Silymarin Plus Ingredients & Drug Interactions
by BIOVEA
What is this page for?
First and foremost: checking Silymarin Plus 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
Silymarin Plus is a dietary supplement by BIOVEA with 5 active ingredients. Its ingredients are commonly taken for common cold and immune support, antioxidant support, skin health and collagen formation.Based on those ingredients, 915 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Vitamin C, Inositol. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Silymarin Plus by BIOVEA
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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 Silymarin Plus by BIOVEA
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
Silymarin Plus contains 5 ingredients. The active ones are vitamin C (for immune support and collagen formation), choline (involved in brain and liver function), vitamin E (a fat-soluble antioxidant), inositol (a compound related to B vitamins, used in cell signaling), and silymarin (the active extract from milk thistle).
The product also contains inactive ingredients: rice flour, hydroxypropyl methylcellulose, vegetable magnesium stearate, and silicon dioxide, which serve as fillers and capsule material.
Does it work?
Strong evidence
In our data, vitamin C is Effective for preventing vitamin C deficiency and Possibly Effective for anemia of chronic disease, atrial fibrillation, cataracts, and exercise-induced respiratory infections. Vitamin E is Effective for vitamin E deficiency and Possibly Effective for Alzheimer disease, beta-thalassemia, G6PD deficiency, and intracranial hemorrhage.
Inositol is Possibly Effective for polycystic ovary syndrome (PCOS), metabolic syndrome, and preterm labor. For choline, the evidence we hold does not establish effectiveness for the conditions listed.
We hold no effectiveness data for silymarin.
How safe is it?
Well-documented data
Vitamin C is generally well tolerated at normal doses but can cause abdominal cramps, heartburn, diarrhea, nausea, and kidney stones (especially in people prone to them) at high doses above 2 grams daily. Vitamin E is generally well tolerated but may increase bleeding risk at high doses, particularly with doses above 400 IU daily.
Choline is well tolerated at normal amounts but at very high doses (over 3.5 grams daily) can cause fishy body odor, diarrhea, nausea, and sweating. Inositol is generally well tolerated, with mild digestive side effects like diarrhea, gas, and nausea most common.
Regarding pregnancy and lactation: vitamin C is Likely Safe in normal prenatal amounts but Possibly Unsafe at high-dose supplemental levels — avoid high-dose supplements unless your doctor advises otherwise. Choline is Likely Safe during pregnancy and lactation.
Vitamin E is Possibly Safe in pregnancy and Possibly Unsafe in lactation at high doses. Inositol is Possibly Safe in pregnancy but data for lactation is not on file — talk with your doctor or pharmacist before using it if you are breastfeeding.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before starting this product if you take any of these: birth control pills or hormone replacement therapy (estrogens); blood thinners or antiplatelet drugs like warfarin, aspirin, or clopidogrel; diabetes medications; chemotherapy drugs; the antipsychotic fluphenazine; the thyroid medication levothyroxine; or the immunosuppressant cyclosporine. These are the medication types with documented Moderate interactions.
Choline also has a Minor interaction with atropine.
The bottom line
Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
Silymarin Plus may be worth considering if you're looking for support from milk thistle and B-complex nutrients and you don't take prescription medications that interact with vitamin C, E, or inositol. If you take birth control pills, hormone therapy, blood thinners, diabetes drugs, or chemotherapy, you need to check your exact medications first.
Talk it over with your doctor or pharmacist — especially if you're pregnant, breastfeeding, or taking any prescription drugs — before you start.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2019.
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 Silymarin Plus, straight from the product label.
| Brand | BIOVEA |
|---|---|
| Barcode (UPC) | 818423024035 |
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Oct 23, 2019 |
| DSLD ID | 208150 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other |
| Intended target group(s) | Vegan, Vegetarian, Adult (18 - 50 Years), Gluten 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 Silymarin Plus by BIOVEA, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin C | 200 mg | 222% |
| Choline | 83 mg | -- |
| Vitamin E | 41.5 mg | 277% |
| Inositol | 100 mg | -- |
| Silymarin | 326 mg | -- |
Other ingredients: Rice Flour, Hydroxypropyl Methylcellulose, Vegetable Magnesium Stearate, Silicon Dioxide
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.
Seals/Symbols
GMP Compliant VG Vegan Gluten free Non-GMO
Formulation
VG Vegan
Gluten free Non-GMO
General Statements
Premium quality guaranteed since 2001. BIOVEA is committed to product quality to support you and your family's wellness goals. Because we feel so strongly about the quality, potency and purity of our products, we 100% guarantee your satisfaction with every purchase.
Guaranteed premium quality
Suggested/Recommended/Usage/Directions
Suggested Daily Intake: Take 2 capsules, twice daily with a meal.
Precautions
Warning: If you are pregnant or lactating, consult a healthcare professional before using this product.
Keep out of reach of children.
Do not use this product if the safety seal on the bottle is broken.
Storage
Store in a cool, dry place.
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Silymarin Plus by BIOVEA 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 Silymarin Plus by BIOVEA
These are the 5 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Vegetarian Capsule(s) Dosage formCapsule Servings per container30 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.
Vitamin C
Interacts with207 drugs
Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...
Vitamin C monograph & interactionsCholine
Interacts with16 drugs
Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like egg...
Choline monograph & interactionsVitamin E
Interacts with764 drugs
Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...
Vitamin E monograph & interactionsInositol
Interacts with86 drugs
Inositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, m...
Inositol monograph & interactionsSilymarin
Other (inactive) ingredients: Rice Flour, Hydroxypropyl Methylcellulose, Vegetable Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Silymarin Plus by BIOVEA Drug Interactions
HelloPharmacist Interaction Report
Silymarin Plus by BIOVEA contains several ingredients with documented interactions: vitamin C, choline, vitamin E, and inositol.
The most serious interaction is vitamin C with estrogens (birth control pills and hormone replacement therapy), which is Moderate in severity — vitamin C can increase blood estrogen levels by up to 55% under some circumstances, potentially altering the effectiveness of these hormones.
Read the full breakdown — every affected drug type, severity by severity
Vitamin C also has Moderate interactions with blood thinners like warfarin, chemotherapy drugs (alkylating agents and antitumor antibiotics), aluminum-containing products, the antipsychotic fluphenazine, the HIV medication indinavir, and the thyroid drug levothyroxine. Vitamin E carries Moderate interactions with blood thinners and antiplatelet drugs, chemotherapy drugs, warfarin, the immunosuppressant cyclosporine, and the cancer drug selumetinib — and a Minor interaction with niacin.
Inositol has a Moderate interaction with diabetes medications, raising the theoretical risk of low blood sugar (hypoglycemia). Choline carries a Minor interaction with atropine.
We could not check silymarin, as we hold no data for that ingredient. Altogether, these interactions span 916 individual medications.
If you take any prescription medication — especially birth control, hormone therapy, blood thinners, diabetes drugs, or chemotherapy — run your exact drugs through the checker on this page before starting Silymarin Plus.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Silymarin Plus?
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 Silymarin Plus interact with 915 drugs. Click any drug to see the details.
4 of the 5 ingredients in Silymarin Plus interact with drugs. Each result below shows which ingredient is responsible. Vitamin E Vitamin C Inositol Choline
Aluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Silymarin Plus — through 2 ingredients. Tap an ingredient for the detail:
Vitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionVitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Silymarin Plus — through 2 ingredients. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionVitamin CAspirin, Aluminum Moderate
Interaction Summary
Acidification of the urine by vitamin C might increase aspirin levels.
Read the full Vitamin C + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin CAluminum Moderate
Interaction Summary
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Read the full Vitamin C + Aluminum, Magnesium Hydroxide (otc Drug) interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Ambrisentan interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amitriptyline, Perphenazine interactionAmlodipineNorliqva
How Amlodipine interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amlodipine interactionAmlodipine BenzoateKaterzia
How Amlodipine Benzoate interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amlodipine Benzoate interactionAmlodipine BesilateIstin
How Amlodipine Besilate interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amlodipine Besilate interactionAmlodipine BesylateNorvasc
How Amlodipine Besylate interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amlodipine Besylate interactionAmlodipine Besylate, BenazeprilLotrel
How Amlodipine Besylate, Benazepril interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amlodipine Besylate, Benazepril interactionAmlodipine, CelecoxibConsensi
How Amlodipine, Celecoxib interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amlodipine, Celecoxib interactionAmoxicillin, Omeprazole Magnesium, RifabutinTalicia
How Amoxicillin, Omeprazole Magnesium, Rifabutin interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amoxicillin, Omeprazole Magnesium, Rifabutin interactionAmprenavirAgenerase
How Amprenavir interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Amprenavir interactionAnacaulase-bcdbNexoBrid
How Anacaulase-bcdb interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Anacaulase-bcdb interactionAnagrelideAgrylin
How Anagrelide interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Anagrelide interactionAnisindioneMiradon
How Anisindione interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Anisindione interactionAntidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
How Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionAntithrombin IiiThrombate III
How Antithrombin Iii interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin EAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Read the full Vitamin E + Antithrombin Iii interactionApalutamideErleada
How Apalutamide interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Apalutamide interactionApixabanEliquis
How Apixaban interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Apixaban interactionApremilastOtezla
How Apremilast interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Apremilast interactionAprepitantCinvanti, Emend
How Aprepitant interacts with Silymarin Plus — through 1 ingredient. Tap an ingredient for the detail:
Vitamin ECytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Read the full Vitamin E + Aprepitant interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Silymarin Plus 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.
Vitamin E
Alkylating Agents
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Anticoagulant/Antiplatelet Drugs
Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.
Antitumor Antibiotics
Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.
Cyclosporine (Neoral, Sandimmune)
A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.
Selumetinib (Koselugo)
Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.
Warfarin (Coumadin)
Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.
Niacin
Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.
Vitamin C
Alkylating Agents
Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
Aluminum
Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.
Antitumor Antibiotics
Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.
Estrogens
Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.
Fluphenazine (Prolixin)
Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.
Indinavir (Crixivan)
Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.
Levothyroxine (Synthroid, Others)
Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Warfarin (Coumadin)
High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.
Acetaminophen (Tylenol, Others)
High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.
Aspirin
Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.
Choline Magnesium Trisalicylate (Trilisate)
Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Niacin
Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.
Salsalate (Disalcid)
Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.
Inositol
Antidiabetes Drugs
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that inositol lowers blood glucose levels and glycated hemoglobin (HbA1c) levels in patients with diabetes.
Choline
Atropine
Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.
Brand information
Manufacturer and brand details for Silymarin Plus, from the product label.
BIOVEA
See all BIOVEA products- Name
- BIOVEA
- Street Address
- 9160 E. Bahia Dr.
- City
- Scottsdale
- State
- AZ
- ZipCode
- 85260
- Web Address
- www.biovea.com
Silymarin Plus by BIOVEA: 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 Silymarin Plus’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin C
Interacts with 207 drugsVitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...
Read the full Vitamin C monograph → Herb & supplement monographCholine
Interacts with 16 drugsCholine is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help...
Read the full Choline monograph → Herb & supplement monographVitamin E
Interacts with 764 drugsVitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...
Read the full Vitamin E monograph → Herb & supplement monographInositol
Interacts with 86 drugsInositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, mood, and metabolic concerns. The stronge...
Read the full Inositol monograph →Sources & How We Checked
Silymarin Plus'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 143 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.
Vitamin C 51 references
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- Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
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- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
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- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
- Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
- Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
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- Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
- Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
- Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
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- Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
- Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
- Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
- Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
- Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
- Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
- Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
- Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
- Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
- Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
- Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
- Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
- Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
- Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
- Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
- Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
- Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
- 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
- Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
- Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
- Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
- Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
- Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
- Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
- Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
- Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
- Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
- Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
- Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed
Choline 14 references
- Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
- Cho E, Willett WC, Colditz GA, et al. Dietary choline and betaine and the risk of distal colorectal adenoma in women. J Natl Cancer Inst 2007;99:1224-31. PubMed
- Schmidt, C., Abicht, A., Krampfl, K., Voss, W., Stucka, R., Mildner, G., Petrova, S., Schara, U., Mortier, W., Bufler, J., Huebner, A., and Lochmuller, H. Congenital myasthenic syndrome due to a novel missense mutation in the gene encoding choline acetyl
- Tamminga, C., Smith, R. C., Chang, S., Haraszti, J. S., and Davis, J. M. Depression associated with oral choline. Lancet 10-23-1976;2(7991):905. PubMed
- Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
- Growdon, J. H. and Gelenberg, A. J. Choline and lecithin administration to patients with tardive dyskinesia. Trans.Am.Neurol.Assoc. 1978;103:95-99.
- Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318. PubMed
- Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
- Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5
- Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. PubMed
- Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res. 2013;33(11):897-904. PubMed
- Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015;102(5): 1113-25.
- Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8. PubMed
- Food and Nutrition Board, Institute of Medicine. Choline. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington D.C.: National Academy Press; 1998:390-422.
Vitamin E 64 references
- Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
- Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
- Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
- Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
- Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
- Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
- Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
- Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
- Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
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- Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
- The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
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- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
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- Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
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- Lonn E, Bosch J, Yusuf S, et al. HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-47. PubMed
- Landes N, Pfluger P, Kluth D, et al. Vitamin E activates gene expression via the pregnane X receptor. Biochem Pharmacol 2003;65:269-73. . PubMed
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- Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
- Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
- Schurks M, Glynn RJ, Rist PM, et al. Effects of vitamin E on stroke subtypes: meta-analysis of randomized controlled trials. BMJ 2010;341: c5702. doi: 10.1136/bmj.c5702.
- Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
- Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate total cancer in men: the physicians' health study II randomised controlled trial. JAMA 2009;301:52-62.
- Hayden KM, Welsh-Bohmer KA, Wengreen HJ, et al; Cache County Investigators. Risk of mortality with vitamin E supplements: the Cache County study. Am L Med 2007;120:180-4. PubMed
- Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG 2009;116:416-23. PubMed
- Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011;306:1549-56. PubMed
- Huang, H. Y., Caballero, B., Chang, S., Alberg, A. J., Semba, R. D., Schneyer, C. R., Wilson, R. F., Cheng, T. Y., Vassy, J., Prokopowicz, G., Barnes, G. J., and Bass, E. B. The efficacy and safety of multivitamin and mineral supplement use to prevent ca
- Sesso, H. D., Buring, J. E., Christen, W. G., Kurth, T., Belanger, C., MacFadyen, J., Bubes, V., Manson, J. E., Glynn, R. J., and Gaziano, J. M. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomiz
- Papaioannou, D., Cooper, K. L., Carroll, C., Hind, D., Squires, H., Tappenden, P., and Logan, R. F. Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis. Colorec PubMed
- Cooper, K., Squires, H., Carroll, C., Papaioannou, D., Booth, A., Logan, R. F., Maguire, C., Hind, D., and Tappenden, P. Chemoprevention of colorectal cancer: systematic review and economic evaluation. Health Technol.Assess. 2010;14(32):1-206. PubMed
- Mathew, M. C., Ervin, A. M., Tao, J., and Davis, R. M. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane.Database.Syst.Rev. 2012;6:CD004567. PubMed
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