Milk thistle & drug interactions

Written by madisyn tyler
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Milk thistle & drug interactions
Mixing certain drugs or herbal supplements can have undesirable effects. (drugs image by Alexey Klementiev from

Although no strong evidence supports its effectiveness, the herb milk thistle is thought to have properties that promote liver health. The plant's seeds provide a flavonoid complex known as silymarin, which is thought to be the active ingredient in milk thistle supplements. Overall, milk thistle appears to have a good safety profile, but interactions with medications and other supplements are possible.


As part of alternative therapies, milk thistle traditionally has been used to treat liver and gallbladder ailments. Users believe this herb can strengthen liver cells and thereby aid the body in detoxification. Although published research on milk thistle suggests that this herb may indeed help patients with liver disease, the Mayo Clinic says that most of the studies were not well designed or reported.


Medications and supplements might be perfectly safe when taken alone but can have dangerous consequences when taken in combination. In the case of milk thistle, any potential interactions are considered minor. Taking this herb can lower the effectiveness of certain medications, although the effects generally are not considered significant.


Milk thistle may cause minor interactions with the drug indinavir, sometimes sold under the name Crixivan. This drug may be prescribed to HIV patients to slow the growth of the virus. Taking milk thistle can reduce blood plasma concentrations of indinavir, but in most cases this reduction is not thought to be significant. Those who take medications that alter blood sugar levels, or who have hypoglycaemia or diabetes, also should be cautious when considering taking milk thistle, as it theoretically can lower blood sugar levels.


The most effective way to prevent drug interactions that may occur when taking milk thistle is to meet with your doctor before you begin taking it. Online drug interaction checkers may give you a rough idea about the safety of combining different drugs and supplements, but it is always safer to meet with your doctor, as drug interactions can affect each individual differently.

Expert Insight

Alternative medicine expert Dr. Andrew Weil acknowledges a lack of well-designed studies on milk thistle. "We need basic science studies as well as a large clinical trial in patients with hepatitis to shed light on exactly how milk thistle works to protect the liver and who it might benefit", he says. But he states that the current findings seem promising. "The accumulated evidence we have now suggests that milk thistle does have a positive effect on the liver and confirms that it is safe".

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