Evolution of fascioliasis after eating wild watercress. Aust.N.Z.J.Med. 1982;12(5):525-527. PubMed
  29. Bendezu, P., Frame, A., and Hillyer, G. V. Human fascioliasis in Corozal, Puerto Rico. J Parasitol. 1982;68(2):297-299. DOI
  30. Derrick, E. and Darley, C. Contact dermatitis to nasturtium. Br.J Dermatol 1997;136(2):290-291. PubMed
  31. Narain, K., Biswas, D., Rajguru, S. K., and Mahanta, J. Human distomatosis due to Fasciola hepatica infection in Assam, India. J Commun.Dis 1997;29(2):161-165.
  32. Brinker, F. Herb Contraindications and Drug Interactions. 1998;2nd edition.
  33. Gruenwald, J. PDR for Herbal Medicines. 1998;1st ed.
  34. Clemente M, Miguel MD, Felipe KB, et al. Effect of watercress extract supplementation on lipid profile and oxidative stress markers in overweight people with physical disability: A randomized, double-blind, and placebo-controlled trial. Phytother Res. 202 PubMed

See these in context on the Watercress monograph →

Parsley 21 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  4. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  5. Robbers JE, Tyler VE. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press, 1999.
  6. Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999. DOI
  7. Eberhard P, Gall HM, Muller I, Moller R. Dramatic augmentation of a food allergy by acetylsalicylic acid. J Allergy Clin Immunol 2000;105:844 PubMed
  8. Tunali T, Yarat A, Yanardag R, et al. Effect of parsley (Petroselinum crispum) on the skin of STZ induced diabetic rats. Phytother Res 1999;13:138-41.. DOI
  9. Chuang CH, Doyle P, Wang JD, et al. Herbal medicines used during the first trimester and major congenital malformations: an analysis of data from a pregnancy cohort study. Drug Saf 2006;29:537-48. PubMed
  10. Ciganda C, and Laborde A. Herbal infusions used for induced abortion. J Toxicol.Clin Toxicol. 2003;41:235-239. PubMed
  11. Jakovljevic, V., Raskovic, A., Popovic, M., and Sabo, J. The effect of celery and parsley juices on pharmacodynamic activity of drugs involving cytochrome P450 in their metabolism. Eur.J Drug Metab Pharmacokinet. 2002;27(3):153-156. PubMed
  12. Kreydiyyeh, S. I. and Usta, J. Diuretic effect and mechanism of action of parsley. J Ethnopharmacol 2002;79(3):353-357. PubMed
  13. Yanardag, R., Bolkent, S., Tabakoglu-Oguz, A., and Ozsoy-Sacan, O. Effects of Petroselinum crispum extract on pancreatic B cells and blood glucose of streptozotocin-induced diabetic rats. Biol Pharm Bull. 2003;26(8):1206-1210. PubMed
  14. Bolkent, S., Yanardag, R., Ozsoy-Sacan, O., and Karabulut-Bulan, O. Effects of parsley (Petroselinum crispum) on the liver of diabetic rats: a morphological and biochemical study. Phytother.Res 2004;18(12):996-999.
  15. Ozsoy-Sacan, O., Yanardag, R., Orak, H., Ozgey, Y., Yarat, A., and Tunali, T. Effects of parsley (Petroselinum crispum) extract versus glibornuride on the liver of streptozotocin-induced diabetic rats. J Ethnopharmacol 3-8-2006;104(1-2):175-181. PubMed
  16. Peterson, S., Lampe, J. W., Bammler, T. K., Gross-Steinmeyer, K., and Eaton, D. L. Apiaceous vegetable constituents inhibit human cytochrome P-450 1A2 (hCYP1A2) activity and hCYP1A2-mediated mutagenicity of aflatoxin B1. Food Chem.Toxicol. 2006;44(9):147 PubMed
  17. Gadi, D., Bnouham, M., Aziz, M., Ziyyat, A., Legssyer, A., Legrand, C., Lafeve, F. F., and Mekhfi, H. Parsley extract inhibits in vitro and ex vivo platelet aggregation and prolongs bleeding time in rats. J Ethnopharmacol 8-17-2009;125(1):170-174. PubMed
  18. Arslan S, Ucar R, Caliskaner AZ. A Cases of Near-fatal Anaphylaxis: Parsley "Over-use" as an Herbal Remedy. Med Arch. 2014;68(6):426-7.
  19. Foti C, Cassano N, Mistrello G, Amato S, Romita P, Vena GA. Contact urticaria to raw arugula and parsley. Ann Allergy Asthma Immunol. 2011 May;106(5):447-8. PubMed
  20. Farzaei MH, Abbasabadi Z, Ardekani MR, Rahimi R, Farzaei F. Parsley: a review of ethnopharmacology, phytochemistry and biological activities. J Tradit Chin Med. 2013;33(6):815-26. PubMed
  21. Kurtaran M, Koc NS, Aksun MS, Yildirim T, Yilmaz SR, Erdem Y. Petroselinum crispum, a commonly consumed food, affects sirolimus level in a renal transplant recipient: a case report. Ther Adv Drug Saf 2021;12:20420986211009358.

See these in context on the Parsley monograph →

Betaine Hydrochloride 2 references
  1. Yago MR, Frymoyer A, Benet LZ, Smelick GS, Frassetto LA, Ding X, Dean B, Salphati L, Budha N, Jin JY, Dresser MJ, Ware JA. The use of betaine HCl to enhance dasatinib absorption in healthy volunteers with rabeprazole-induced hypochlorhydria. AAPS J. 2014 PubMed
  2. Yago MR, Frymoyer AR, Smelick GS, Frassetto LA, Budha NR, Dresser MJ, Ware JA, Benet LZ. Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria. Mol Pharm. 2013 Nov 4;10(11):4032-7. PubMed

See these in context on the Betaine Hydrochloride 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
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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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