⚠️ Mechanism
Milk thistle inhibits CYP3A4 and P-gp, potentially increasing sirolimus levels.
📋 Effect
Increased sirolimus levels; potential toxicity
💊 Management
Monitor sirolimus levels closely. May need dose reduction.
Plain Language Summary
This combination carries a moderate risk because milk thistle can cause sirolimus levels to rise in your body. These higher levels may lead to increased side effects or toxicity.
Source
Mills E et al. Pharmacotherapy 2005; DiCenzo R et al. J Clin Pharmacol 2003
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.