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Milk Thistle × Antibiotics

MODERATE Cyp-Inferred Evidence

Mechanism

Milk Thistle is a weak inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.

Effect

Increased plasma levels of clarithromycin (antibiotics), potentially leading to toxicity or enhanced adverse effects.

Management

Monitor for increased adverse effects of clarithromycin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.

Plain Language Summary

✨ AI-generated · Qwen 3.6 · grounded in 2 sources · methodology

This combination may be risky because Milk Thistle can slow down how your body processes certain antibiotics. This can lead to higher levels of the medication in your bloodstream, which may increase your risk of experiencing side effects.

Source

Flockhart CYP450 Table (drug-interactions.medicine.iu.edu)

Research

Supporting Research

Evaluation of the effect of herbal agents as management of radiodermatitis in breast cancer patients: A systematic review and meta-analysis
PMID:37816677 DOI 2024
Efficacy of different interventions for nonalcoholic fatty liver disease: A meta-analysis of lifestyle modifications, silymarin, and medications
PMID:40738719 DOI 2025
Pharmacotherapy for trichotillomania
PMID:34582562 DOI 2021
Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review
PMID:38306552 DOI 2024
Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on randomized trials targeting liver injury
PMID:40221681 DOI 2025
The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: A meta-analysis
PMID:33019400 DOI 2020
The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials
PMID:29245314 DOI 2017
Prevention and management of idiosyncratic drug-induced liver injury: Systematic review and meta-analysis of randomised clinical trials
PMID:33359912 DOI 2021
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Medical Disclaimer: This interaction record is for informational and educational purposes only and does not constitute medical advice. Always consult your healthcare provider or pharmacist before combining any supplement with prescription medications.