Warfarin/Milk Thistle Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Milk thistle may slow down how quickly your body processes warfarin.
What might happen:
You may experience an increased chance for bleeding including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together or if you stop taking milk thistle. Your doctor may want to check your bleeding times more often and may need to change the dose of your warfarin. Let your doctor know right away if you have any symptoms of bleeding.If you have not yet started taking milk thistle, discuss it with your healthcare professional first.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
- 2.Lash DB, Ward S. CYP2C9-mediated warfarin and milk thistle interaction. J Clin Pharm Ther 2019 Oct 21.
- 3.Han Y, Guo D, Chen Y, Chen Y, Tan ZR, Zhou HH. Effect of silymarin on the pharmacokinetics of losartan and its active metabolite E-3174 in healthy Chinese volunteers. Eur J Clin Pharmacol 2009 Jun;65(6):585-91.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.