⚠️ Mechanism
Milk thistle may inhibit CYP3A4 and CYP2C9, potentially increasing metronidazole levels.
📋 Effect
Possible increased metronidazole levels
💊 Management
Monitor for metronidazole side effects. Minor clinical concern.
Plain Language Summary
This interaction is considered a minor concern. Milk thistle may cause the levels of metronidazole in your body to increase, which could potentially lead to more side effects.
Source
Gurley BJ et al. Drug Metab Dispos 2006
Supporting Research
Evaluation of the effect of herbal agents as management of radiodermatitis in breast cancer patients: A systematic review and meta-analysis
Efficacy of different interventions for nonalcoholic fatty liver disease: A meta-analysis of lifestyle modifications, silymarin, and medications
Pharmacotherapy for trichotillomania
Efficacy of traditional Chinese medicine combined with Silibinin on nonalcoholic fatty liver disease: A meta-analysis and systematic review
Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on randomized trials targeting liver injury
The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: A meta-analysis
The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials
Prevention and management of idiosyncratic drug-induced liver injury: Systematic review and meta-analysis of randomised clinical trials
Medical Disclaimer: This interaction record is for informational and educational purposes only and does not constitute medical advice. Drug-supplement interactions can be dangerous. Always consult your healthcare provider or pharmacist before combining any supplement with prescription medications. Do not stop or change any medication without professional guidance.