Milk Thistle 1000 mg Ingredients & Drug Interactions
by Bronson
What is this page for?
First and foremost: checking Milk Thistle 1000 mg 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
Milk Thistle 1000 mg is a dietary supplement by Bronson with 2 active ingredients. Its ingredients are commonly taken for liver health and protection, hepatitis, cirrhosis.Based on those ingredients, 1,071 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Milk Thistle seed extract, Dandelion root extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Milk Thistle 1000 mg by Bronson
Ask about any prescription or over-the-counter medication and we check it for interactions with Milk Thistle 1000 mg by Bronson — 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 Milk Thistle 1000 mg by Bronson
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This supplement contains 2 active ingredients. Milk thistle seed extract is the main ingredient at 1,000 mg per capsule — it's been studied for liver health and type 2 diabetes support.
Dandelion root extract completes the formula. The capsule also contains inactive ingredients: microcrystalline cellulose (a binding agent), magnesium stearate, silicon dioxide, and gelatin.
Does it work?
Insufficient evidence
The evidence we hold shows milk thistle is possibly effective for type 2 diabetes — clinical research found it can lower blood glucose levels and HbA1c in patients with type 2 diabetes. For other conditions on file — acne, alcohol-related liver disease, hay fever, gambling disorder, and amanita mushroom poisoning — the data doesn't establish whether it works.
For dandelion root extract, we don't have effectiveness ratings for the conditions in our database (joint pain, tonsillitis, and post-operative swelling and pain), so the evidence isn't established in the data we hold.
How safe is it?
Well-documented data
Milk thistle is generally well tolerated by most adults. The most common side effects are mild stomach upset — bloating, diarrhea, indigestion, gas, and nausea — but these don't typically occur more often than placebo.
Rare allergic reactions, including anaphylaxis, have been reported. Some people report headache, dizziness, or sleep disturbances.
Dandelion is also generally well tolerated, with diarrhea, heartburn, and stomach discomfort being the most common oral side effects. Allergic reactions are rare but possible, especially in people sensitive to plants in the ragweed family (like chrysanthemums and daisies).
During pregnancy, the safety data advises against milk thistle. For dandelion and breastfeeding with either ingredient, there isn't enough data to know either way — talk with your doctor or pharmacist before using this product if you're pregnant or breastfeeding.
Meds to double-check
Moderate interaction found
Before taking this product, double-check with your doctor or pharmacist if you take blood thinners like warfarin, diabetes medications, potassium-sparing diuretics (water pills that keep potassium), hepatitis C drugs (ledipasvir or sofosbuvir), lithium, antiplatelet drugs like aspirin, fluoroquinolone antibiotics (like ciprofloxacin), or any drug your liver breaks down via a process called glucuronidation. Both ingredients interact with multiple medication groups at Moderate severity.
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.
This product is a two-herb combination with several documented interactions, especially with blood thinners, diabetes medications, and hepatitis C drugs. If you take any prescription medications — particularly for blood clotting, blood sugar, or hepatitis — you'll want to check the details with your own doctor or pharmacist before starting.
Generally well-tolerated adults who aren't on interacting drugs may find it worth considering, especially for type 2 diabetes support, but quality varies and anyone with liver concerns should involve their doctor.
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 Dec 18, 2021.
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 Milk Thistle 1000 mg, straight from the product label.
| Brand | Bronson |
|---|---|
| Barcode (UPC) | 716563792015 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Dec 18, 2021 |
| DSLD ID | 258119 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
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 Milk Thistle 1000 mg by Bronson, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Milk Thistle seed extract | 1000 mg | -- |
| Dandelion root extract | 50 mg | -- |
Other ingredients: Microcrystalline Cellulose, Magnesium Stearate, Silicon Dioxide, Gelatin
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.
Brand IP Statement(s)
Bronson Since 1960 Nutrition+
Discover the Bronson Difference
Formula
Powerful antioxidant
Fortified with dandelion root
Traditional herb
Formulation
Promotes healthy liver function
Liver health From the earth
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: As a dietary supplement for adults, take 1 capsule daily preferably with meals or as directed by a healthcare professional.
Precautions
Warning: If you are pregnant, nursing or taking any medications, consult your doctor before use.
Do not use if seal under cap is broken or missing.
Avoid this product if you are allergic to ragweed or daisy-like flowers.
Keep out of reach of children.
Storage
Store at room temperature.
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.
General Statements
To reorder: www.bronsonvitamins.com
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Milk Thistle 1000 mg by Bronson 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 Milk Thistle 1000 mg by Bronson
These are the 2 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Milk Thistle seed extract
Interacts with954 drugs
Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin....
Milk Thistle seed extract monograph & interactionsDandelion root extract
Interacts with457 drugs
Dandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for thes...
Dandelion root extract monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Magnesium Stearate, Silicon Dioxide, Gelatin. These complete the product’s ingredient list but are not active constituents.
Milk Thistle 1000 mg by Bronson Drug Interactions
HelloPharmacist Interaction Report
Bronson's Milk Thistle 1000 mg contains milk thistle seed extract and dandelion root extract, both of which interact with medications.
The most serious documented interaction involves milk thistle and blood thinners like warfarin (Coumadin) — a case report showed one person's blood thinner effect increased significantly after starting a product containing milk thistle. Altogether, these interactions span 1,072 individual medications.
Read the full breakdown — every affected drug type, severity by severity
Milk thistle affects several drug groups through different pathways. It may slow how your body clears ledipasvir (a hepatitis C drug), increase low blood sugar (hypoglycemia) risk with diabetes medications, interfere with drugs your liver breaks down via glucuronidation, and affect morphine levels unpredictably — either raising or lowering them.
It may also decrease sofosbuvir (another hepatitis C drug) effectiveness and reduce how quickly your body clears sirolimus, an immunosuppressant. Additionally, milk thistle might inhibit an enzyme (CYP2B6) that metabolizes a number of other medications.
Dandelion root extract adds further interactions. It may raise levels of drugs metabolized by CYP1A2, increase potassium to unsafe levels if you're on potassium-sparing diuretics, raise bleeding risk with blood thinners (anticoagulants) or antiplatelet drugs, increase hypoglycemia risk with diabetes medications, speed clearance of glucuronidated drugs, concentrate lithium to toxic levels through its diuretic effect, and lower effectiveness of fluoroquinolone antibiotics like ciprofloxacin.
Before you start this product, check your exact medications with the search tool on this page or talk it over with your doctor or pharmacist.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Milk Thistle 1000 mg?
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 Milk Thistle 1000 mg interact with 1,071 drugs. Click any drug to see the details.
2 of the 2 ingredients in Milk Thistle 1000 mg interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle seed extract Dandelion root extract
Acetaminophen, Chlorpheniramine, Phenylpropanolamine, PhenyltoloxamineNorel Plus
How Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interacts with Milk Thistle 1000 mg — 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, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionDandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Chlorpheniramine, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, Chlorpheniramine, PseudoephedrineAlka-Seltzer PLUS Liquid Gels, Children's Tylenol Cold, Codimal, Comtrex, Extra Strength Tylenol Allergy Sinus, Lorsin +3 more
How Acetaminophen, Chlorpheniramine, Pseudoephedrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Chlorpheniramine, Pseudoephedrine 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, Pseudoephedrine interactionAcetaminophen, ChlorzoxazoneAcetazone Forte, Extra Strength Tylenol Aches & Strains, Parafon Forte
How Acetaminophen, Chlorzoxazone interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Chlorzoxazone 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, Chlorzoxazone interactionAcetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Milk Thistle 1000 mg — 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, Chlorzoxazone, Codeine interactionDandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, 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, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Codeine, Doxylamine 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, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Milk Thistle 1000 mg — 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, Codeine, Methocarbamol interactionDandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dexbrompheniramine, PseudoephedrineSinadrin Plus
How Acetaminophen, Dexbrompheniramine, Pseudoephedrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Dexbrompheniramine, Pseudoephedrine 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, Dexbrompheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan 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, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Milk Thistle 1000 mg — 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, Dextromethorphan, Doxylamine, Pseudoephedrine interactionDandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan, Guaifenesin, 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, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Milk Thistle 1000 mg — 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, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionDandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine 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, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionMilk Thistle Seed ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle Seed Extract + Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interactionAcetaminophen, Dextromethorphan, PseudoephedrineAlka-Seltzer PLUS Flu Liquid Gels, Non Aspirin Cold Caps, Tylenol Cold, Tylenol Flu Daytime Ex Strength, Tylenol Flu Ex Strength
How Acetaminophen, Dextromethorphan, Pseudoephedrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dextromethorphan, Pseudoephedrine 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, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dichloralantipyrine, Isometheptene 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, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Dichloralphenazone, Isometheptene 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, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Dichlorophenazone, Isometheptane 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, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Diphenhydramine 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, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Diphenhydramine, Pseudoephedrine 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, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, Doxylamine, PseudoephedrineEx Strength Tylenol Sinus Nighttime
How Acetaminophen, Doxylamine, Pseudoephedrine interacts with Milk Thistle 1000 mg — 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, Doxylamine, Pseudoephedrine interactionDandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Doxylamine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Hydrocodone 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, Hydrocodone interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Ibuprofen interactionDandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs +1 Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Ibuprofen interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Meperidine 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, Meperidine interactionAcetaminophen, MethocarbamolRobaxacet
How Acetaminophen, Methocarbamol interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Methocarbamol 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, Methocarbamol interactionAcetaminophen, OrphenadrineOrfenagesic
How Acetaminophen, Orphenadrine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk Thistle Seed ExtractGlucuronidated Drugs, Cytochrome P450 2b6 (cyp2b6) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Seed Extract + Acetaminophen, Orphenadrine interactionDandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Orphenadrine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Oxycodone 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, Oxycodone interactionAcetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractGlucuronidated Drugs, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Read the full Dandelion Root Extract + Acetaminophen, Pamabrom, Pyrilamine 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, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Milk Thistle 1000 mg — 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, Pentazocine interactionDandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Milk Thistle 1000 mg — through 2 ingredients. Tap an ingredient for the detail:
Dandelion Root ExtractCytochrome P450 1a2 (cyp1a2) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Read the full Dandelion Root Extract + Acetaminophen, Phenylephrine, Chlorpheniramine 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, Phenylephrine, Chlorpheniramine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Milk Thistle 1000 mg with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Milk Thistle seed extract
Antidiabetes Drugs
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.
Glucuronidated Drugs
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.
Ledipasvir
Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.
Morphine
Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.
Raloxifene (Evista)
Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.
Sirolimus (Rapamune)
Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.
Sofosbuvir (Solvaldi)
Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.
Tamoxifen (Nolvadex)
Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.
Warfarin (Coumadin)
Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.
Estrogens
Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.
Indinavir (Crixivan)
Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
P-Glycoprotein Substrates
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.
Dandelion root extract
Anticoagulant/Antiplatelet Drugs
Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
In vitro research suggests that dandelion root inhibits platelet aggregation.
Antidiabetes Drugs
Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion. Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Laboratory research suggests that dandelion might inhibit CYP1A2. So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.
Glucuronidated Drugs
Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme.
Lithium
Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Animal research suggests that dandelion has diuretic properties. As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.
Potassium-Sparing Diuretics
Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Dandelion contains significant amounts of potassium.
Quinolone Antibiotics
Theoretically, dandelion might lower fluoroquinolone levels.
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73%. However, this effect has not been reported in humans.
Brand information
Manufacturer and brand details for Milk Thistle 1000 mg, from the product label.
Bronson
- Name
- Bronson Laboratories
- Street Address
- 350 South 400 West #102
- City
- Lindon
- State
- UT
- ZipCode
- 84042
- Phone Number
- 1-800-235-3200
- Web Address
- www.bronsonvitamins.com
Milk Thistle 1000 mg by Bronson: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Milk Thistle 1000 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Milk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph → Herb & supplement monographDandelion
Interacts with 457 drugsDandelion is a common plant used in food and traditional medicine, often promoted as a natural 'water pill' and digestive aid. Human evidence for these uses is very limited, so its benefits...
Read the full Dandelion monograph →Sources & How We Checked
Milk Thistle 1000 mg'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 96 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Milk Thistle 69 references
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- Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.g
- Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, et al. Inhibitory effects of silibinin on cytochrome P-450 enzymes in human liver microsomes. Pharmacol Toxicol 2000;86:250-6. PubMed
- Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug Metab Dispos 2000;28:1270-3. DOI
- Kim DH, Jin YH, Park JB, Kobashi K. Silymarin and its components are inhibitors of beta-glucuronidase. Biol Pharm Bull 1994;17:443-5. PubMed
- Pares A, Planas R, Torres M, et al. Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial. J Hepatol 1998;28:615-21. PubMed
- Piscitelli SC, Formentini E, Burstein AH, et al. Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers. Pharmacotherapy 2002;22:551-6. PubMed
- Boerth J, Strong KM. The clinical utility of milk thistle (Silybum marianum) in cirrhosis of the liver. J Herb Pharmacother 2002;2:11-7.
- Tanamly MD, Tadros F, Labeeb S, et al. Randomised double-blinded trial evaluating silymarin for chronic hepatitis C in an Egyptian village: study description and 12-month results. Dig Liver Dis 2004;36:752-9. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-40. .
- Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res 2006;20;1036-9.
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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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- 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.
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- Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. PubMed
- Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. PubMed
- Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
- Hussain, S. A. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J.Med.Food 2007;10(3):543-547. PubMed
- El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally, M., Mikhail, N., Hashem, M., Mousa, A., Aboul-Fotouh, A., El-Kassas, M., Esmat, G., and Strickland, G. T. A randomized controlled trial to assess the safety and effic
- Gharagozloo, M., Moayedi, B., Zakerinia, M., Hamidi, M., Karimi, M., Maracy, M., and Amirghofran, Z. Combined therapy of silymarin and desferrioxamine in patients with beta-thalassemia major: a randomized double-blind clinical trial. Fundam.Clin.Pharmaco
- Ladas, E. J., Kroll, D. J., Oberlies, N. H., Cheng, B., Ndao, D. H., Rheingold, S. R., and Kelly, K. M. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL PubMed
- Sayyah, M., Boostani, H., Pakseresht, S., and Malayeri, A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive-Compulsive Disorder. Prog.Neuropsychopharmacol.Biol.Psychiatry 3-17-2010;34(2):362-365. PubMed
- Flaig, T. W., Glode, M., Gustafson, D., van, Bokhoven A., Tao, Y., Wilson, S., Su, L. J., Li, Y., Harrison, G., Agarwal, R., Crawford, E. D., Lucia, M. S., and Pollak, M. A study of high-dose oral silybin-phytosome followed by prostatectomy in patients w
- Ramirez-Santos, A., Perez-Bustillo, A., Gonzalez-Sixto, B., Suarez-Amor, O., and Rodriguez-Prieto, M. A. [Acute generalized exanthematous pustulosis due to milk thistle (Silybum marianum) tea]. Actas Dermosifiliogr. 2011;102(9):744-745. DOI
- Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med 2012;52(9):1658-65. PubMed
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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
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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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