Siliphos Ingredients & Drug Interactions
by NOW
What is this page for?
First and foremost: checking Siliphos 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
Siliphos is a dietary supplement by NOW with 3 active ingredients. Its ingredients are commonly taken for liver health, memory and brain support, ulcerative colitis.Based on those ingredients, 954 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are standardized to 60 mg Silybin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Siliphos by NOW
Ask about any prescription or over-the-counter medication and we check it for interactions with Siliphos by NOW — 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 Siliphos by NOW
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Low disclosure
Siliphos contains 3 active ingredients. Phosphatidyl Choline Complex is a fat-based compound (phospholipid) that plays a role in cell membranes and brain function.
The other two — a milk thistle extract standardized to 60 mg of silybin and Silybin Phospholipids — are both forms of milk thistle's active compound. The product also contains cellulose (a fiber-based filler), stearic acid (a thickener), and silica (an anti-caking agent) as inactive ingredients.
Does it work?
Insufficient evidence
For phosphatidyl choline, the evidence is mixed. It's rated possibly effective for ulcerative colitis, but for Alzheimer's, anxiety, and liver disease, the evidence isn't strong enough yet to say whether it helps.
For milk thistle, there's evidence it may help with diabetes — research shows it can lower blood sugar in people with type 2 diabetes. Beyond that, milk thistle's effectiveness for other uses we have data on (acne, liver disease, hay fever, and mushroom poisoning) is not established.
How safe is it?
Well-documented data
Both ingredients are generally well tolerated. Phosphatidyl choline may cause digestive upset — bloating, diarrhea, nausea, or altered taste — especially at high doses.
Milk thistle causes similar mild digestive side effects (bloating, diarrhea, nausea, gas) in some people, though not more often than placebo; allergic reactions including anaphylaxis are very rare. For pregnancy, choline is actually needed, but supplement safety beyond food amounts isn't well studied — check with your doctor.
Milk thistle should be avoided in pregnancy due to insufficient safety data. During breastfeeding, there isn't enough data on either ingredient; talk with your healthcare provider first.
Meds to double-check
Moderate interaction found
Before taking Siliphos, check with your doctor or pharmacist if you take a blood thinner like warfarin, diabetes medications, morphine, sirolimus, or any drug your provider metabolizes through CYP2B6 or glucuronidation pathways. Also confirm with your provider if you take ledipasvir or sofosbuvir for hepatitis C.
If you're unsure whether your medication falls into these categories, run it through the search tool on this page.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with insufficient evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Siliphos is a liver-support formula with two milk thistle forms plus phosphatidyl choline, possibly effective for diabetes and ulcerative colitis. The main caution is milk thistle's interactions with blood thinners, diabetes drugs, and several other medication types — if you take any prescriptions, check them against this page's search tool before starting.
Talk to your doctor or pharmacist about whether this product fits your health plan.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 25, 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
General information
Key facts about Siliphos, straight from the product label.
| Brand | NOW |
|---|---|
| Barcode (UPC) | 733739040787 |
| Net contents | 90 Veg Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Feb 25, 2015 |
| DSLD ID | 42818 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten Free, Dairy Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Siliphos by NOW, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Phosphatidyl Choline Complex | 0 NP | -- |
| standardized to 60 mg Silybin | 60 mg | -- |
| Milk Thistle extract | 0 NP | -- |
| Silybin Phospholipids | 200 mg | -- |
Other ingredients: Cellulose powder, Cellulose, Stearic Acid, Silica
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
SUGGESTED USAGE: Take 1 capsule 1 to 3 times daily.
General Statements
Silybin is the most bioactive component found in the extract of Milk Thistle known as Silymarin. Silybin has been shown to support the liver’s free radical neutralizing ability, thereby promoting healthy liver detoxification mechanisms, as well as the maintenance of cell membrane stability.
Natural color variation may occur in this product.
CAPSULE SIZE
Clinical Liver Health
- Superior Bioavailability*
Please Recycle.
Botanicals/Herbs
Family owned since 1968.
Formula
Silybin typically exhibits poor bioavailability, however, this clinical strength NOW product features Siliphos(R), a phytosome comprised of Silybin complexed with phosphatidyl choline, which has demonstrated absorbability of up to 4.6 times that of standard Milk Thistle extracts.*
- Silybin Phytosome Complex
Milk Thistle Extract
Contains soy (phosphatidyl choline, non-gmo).
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.
Precautions
Caution: For adults only.
Consult physician if pregnant/nursing, taking medication, or have a medical condition.
Keep out of reach of children.
Do Not Eat Freshness Packet. Keep in Bottle.
Not manufactured with wheat, gluten, milk, egg, fish, shellfish or tree nut ingredients. Produced in a GMP facility that processes other ingredients containing these allergens.
Contains soy (phosphatidyl choline, non-gmo).
General
CODE 4078 V2
FDA Statement of Identity
A Dietary Supplement
Formulation
Vegetarian/Vegan
Not manufactured with wheat, gluten, milk, egg, fish, shellfish or tree nut ingredients.
Seals/Symbols
GMP QUALITY ASSURED
Brand IP Statement(s)
Siliphos(R) is a registered trademark of Indena S.p.A.
Storage
Store in a cool, dry place after opening.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Siliphos by NOW 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 Siliphos by NOW
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Veg 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.
Silybin Phospholipids
Other (inactive) ingredients: Cellulose powder, Cellulose, Stearic Acid, Silica. These complete the product’s ingredient list but are not active constituents.
Siliphos by NOW Drug Interactions
HelloPharmacist Interaction Report
Siliphos by NOW contains milk thistle (in two forms) that does interact with medications.
The milk thistle ingredients can affect how your body handles eight major drug categories. The most serious documented case involved warfarin (a blood thinner), where milk thistle raised blood-clotting risk by increasing warfarin's effects.
Read the full breakdown — every affected drug type, severity by severity
Milk thistle may lower blood sugar (glucose) more than expected if you're already on diabetes medications, raising the risk of low blood sugar (hypoglycemia). It can also slow how your liver clears several other drug types: drugs processed through the CYP2B6 enzyme pathway, glucuronidated drugs (those broken down by a different liver pathway), morphine, and sirolimus (an immunosuppressant).
Additionally, it might increase levels of the hepatitis C drug ledipasvir or decrease levels of sofosbuvir.
Phosphatidyl Choline Complex has no interactions documented in our data.
Altogether, these interactions span 955 individual medications. Check your exact prescriptions with the search tool on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Siliphos?
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 Siliphos interact with 954 drugs. Click any drug to see the details.
1 of the 3 ingredients in Siliphos interact with drugs. Each result below shows which ingredient is responsible. standardized to 60 mg Silybin
Acetaminophen, Chlorzoxazone, CodeineAcetazone Forte C8, Parafon Forte C8
How Acetaminophen, Chlorzoxazone, Codeine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Chlorzoxazone, Codeine interactionAcetaminophen, CodeineTylenol No.3, Tylenol w/ Codeine
How Acetaminophen, Codeine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Codeine interactionAcetaminophen, Codeine, DoxylamineMersyndol
How Acetaminophen, Codeine, Doxylamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Codeine, Doxylamine interactionAcetaminophen, Codeine, MethocarbamolAcetaminophen, Codeine, Methocarbamol, Robaxacet 8
How Acetaminophen, Codeine, Methocarbamol interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Codeine, Methocarbamol interactionAcetaminophen, Dexbrompheniramine, PseudoephedrineSinadrin Plus
How Acetaminophen, Dexbrompheniramine, Pseudoephedrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Dexbrompheniramine, Pseudoephedrine interactionAcetaminophen, DextromethorphanTylenol Cough Ex Strength
How Acetaminophen, Dextromethorphan interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Dextromethorphan interactionAcetaminophen, Dextromethorphan, Doxylamine, PseudoephedrineVicks NyQuil
How Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Dextromethorphan, Doxylamine, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylephrineConar-A
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PhenylpropanolamineAnatuss
How Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Phenylpropanolamine interactionAcetaminophen, Dextromethorphan, Guaifenesin, PseudoephedrineRobitussin Cold, Severe Cold, Suphedrine Cold/Cough
How Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine interactionAcetaminophen, Dextromethorphan, Phenylpropanolamine, PyrilamineTheracaps
How Acetaminophen, Dextromethorphan, Phenylpropanolamine, Pyrilamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 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 Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Dichloralantipyrine, IsomethepteneAmidrine, Midchlor, Migquin, Migratine
How Acetaminophen, Dichloralantipyrine, Isometheptene interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Dichloralantipyrine, Isometheptene interactionAcetaminophen, Dichloralphenazone, IsomethepteneMidrin
How Acetaminophen, Dichloralphenazone, Isometheptene interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Dichloralphenazone, Isometheptene interactionAcetaminophen, Dichlorophenazone, IsometheptaneIsocom
How Acetaminophen, Dichlorophenazone, Isometheptane interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Dichlorophenazone, Isometheptane interactionAcetaminophen, DiphenhydramineTylenol PM, Tylenol PM Ex Strength
How Acetaminophen, Diphenhydramine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Diphenhydramine interactionAcetaminophen, Diphenhydramine, PseudoephedrineChildren's Tylenol Allergy, Cold Control, Contac Night Allergy Relief
How Acetaminophen, Diphenhydramine, Pseudoephedrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Diphenhydramine, Pseudoephedrine interactionAcetaminophen, Doxylamine, PseudoephedrineEx Strength Tylenol Sinus Nighttime
How Acetaminophen, Doxylamine, Pseudoephedrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Doxylamine, Pseudoephedrine interactionAcetaminophen, HydrocodoneAnexsia, Anodynos DHC, Azdone, Co-Gesic, Doucet, Lorcet +9 more
How Acetaminophen, Hydrocodone interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Hydrocodone interactionAcetaminophen, IbuprofenCombogesic
How Acetaminophen, Ibuprofen interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle Extract + Acetaminophen, Ibuprofen interactionAcetaminophen, MeperidineDemerol APAP
How Acetaminophen, Meperidine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Meperidine interactionAcetaminophen, MethocarbamolRobaxacet
How Acetaminophen, Methocarbamol interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Methocarbamol interactionAcetaminophen, OrphenadrineOrfenagesic
How Acetaminophen, Orphenadrine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Orphenadrine interactionAcetaminophen, OxycodonePercocet, Roxicet, Tylox, Xartemis XR
How Acetaminophen, Oxycodone interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Oxycodone interactionAcetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle 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 Extract + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with Siliphos — through 1 ingredient. Tap an ingredient for the detail:
Milk Thistle ExtractGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle Extract + Acetaminophen, Phenyltoloxamine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Siliphos with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
standardized to 60 mg Silybin
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.
Brand information
Manufacturer and brand details for Siliphos, from the product label.
NOW
See all NOW products- Name
- NOW Foods
- Street Address
- 395 S. Glen Ellyn Rd.
- City
- Bloomingdale
- State
- IL
- ZipCode
- 60108
- Web Address
- nowfoods.com
Siliphos by NOW: Common Questions
Does Siliphos by NOW interact with any medications?
How can one product interact with so many drugs?
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Can this help my diabetes?
What is silybin, and why is it in here twice?
Does phosphatidyl choline interact with my medications?
What's in this capsule besides the active ingredients?
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.
The Full Monographs Behind Siliphos’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Phosphatidylcholine
Phosphatidylcholine is a phospholipid that is part of every cell membrane and a source of choline. People take it for liver, brain, and gut health, but solid human evidence is limited for mo...
Read the full Phosphatidylcholine monograph → Herb & supplement monographMilk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph →Sources & How We Checked
Siliphos'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 84 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.
Phosphatidylcholine 15 references
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- Hexsel DM, Serra M, de Oliveira Dal'Forno T, et al. Cosmetic uses of injectable phosphatidylcholine on the face. Otolaryngol Clin North Am 2005;38:1119-29. PubMed
- Kopera D, Binder B, Toplak H, et al. Histopathologic changes after intralesional application of phosphatidylcholine for lipoma reduction: report of a case. Am J Dermatopathol 2006;28:331-3. PubMed
- Rittes PG. The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads. Dermatol Surg 2001;27:391-2. PubMed
- Rotunda AM, Kolodney MS. Mesotherapy and phosphatidylcholine injections: historical clarification and review. Dermatol Surg 2006;32:465-80. PubMed
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- Hasengschwandtner F. Phosphatidylcholine treatment to induce lipolysis. Cosmet Dermatol 2005;4:308-13. PubMed
- Rittes PG. The use of phosphatidylcholine for correction of localized fat deposits. Aesthetic Plast Surg 2003;27:315-8. PubMed
- Ablon G, Rotunda AM. Treatment of lower eyelid fat pads using phosphatidylcholine: clinical trial and review. Dermatol Surg 2004;30:422-7. PubMed
- 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
- Panos, J. M., Palson, R., Johnson, R., Portmann, B., and Williams, R. Polyunsaturated phosphatidylcholine for acute alcoholic hepatitis: a double blind randomized placebo controlled trial. Eur.J.Gastroenterol 1990;2:351-355.
- Stremmel W, Braun A, Hanemann A, Ehehalt R, Autschbach F, Karner M. Delayed release phosphatidylcholine in chronic-active ulcerative colitis: a randomized, double-blinded, dose finding study. J Clin Gastroenterol 2010;44(5):e101-7. PubMed
- Stremmel W, Ehehalt R, Autschbach F, Karner M. Phosphatidylcholine for steroid-refractory chronic ulcerative colitis: a randomized trial. Ann Intern Med. 2007;147(9):603-10. PubMed
- Stremmel W, Vural H, Evliyaoglu O, Weiskirchen R. Delayed Release Phosphatidylcholine is Effective for Treatment of Ulcerative Colitis: A Meta-Analysis. Dig Dis 2021;39(5):508-515. PubMed
Milk Thistle 69 references
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- Anon. Milk thistle: Effects on liver disease and cirrhosis and clinical adverse effects. Summary, Evidence Report/Technology Assessment: Number 21, September 2000. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.g
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- 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. .
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- Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011;25:21-7. PubMed
- Jiao Z, Shi XJ, Li ZD, et al. Population pharmacokinetics of sirolimus in de novo Chinese adult renal transplant patients. Br.J.Clin.Pharmacol. 2009;68(1):47-60.
- Gurley, B. J., Barone, G. W., Williams, D. K., Carrier, J., Breen, P., Yates, C. R., Song, P. F., Hubbard, M. A., Tong, Y., and Cheboyina, S. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin phar
- Allain, H., Schuck, S., Lebreton, S., Strenge-Hesse, A., Braun, W., Gandon, J. M., and Brissot, P. Aminotransferase levels and silymarin in de novo tacrine-treated patients with Alzheimer's disease. Dement.Geriatr.Cogn Disord. 1999;10(3):181-185. PubMed
- Angulo, P., Patel, T., Jorgensen, R. A., Therneau, T. M., and Lindor, K. D. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology 2000;32(5):897-900. PubMed
- Bean, P. The use of alternative medicine in the treatment of hepatitis C. Am.Clin.Lab 2002;21(4):19-21.
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- 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
- Yakoot, M. and Salem, A. Spirulina platensis versus silymarin in the treatment of chronic hepatitis C virus infection. A pilot randomized, comparative clinical trial. BMC.Gastroenterol. 2012;12:32. PubMed
- Fallahzadeh, M. K., Dormanesh, B., Sagheb, M. M., Roozbeh, J., Vessal, G., Pakfetrat, M., Daneshbod, Y., Kamali-Sarvestani, E., and Lankarani, K. B. Effect of addition of silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic
- 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
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Parts of this content are provided by the Therapeutic Research Center, LLC.
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.
© 2021 Therapeutic Research Center, LLC