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How Milk Thistle interacts with Medications metabolized by the CYP-3A4 isoenzyme system

Interaction type: Interactions

Interaction rating: Potential/Theoritical

Some studies have reported that milk thistle can affect the way that the liver breaks down certain medications. This may alter the effects of these medications and possibly the dose needed for treatment. Use with caution. (1) (2) (3)


  1. View Abstract: Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, et al. Inhibitory Effects of Silibinin on Cytochrome P-450 Enzymes in Human Liver Microsomes. Pharmacol Toxicol. Jun2000;86(6):250-6.
  2. View Abstract: Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk Thistle, a Herbal Supplement, Decreases the Activity of CYP3A4 and Uridine Diphosphoglucuronosyl Transferase in Human Hepatocyte Cultures. Drug Metab Dispos. Nov2000;28(11):1270-3.
  3. View Abstract: Zhao J, et al. Tissue Distribution of Silibinin, the Major Active Constituent of Silymarin, in Mice and Its Association with Enhancement of Phase II Enzymes: Implications in Cancer Chemoprevention. Carcinogenesis. Nov1999;20(11):2101-8.

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