Milk Thistle × Sirolimus

Severity: MODERATE Evidence: probable

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.

Source

Mills E et al. Pharmacotherapy 2005; DiCenzo R et al. J Clin Pharmacol 2003

⚠️ MODERATE INTERACTION: Monitor closely if this combination is used.

Disclaimer

This interaction record is for informational purposes only and does not constitute medical advice. Always consult a healthcare provider before starting or stopping any supplement or medication.