Interactions

Possible interactions include:

• Cytochrome P450 2C9 (CYP2C9) substrates. Taking milk thistle might affect this enzyme and drugs it processes, such as diazepam (Valium), warfarin (Jantoven) and others. This means milk thistle might affect the levels of these drugs in your body.
• Diabetes medications. Milk thistle might lower blood sugar in people who have type 2 diabetes. Closely monitor your blood sugar levels, and talk to your doctor before taking milk thistle supplements if you take diabetes medications.
• Raloxifene (Evista). Milk thistle may affect how your liver processes this osteoporosis medication, causing higher levels of the drug in your bloodstream. Talk to your doctor before taking milk thistle if you're taking raloxifene.
• Simeprevir. Taking milk thistle with this hepatitis C medication might increase levels of the drug in your blood plasma. Avoid using milk thistle and simeprevir together.
• Sirolimus (Rapamune). Taking milk thistle with this immunosuppressant might change the way your body processes the medication.