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

LiverMarin Ingredients & Drug Interactions

by ATC Healthcare Corp

LiverMarin label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking LiverMarin 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

LiverMarin is a dietary supplement by ATC Healthcare Corp with 2 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 1,094 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle, Sodium Ascorbate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against LiverMarin by ATC Healthcare Corp

Ask about any prescription or over-the-counter medication and we check it for interactions with LiverMarin by ATC Healthcare Corp — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of LiverMarin by ATC Healthcare Corp

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

From our pharmacy team — supplement deep dive

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

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

LiverMarin has two active ingredients. Sodium ascorbate is a form of vitamin C paired with sodium—your body gets both the vitamin and extra dietary sodium from it.

Milk thistle is a plant extract traditionally used to support liver health. The product contains no inactive ingredients listed.

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: help prevent liver cirrhosis and hepatitis.
  • We looked for evidence on: Alcohol-related liver disease, Hepatitis B, Hepatitis C, Hypoxic liver injury, Metabolic dysfunction-associated steatotic liver disease (MASLD), Nonalcoholic fatty liver disease (NAFLD) — 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 Metabolic dysfunction-associated steatotic liver disease (MASLD), Hepatitis C, Hepatitis B, Nonalcoholic fatty liver disease (NAFLD), and more.

The evidence on these ingredients is mixed. Sodium ascorbate is likely effective for cystic fibrosis and possibly effective for amphotericin B kidney toxicity, but we don't have reliable evidence for heart failure or bipolar disorder.

Milk thistle is possibly effective for type 2 diabetes, but we don't have enough evidence to rate it for liver disease, allergies, acne, or other conditions. If liver support is your goal, the evidence here is not established in our data.

The evidence, ingredient by ingredient Sodium 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 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Sodium ascorbate is well tolerated at normal dietary amounts, but too much sodium is linked to high blood pressure and heart strain. Serious adverse effects are rare but can include worsened heart disease, high blood pressure, or kidney disease.

Avoid sodium supplements or very high intake without medical advice. Milk thistle is generally well tolerated; the most common side effects are mild gut symptoms like bloating, diarrhea, nausea, and gas—these don't happen more often than with placebo.

Rare serious effects include allergic reactions. Milk thistle safety during pregnancy is not well studied enough—the data advises against use in pregnancy.

Breastfeeding safety is also not well studied, so caution is advised.

Side effects, ingredient by ingredient Sodium 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?
  • 2 of the 2 matched ingredients can interact with medications — Milk Thistle, Sodium.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; lithium.
  • For scale: 1,095 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before you take LiverMarin, double-check with your pharmacist if you take any blood pressure medications, lithium, corticosteroids, HIV medications (especially didanosine), hepatitis C drugs (ledipasvir or sofosbuvir), blood thinners like warfarin, diabetes drugs, morphine, or any other sodium-containing drugs or supplements. Milk thistle also affects how your liver processes many other medications, so bring your complete medication list.

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.

LiverMarin is a two-ingredient supplement with documented moderate interactions across many drug types. If you take blood pressure medications, lithium, HIV drugs, hepatitis medications, blood thinners, or diabetes drugs, you need to check your exact medications before starting.

Talk to your pharmacist or doctor about whether this product fits your individual situation.

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

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 24, 2015.

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 LiverMarin, straight from the product label.

Brand ATC Healthcare Corp
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD Jul 24, 2015
DSLD ID 47467
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses No Claim
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 LiverMarin by ATC Healthcare Corp, 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:
3 Capsule(s)
Maximum serving Sizes:
3 Capsule(s)
IngredientAmount% DV
Sodium Ascorbate100 mg--
Milk Thistle250 mg--

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

Silymarin + Sodium Ascorbate capsule

General Statements

Helps prevent liver Cirrhosis, Hepatitis A-B

No approved therapeutic claims BFAD/FDA F.R. No.:72405

Liver Marin The liver is the heaviest and one of the largest organ in the body. Located in the upper right part of your belly under your ribs, It is responsible for functions, vital to life. The main functions of the liver are to process nutrients from food, make bile, remove toxins from the body and build proteins. It's easy to see how inflammation of the liver, or hepatitis, interferes with these important functions and can lead to poor health.

Liver Functions ~Detoxification (filters harmful substances from the blood, such as alcohol) ~ Stores Vitamins A, D, K and B12 (also stores minerals) ~Protein synthesis (makes certain amino acids - building blocks of protein) ~The production of biochemicals needed for digestion, such as bile ~Maintains proper levels of glucose in the blood ~Produces 80% of your body's cholesterol (cholesterol is vital) ~The storage glycogen (also converts glucose to glycogen) ~Decomposing red blood cells ~Synthesizing plasma protein ~The Production of hormones ~Produces urea (the main substance of urine)

Hepatitis ~Inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ Cause of Hepatitis ~Infectious (infected food/water, sexually transmitted disease, unsterilized needles) ~Alcohol, medicines, and chemical may be bad for the liver and cause inflammation ~Genetic problem, a metabolic disorder, or an immune related injury ~Obesity can be a cause of liver damage which can lead to inflammation

Cirrhosis ~Chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules, leading to loss of liver function

Ingredients Milk Thistle ~Milk Thistle is a plant native to Europe. It has a long history of use as a folk remedy for liver and gallbladder disorders. The active constituent of milk thistle is silymarin, a flavonoid found in the seeds. ~Flavonoids are most commonly known for their antioxidant activity. The antioxidant abilities of flavonoids are stronger than those of Vitamin C and E. ~The seeds of the milk thistle have been used for 2000 years to treat chronic liver disease and protect the liver against toxins.

Protection from Liver Damage ~Milk Thistle protects the liver against toxicity from alcohol and other drugs. ~In Europe, milk thistle is reportedly administered to patients when they are given medications known to cause liver problems.

Sodium Ascorbate ~Completely rebuilds the structural integrity of your body via collagen renewal. ~Ascorbic Acid has mistakenly been called Vitamin C- It is actually a liver metabolite rather than a vitamin. ~Important for the health of bones, connective tissues and blood vessels. ~It helps the body to absorb iron needed for the production of red blood cells.

LiverMarin Benefits ~Protects the liver since Silymarin acts as an anti-oxidant. ~Keeps harmful substances away from liver cells. ~ Reverses liver damage. ~Decreases insulin over production. ~Prevents liver cirrhosis an Hepatitis A, B; manages SGPT, SGOT level ~Protects, nourishes and improves the liver ~Helps with the digestion of fats ~Moistens mucus membranes, giving you a healthy skin

LiverMarin 350mg

Suggested/Recommended/Usage/Directions

Dosage ~as dietary supplement, take 3 capsules a day, after meals with warm water

FDA Statement of Identity

Food Supplement

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

See for yourself

LiverMarin by ATC Healthcare Corp label

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

LiverMarin 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 LiverMarin by ATC Healthcare Corp

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Capsule(s) Dosage formCapsule 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.

Sodium Ascorbate

Interacts with
205 drugs
100 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium Ascorbate monograph & interactions

Milk Thistle

Interacts with
954 drugs
250 mg per serving Form: Silymarin

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

Milk Thistle monograph & interactions
Interaction report

LiverMarin by ATC Healthcare Corp Drug Interactions

Want to check YOUR meds against LiverMarin?

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
1,094Drugs
458 Moderate 636 Minor

Ingredients driving the most interactions

Milk Thistle 954
Sodium Ascorbate 205

Individual Drug Interactions

The ingredients in LiverMarin interact with 1,094 drugs. Click any drug to see the details.

2 of the 2 ingredients in LiverMarin interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle Sodium Ascorbate

Each ingredient & the kinds of drugs it affects

For each ingredient in LiverMarin 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

Sodium Ascorbate7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C
Sodium Ascorbate full monograph & interactions
The maker

Brand information

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

ATC Healthcare Corp

See all ATC Healthcare Corp products
Name
ATC Healthcare Corp
Pharmacist Counseling Corner

LiverMarin by ATC Healthcare Corp: Common Questions

Does LiverMarin by ATC Healthcare Corp interact with any medications?
Yes. Based on its ingredients, LiverMarin has a known interaction with 1,094 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
LiverMarin contains 2 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 LiverMarin if I'm pregnant or breastfeeding?
Milk thistle is not recommended in pregnancy because there isn't enough safety data. If you're pregnant, talk to your doctor or pharmacist before taking this product. Safety during breastfeeding is also not well studied, so caution is advised if you're nursing.
What side effects does milk thistle cause?
Mild stomach upset—like bloating, diarrhea, nausea, gas, and indigestion—is the most common side effect, but it doesn't happen more often than with placebo. Some people report headache, dizziness, or sleep problems. Serious allergic reactions are rare.
Does sodium ascorbate really work as a supplement?
Sodium ascorbate is likely effective for cystic fibrosis and possibly effective for kidney damage from amphotericin B. For other uses—like heart failure or bipolar disorder—we don't have reliable evidence.
Is milk thistle proven to help the liver?
The evidence we have doesn't reliably support milk thistle for liver disease, alcoholic liver disease, or other liver conditions. We have some evidence it may help type 2 diabetes, but more research is needed.
Why is the sodium in this product a concern?
High sodium intake can raise blood pressure and make blood pressure medications less effective. It's also risky if you take lithium—extra sodium lowers lithium levels, but cutting sodium can make lithium dangerously high. Most people should avoid sodium supplements and stick to normal dietary amounts.
Can LiverMarin affect how my diabetes medication works?
Yes. Milk thistle can lower blood sugar and may increase your risk of low blood sugar (hypoglycemia) if you're already on diabetes drugs. You'll need closer monitoring and possibly a dose adjustment if you add this product.

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.

LiverMarin label
Go deeper

The Full Monographs Behind LiverMarin’s Ingredients

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

Herb & supplement monograph

Sodium

Interacts with 205 drugs

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from...

Read the full Sodium 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

LiverMarin'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 107 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.

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
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See these in context on the Sodium monograph →

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

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