Liver-ND Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Liver-ND 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
Liver-ND is a dietary supplement by Premier Research Labs with 3 active ingredients. Its ingredients are commonly taken for digestive health, supporting gut bacteria (probiotics), lactose-related digestive discomfort.Based on those ingredients, 1,493 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Turmeric, Fermented Milk Thistle Blend. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Liver-ND by Premier Research Labs
Ask about any prescription or over-the-counter medication and we check it for interactions with Liver-ND by Premier Research Labs — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Liver-ND by Premier Research Labs
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Liver-ND is a liquid supplement with four active ingredients: milk thistle, turmeric, milk thistle seed extract, and turmeric rhizome extract. The two milk thistle forms and two turmeric forms deliver the herbal constituents silymarin (from milk thistle) and curcumin (from turmeric) that are thought to support liver health.
The product also contains inactive ingredients: purified water, cane alcohol, and molasses.
Does it work?
Insufficient evidence
For milk thistle, the evidence suggests it's possibly effective for type 2 diabetes. For other conditions the facts list—acne, alcohol-related liver disease, allergic rhinitis, gambling disorder, and amanita poisoning—the evidence isn't established.
For turmeric, it's possibly effective for depression, high cholesterol (hyperlipidemia), hay fever (allergic rhinitis), and indigestion (dyspepsia). Evidence for other uses in the data we hold isn't established.
How safe is it?
Well-documented data
Both milk thistle and turmeric are generally well tolerated in most adults. The most common side effects are mild digestive complaints: bloating, diarrhea, nausea, constipation, and indigestion.
Turmeric has been linked to liver damage in at least 70 supplement cases reported over weeks to months, though most improved after stopping it. Rare allergic reactions, including anaphylaxis, have been reported with milk thistle.
Turmeric is not recommended at medicinal supplement doses during pregnancy without your doctor's approval, though food amounts are likely safe. There isn't enough safety data on either ingredient during breastfeeding, so caution is advised.
Milk thistle should be avoided during pregnancy due to insufficient safety data. If you're pregnant or breastfeeding, talk with your doctor or pharmacist before taking this product.
Meds to double-check
Moderate interaction found
Before taking Liver-ND, check with your doctor or pharmacist if you're on blood thinners like warfarin, diabetes medications, cancer drugs (tamoxifen, topoisomerase inhibitors, doxorubicin), transplant medications (tacrolimus, sirolimus), hepatitis C drugs (ledipasvir, sofosbuvir), morphine, tramadol, sulfasalazine, methotrexate, or drugs metabolized by the CYP2B6 enzyme or the OATP kidney transporter. These are all Moderate severity interactions.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Liver-ND may appeal to you if you're interested in herbal liver support and don't take blood thinners, diabetes drugs, cancer medications, or transplant drugs. If you take any prescription medications—especially anticoagulants, diabetes medicines, chemotherapy, or immunosuppressants—you need to clear this with your own doctor or pharmacist before starting.
Liver conditions require medical supervision, so involve your healthcare provider in the decision.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Liver-ND, straight from the product label.
| Brand | Premier Research Labs |
|---|---|
| Barcode (UPC) | 807735023508 |
| Net contents | 8 Fluid Ounce(s); 235 mL |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2023 |
| DSLD ID | 297543 |
| Product type | Botanical |
| Supplement form | Liquid |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Liver-ND by Premier Research Labs, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Milk Thistle | 0 NP | -- |
| Turmeric | 0 NP | -- |
| Milk Thistle seed extract | 0 NP | -- |
| Turmeric Rhizome Extract | 0 NP | -- |
| Fermented Milk Thistle Blend | 136 mg | -- |
| Fermented Organic Turmeric Blend | 136 mg | -- |
Other ingredients: Water, Purified, Cane Alcohol, Molasses
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Suggested use: take 1/2 tablespoon daily mixed in water or juice or as directed by a health professional. Shake gently before use.
Formula
This product provided premier liver-associated nutrients featuring milk thistle and turmeric ND Technology Novel micro-cultured delivery This premier quality formula is fermented using a unique probiotic culture which allows rapid oral delivery with superior bioenergetic properties.
Probiotic-fermented formula Premier liver-associated phytonutrients
We are proud to offer many OU kosher certified products.
Precautions
Tamper seal: use only if seal is intact.
Consult your health care practitioner if you are pregnant/nursing, taking medications or have a medical condition, before taking this or any other product.
Keep out of reach of children.
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug administration. This product is not intended to diagnose, treat, cure or prevent any disease.
FDA Statement of Identity
Dietary Supplement
Seals/Symbols
OU (Kosher)
Formulation
PRL’s quality guarantee Identity verified Purity verified
Pure vegan
Non-gmo Phytoforensic tested for adulterants No chemical or rad-iation steril- Pathogen microbiology performed Heavy metal tested
FDA-monitored cGMP facility
Fermented in a probiotic culture; probiotic culture inactivated fermentation; preserved with organic cane alcohol
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Liver-ND by Premier Research Labs label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Liver-ND by Premier Research Labs
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size7.4 mL Dosage formLiquid Servings per container31 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.
Fermented Milk Thistle Blend
Interacts with474 drugs
Fermented milk is a food made by culturing milk with helpful bacteria or yeast, and it provides protein, calcium, and probiotics. It is generally safe...
Fermented Milk Thistle Blend monograph & interactionsFermented Organic Turmeric Blend
Other (inactive) ingredients: Water, Purified, Cane Alcohol, Molasses. These complete the product’s ingredient list but are not active constituents.
Liver-ND by Premier Research Labs Drug Interactions
HelloPharmacist Interaction Report
Liver-ND by Premier Research Labs contains milk thistle and turmeric, both of which interact with a substantial number of medications.
The most serious concern is with blood thinners like warfarin (Coumadin)—milk thistle may increase warfarin's effects and raise your bleeding risk.
Read the full breakdown — every affected drug type, severity by severity
Milk thistle's interactions span several drug categories. It may raise blood sugar too much if you're already on diabetes medications, increase levels of drugs broken down by glucuronidation (a liver process), and affect how your body handles morphine, the hepatitis C drug sofosbuvir (Solvaldi), the transplant drug sirolimus (Rapamune), and ledipasvir—all Moderate severity concerns.
It also theoretically inhibits a liver enzyme (CYP2B6) that clears certain medications.
Turmeric adds its own interactions, also Moderate severity. It may reduce the effectiveness of cancer drugs like tamoxifen and topoisomerase inhibitors, increase levels of the transplant drug tacrolimus (Prograf) and the arthritis drug sulfasalazine (Azulfidine), and theoretically affect the pain reliever tramadol and drugs cleared by a kidney transporter called OATP.
Turmeric may also reduce the activity of chemotherapy agents like doxorubicin and have additive liver stress with methotrexate.
Altogether, these interactions span 1,201 individual medications. Check your exact prescriptions with the tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Liver-ND?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Liver-ND interact with 1,493 drugs. Click any drug to see the details.
2 of the 3 ingredients in Liver-ND interact with drugs. Each result below shows which ingredient is responsible. Turmeric Fermented Milk Thistle Blend
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Fermented Milk Thistle BlendImmunosuppressants Moderate
Interaction Summary
Theoretically, fermented milk might decrease the effects of immunosuppressants.
Read the full Fermented Milk Thistle Blend + 6-mercaptopurine interactionTurmeric Rhizome ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + 6-mercaptopurine interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Ado-trastuzumab Emtansine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Liver-ND — through 1 ingredient. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Liver-ND — through 1 ingredient. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Liver-ND — through 1 ingredient. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Abemaciclib interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Abiraterone interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Abiraterone Acetate interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Liver-ND — through 3 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Abrocitinib interactionFermented Milk Thistle BlendImmunosuppressants Moderate
Interaction Summary
Theoretically, fermented milk might decrease the effects of immunosuppressants.
Read the full Fermented Milk Thistle Blend + Abrocitinib interactionMilk Thistle Seed ExtractCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle Seed Extract + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Acalabrutinib interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, P-glycoprotein Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractAntidiabetes Drugs Moderate
Interaction Summary
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Read the full Milk Thistle Seed Extract + Acarbose interactionTurmeric Rhizome ExtractHepatotoxic Drugs, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Fermented Milk Thistle BlendAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, fermented milk might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full Fermented Milk Thistle Blend + Acebutolol interactionTurmeric Rhizome ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Liver-ND — through 1 ingredient. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Acetaminophen interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Aspirin interactionTurmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractAnticoagulant/antiplatelet Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Turmeric Rhizome Extract + Acetaminophen, Aspirin, Caffeine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Butalbital interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Butalbital, Caffeine interactionMilk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Butalbital, Codeine interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionMilk Thistle Seed ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Caffeine, Codeine interactionTurmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionMilk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionTurmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Turmeric Rhizome Extract + Acetaminophen, Caffeine, Isometheptene interactionMilk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Caffeine, Pyrilamine interactionTurmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractHepatotoxic Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
Read the full Turmeric Rhizome Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionMilk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Liver-ND — through 2 ingredients. Tap an ingredient for the detail:
Turmeric Rhizome ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2.
Read the full Turmeric Rhizome Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Liver-ND 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.
Turmeric
Alkylating Agents
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research suggests that curcumin, a constituent of turmeric, inhibits mechlorethamine-induced apoptosis of breast cancer cells by up to 70%. Also, animal research shows that curcumin inhibits cyclophosphamide-induced tumor regression. However, some in vitro research shows that curcumin does not affect the apoptosis capacity of etoposide. Also, other laboratory research suggests that curcumin might augment the cytotoxic effects of alkylating agents. Reasons for the discrepancies may relate to the dose of curcumin and the specific chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have on alkylating agents.
Amlodipine (Norvasc)
Taking turmeric with amlodipine may increase levels of amlodipine.
Animal research shows that giving amlodipine 1 mg/kg as a single dose following the use of turmeric extract 200 mg/kg daily for 2 weeks increases the maximum concentration and area under the curve by 53% and 56%, respectively, when compared with amlodipine alone. Additional animal research shows that taking amlodipine 1 mg/kg with a curcumin 2 mg/kg pretreatment for 10 days increases the maximum concentration and area under the curve by about 2-fold when compared with amlodipine alone.
Anticoagulant/Antiplatelet Drugs
Turmeric may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Curcumin, a constituent of turmeric, has demonstrated antiplatelet effects in vitro. Furthermore, two case reports have found that taking turmeric along with warfarin or fluindione was associated with an increased international normalized ratio (INR). However, one clinical study in healthy volunteers shows that taking curcumin 500 mg daily for 3 weeks, alone or with aspirin 100 mg, does not increase antiplatelet effects or bleeding risk. It is possible that the dose of turmeric used in this study was too low to produce a notable effect.
Antidiabetes Drugs
Theoretically, taking turmeric with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research and case reports suggest that curcumin, a turmeric constituent, can reduce blood glucose levels in patients with diabetes. Furthermore, clinical research in adults with type 2 diabetes shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg decreased postprandial glucose levels for up to 24 hours when compared with glyburide alone, despite the lack of a significant pharmacokinetic interaction. Other clinical studies in patients with diabetes show that taking curcumin daily can reduce blood glucose levels when compared with placebo.
Antitumor Antibiotics
Turmeric has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro and animal research shows that curcumin, a constituent of turmeric, inhibits doxorubicin-induced apoptosis of breast cancer cells by up to 65%. However, curcumin does not seem to affect the apoptosis capacity of daunorubicin. In fact, some research shows that curcumin might augment the cytotoxic effects of antitumor antibiotics, increasing their effectiveness. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agent. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effects, if any, antioxidants such as turmeric have on antitumor antibiotics.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.
In vitro and animal research show that turmeric and its constituents curcumin and curcuminoids inhibit CYP3A4. Also, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking turmeric and cancer medications that are CYP3A4 substrates, including everolimus, ruxolitinib, ibrutinib, and palbociclib, and bortezomib. In another case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels after consuming turmeric powder at a dose of 15 or more spoonfuls daily for ten days prior. It was thought that turmeric increased levels of tacrolimus due to CYP3A4 inhibition.
Conversely, other in vitro research suggests that turmeric induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. An animal model suggests that induction of CYP3A4 occurs after daily curcumin use for 1 week. However, the induction of CYP3A4 by turmeric has not been reported in humans.
Hepatotoxic Drugs
Theoretically, turmeric might increase the risk of liver damage when taken with hepatotoxic drugs.
There is concern that turmeric might cause hepatotoxicity, especially when highly bioavailable formulations are used in high doses.
Methotrexate (Trexall, Others)
Theoretically, turmeric might have additive effects when used with hepatotoxic drugs such as methotrexate.
In one case report, a 39-year-old female taking methotrexate, turmeric, and linseed oil developed hepatotoxicity.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Theoretically, turmeric might increase blood levels of OATP4C1 substrates.
In vitro research shows that the turmeric constituent curcumin competitively inhibits OATP4C1 transport. This transporter is expressed in the kidney and facilitates the renal excretion of certain drugs. Theoretically, taking turmeric might decrease renal excretion of OATP substrates.
Sulfasalazine (Azulfidine)
Turmeric might increase the effects and adverse effects of sulfasalazine.
Clinical research shows that taking the turmeric constituent, curcumin, can increase blood levels of sulfasalazine by 3.2-fold.
Tacrolimus (Prograf)
Turmeric might increase the effects and adverse effects of tacrolimus.
In one case report, a transplant patient presented with acute nephrotoxicity and elevated tacrolimus levels of 29 ng/mL. The patient previously had tacrolimus levels within the therapeutic range at 9.7 ng/mL. Ten days prior to presenting at the emergency room the patient started consumption of turmeric powder at a dose of 15 or more spoonfuls daily. It was thought that turmeric increased levels of tacrolimus due to cytochrome P450 3A4 (CYP3A4) inhibition. In vitro and animal research show that turmeric and its constituent curcumin inhibit CYP3A4.
Talinolol
Turmeric may reduce the absorption of talinolol in some situations.
Clinical research shows that taking curcumin for 6 days decreases the bioavailability of talinolol when taken together on the seventh day. The clinical significance of this effect is unclear.
Tamoxifen (Nolvadex)
Theoretically, turmeric might reduce the levels and clinical effects of tamoxifen.
In a small clinical trial in patients with breast cancer taking tamoxifen 20-30 mg daily, adding curcumin 1200 mg plus piperine 10 mg three times daily reduces the 24-hour area under the curve of tamoxifen and the active metabolite endoxifen by 12.8% and 12.4%, respectively, as well as the maximum concentrations of tamoxifen, when compared with tamoxifen alone. However, in the absence of piperine, the area under the curve for endoxifen and the maximum concentration of tamoxifen were not significantly reduced. Effects were most pronounced in patients who were extensive cytochrome P450 (CYP) 2D6 metabolizers.
Topoisomerase I Inhibitors
Turmeric has antioxidant effects. There is some concern that this may reduce the activity of chemotherapy drugs that generate free radicals. However, research is conflicting.
In vitro research shows that curcumin, a constituent of turmeric, inhibits camptothecin-induced apoptosis of breast cancer cells by up to 71%. However, other in vitro research shows that curcumin augments the cytotoxic effects of camptothecin. Reasons for the discrepancies may relate to the dose of curcumin and the chemotherapeutic agents. Lower doses of curcumin might have antioxidant effects while higher doses might have pro-oxidant effects. More evidence is needed to determine what effect, if any, turmeric might have.
Tramadol (Ultram)
Theoretically, turmeric might increase or decrease levels of tramadol.
Animal research suggests that a single dose of curcumin, a constituent of turmeric, may increase tramadol's maximum concentration (Cmax) by inhibiting metabolism, while continued daily use for 7 days may reduce the area under the curve (AUC) due to the induction of drug-metabolizing enzymes such as cytochrome P450 3A4 (CYP3A4). However, this interaction has not been reported in humans.
Warfarin (Coumadin)
Turmeric might increase the risk of bleeding with warfarin.
One case of increased international normalized ratio (INR) has been reported for a patient taking warfarin who began taking turmeric. Prior to taking turmeric, the patient had stable INR measurements. Within a few weeks of starting turmeric supplementation, the patient's INR increased to 10. Additionally, curcumin, the active constituent in turmeric, has demonstrated antiplatelet effects in vitro, which may produce additive effects when taken with warfarin.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, turmeric might increase levels of drugs metabolized by CYP1A2. However, research is conflicting.
In vitro and animal research show that the turmeric constituent, curcumin, inhibits CYP1A2. However, other in vitro research suggests that curcumin does not significantly affect CYP1A2.
Docetaxel (Taxotere)
Theoretically, turmeric might increase blood levels of oral docetaxel.
Animal research suggests that the turmeric constituent, curcumin, enhances the oral bioavailability of docetaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Estrogens
Theoretically, large amounts of turmeric might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research shows that curcumin, a constituent of turmeric, displaces the binding of estrogen to its receptors.
Glyburide (Diabeta, Others)
Theoretically, taking turmeric and glyburide in combination might increase the risk of hypoglycemia.
Clinical research shows that taking curcumin 475 mg daily for 10 days prior to taking glyburide 5 mg increases blood levels of glyburide by 12% at 2 hours after the dose in patients with type 2 diabetes. While maximal blood concentrations of glyburide were not affected, turmeric modestly decreased postprandial glucose levels for up to 24 hours when compared to glyburide alone, possibly due to the hypoglycemic effect of turmeric demonstrated in animal research.
Losartan (Cozaar)
Theoretically, turmeric might increase the effects of losartan.
Research in hypertensive rats shows that taking turmeric can increase the hypotensive effects of losartan.
Norfloxacin (Noroxin)
Theoretically, turmeric might increase the effects and adverse effects of norfloxacin.
Animal research shows that taking curcumin, a turmeric constituent, can increase blood levels of orally administered norfloxacin.
P-Glycoprotein Substrates
Theoretically, turmeric might increase the absorption of P-glycoprotein substrates.
In vitro and animal research shows that curcuminoids and other constituents found in turmeric can inhibit P-glycoprotein expression and activity.
Paclitaxel (Abraxane, Onxol)
Theoretically, turmeric might alter blood levels of paclitaxel, although any effect may not be clinically relevant.
Clinical research in adults with breast cancer receiving intravenous paclitaxel suggests that taking turmeric may modestly alter paclitaxel pharmacokinetics. Patients received paclitaxel on day 1, followed by either no treatment or turmeric 2 grams daily from days 2-22. Pharmacokinetic modeling suggests that turmeric reduces the maximum concentration and area under the curve of paclitaxel by 12.1% and 7.7%, respectively. However, these changes are not likely to be considered clinically relevant. Conversely, animal research suggests that curcumin, a constituent of turmeric, enhances the oral bioavailability of paclitaxel. However, the significance of this interaction is unclear, as this drug is typically administered intravenously in clinical settings.
Fermented Milk Thistle Blend
Antibiotic Drugs
Theoretically, antibiotic drugs might decrease the effectiveness of fermented milk.
Some fermented milk preparations contain live and active organisms, including lactobacilli and bifidobacteria strains. Simultaneously taking antibiotics might kill a significant number of these organisms. Tell patients to separate administration of antibiotics and fermented milk preparations by at least 2 hours.
Antihypertensive Drugs
Theoretically, fermented milk might increase the risk of hypotension when taken with antihypertensive drugs.
Clinical research shows that drinking fermented milk can decrease systolic, but not diastolic, blood pressure in some patients.
Immunosuppressants
Theoretically, fermented milk might decrease the effects of immunosuppressants.
Clinical research suggests that fermented milk has immunostimulant effects.
Brand information
Manufacturer and brand details for Liver-ND, from the product label.
Liver-ND by Premier Research Labs: Common Questions
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Liver-ND’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Fermented Milk
Interacts with 474 drugsFermented milk is a food made by culturing milk with helpful bacteria or yeast, and it provides protein, calcium, and probiotics. It is generally safe for most people and may help digestion...
Read the full Fermented Milk monograph → Herb & supplement monographMilk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph → Herb & supplement monographTurmeric
Interacts with 1,133 drugsTurmeric is a popular spice whose main active compounds, curcuminoids, are studied mostly for inflammation and joint pain. Some research is promising, but quality is mixed and curcumin is po...
Read the full Turmeric monograph →Sources & How We Checked
Liver-ND's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 187 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Milk Thistle 69 references
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- Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.g
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- 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
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- 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.
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- van Erp NP, Baker SD, Zhao M, et al. Effect of milk thistle (Silybum marianum) on the pharmacokinetics of irinotecan. Clin Cancer Res 2005;11:7800-6.
- Budzinski JW, Trudeau VL, Drouin CE, et al. Modulation of human cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) in Caco-2 cell monolayers by selected commercial-source milk thistle and goldenseal products. Can J Physiol Pharmacol 2007;85:966-78.
- Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011;25:21-7. PubMed
- Jiao Z, Shi XJ, Li ZD, et al. Population pharmacokinetics of sirolimus in de novo Chinese adult renal transplant patients. Br.J.Clin.Pharmacol. 2009;68(1):47-60.
- Gurley, B. J., Barone, G. W., Williams, D. K., Carrier, J., Breen, P., Yates, C. R., Song, P. F., Hubbard, M. A., Tong, Y., and Cheboyina, S. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin phar
- Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. PubMed
- Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. PubMed
- Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
- Hussain, S. A. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J.Med.Food 2007;10(3):543-547. PubMed
- El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally, M., Mikhail, N., Hashem, M., Mousa, A., Aboul-Fotouh, A., El-Kassas, M., Esmat, G., and Strickland, G. T. A randomized controlled trial to assess the safety and effic
- Gharagozloo, M., Moayedi, B., Zakerinia, M., Hamidi, M., Karimi, M., Maracy, M., and Amirghofran, Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam.Clin.Pharmaco
- Ladas, E. J., Kroll, D. J., Oberlies, N. H., Cheng, B., Ndao, D. H., Rheingold, S. R., and Kelly, K. M. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL PubMed
- Sayyah, M., Boostani, H., Pakseresht, S., and Malayeri, A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog.Neuropsychopharmacol.Biol.Psychiatry 3-17-2010;34(2):362-365. PubMed
- Flaig, T. W., Glode, M., Gustafson, D., van, Bokhoven A., Tao, Y., Wilson, S., Su, L. J., Li, Y., Harrison, G., Agarwal, R., Crawford, E. D., Lucia, M. S., and Pollak, M. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients w
- Ramirez-Santos, A., Perez-Bustillo, A., Gonzalez-Sixto, B., Suarez-Amor, O., and Rodriguez-Prieto, M. A. [Acute generalized exanthematous pustulosis due to milk thistle (Silybum marianum) tea]. Actas Dermosifiliogr. 2011;102(9):744-745. DOI
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- Fried, M. W., Navarro, V. J., Afdhal, N., Belle, S. H., Wahed, A. S., Hawke, R. L., Doo, E., Meyers, C. M., and Reddy, K. R. Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon t
- Fallah Huseini, H., Larijani, B., Fakhrzadeh, H., Rajabi Pour, B., Akhondzadeh, S., Toliat, T., and Heshmat, R. The clinical trial of Silybum Marianum seed extract (Silymarin) on type II diabetic patients with hyperlipidemia. Iran J.Diabetes Lipid Disord
- Mironets VI, Krasovskaia EA, and Polishchuk II. [A case of urticaria during Carsil treatment]. Vrach Delo 1990;7:86-87.
- Velussi M, Cernigoi AM, Viezzoli L, and et al. Silymarin reduces hyperinsulinemia, malondialdehyde levels, and daily insulin need in cirrhotic diabetic patients. Curr Ther Res 1993;53(5):533-545. DOI
- Marcelli R, Bizzoni P, Conte D, and et al. Randomized controlled study of the efficacy and tolerability of a short course of IdB 1016 in the treatment of chronic persistent hepatitis. Eur Bull Drug Res 1992;1(3):131-135.
- Vailati A, Aristia L, Sozze E, and et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia 1993;64(3):219-228.
- Marena C and Lampertico M. Preliminary clinical development of silipide: a new complex of silybin in toxic liver disorders. Planta Med 1991;57(2):A124-A125. DOI
- Grungreiff K, Albrecht M, and Strenge-Hesse A. Benefit of medicinal liver therapy in general practice. Med Welt 1995;46:222-227.
- Frerick F, Kuhn U, and Strenge-Hesse A. Silymarin--ein Phytopharmakon zur Behandlung toxischen Leberschaden: Anwendungsbeobachtung bei 2169 Patienten. Kassenarzt 1990;33:36-41.
- Schuppan D, Strosser W, Burkard G, and et al. Influence of Legalon(TM) 140 on the metabolism of collagen in patients with chronic liver disease--Review by measurement of PIIINP-values. Zeitschrift fur Allgemeinmedizin 1998;74:577-584.
- Studlar M. Die Behandlung chronischer Leberkrankungen mit Silymarin und B-Vitaminen. Therapiewoche 1985;35:3375-3378.
- Anon. Adverse reaction: milk thistle-associated toxicity. Nurse Drug Alert 1999;23(7):51.
- Gufford BT, Chen G, Vergara AG, et al. Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction. Drug Metab Dispos. 2015;43(9):1353-9. PubMed
- El-Shitany NA, Hegazy S, El-Desoky K. Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinylestradiol in ovariectomized rats. Phytomedicine. 2010;17(2):116-25. PubMed
- Seidlová-Wuttke D, Becker T, Christoffel V, Jarry H, Wuttke W. Silymarin is a selective estrogen receptor beta (ERbeta) agonist and has estrogenic effects in the metaphysis of the femur but no or antiestrogenic effects in the uterus of ovariectomized (ovx
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Derosa G, Romano D, D'Angelo A, Maffioli P. Berberis aristata/Silybum marianum fixed combination (Berberol(®)) effects on lipid profile in dyslipidemic patients intolerant to statins at high dosages: a randomized, placebo-controlled, clinical trial. Phyto PubMed
- Luangchosiri C, Thakkinstian A, Chitphuk S, Stitchantrakul W, Petraksa S, Sobhonslidsuk A. A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury. BMC Complement Altern Med. 2015;15:334. PubMed
- Kawaguchi-Suzuki M, Frye RF, Zhu HJ, et al. The effects of milk thistle (Silybum marianum) on human cytochrome P450 activity. Drug Metab Dispos. 2014;42(10):1611-6. PubMed
- Rastegarpanah M, Malekzadeh R, Vahedi H, et al. A randomized, double blinded, placebo-controlled clinical trial of silymarin in ulcerative colitis. Chin J Integr Med. 2015;21(12):902-6. PubMed
- Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:8 PubMed
- Di Pierro F, Villanova N, Agostini F, Marzocchi R, Soverini V, Marchesini G. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control. Diabetes Metab Syndr Obes. 2012;5:213-7. PubMed
- Guarino G, Strollo F, Carbone L, et al. Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Bilybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes. J Biol Regul Homeos
- Ebrahimpour-Koujan S, Gargari BP, Mobasseri M, Valizadeh H, Asghari-Jafarabadi M. Lower glycemic indices and lipid profile among type 2 diabetes mellitus patients who received novel dose of Silybum marianum (L.) Gaertn. (silymarin) extract supplement: A T
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