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Are there any interactions with milk thistle?

People have used milk thistle (scientific name Silybum marianum) as an herbal remedy for about 2000 years. Studies show it may protect the liver and gallbladder from chemical damage. Currently, the only known drug interaction with milk thistle is metronidazole (Flagyl). There have not been very many studies regarding drug interactions with milk thistle, so always be sure to talk with your doctor before taking herbal or alternative medicines.

Sources:
Flora, K., et al. "Milk thistle (Silybum marianum) for the therapy of liver disease," The American Journal of Gastroenterology 93 (1998).
Luper, S. "A review of plants used in the treatment of liver disease: part 1," Alternative Medicine Review 3 (1998).
The Review of Natural Products. Facts & Comparisons, 2007.
The Natural Medicines Comprehensive Database. Pharmacists Letter Inc., 2001.
Blumenthal, Mark.“Interactions Between Herbs and Conventional Drugs” HerbalGram 49 (2000).
Micromedex® Healthcare Series. Thomson Micromedex, 2007.

This answer prepared 2/13/2001.
This information updated 1/18/2007.