Re: A Warning about Milk Thistle and Drug Interactions

[Guest guest]

Claudine....is this warning just for HIV or for HCV too? I am taking some

meds on the list. I know this subject came up before....but of course, I

can't remember the answer.

Carol

claudine intexas wrote:

> A Warning about Milk Thistle and Drug Interactions

>

> <http://www.hcvadvocate.org/Medical_Writers_Circle/printer.gif>

>

> The seeds of the milk thistle plant are commonly used to protect the

> liver from damage caused by hepatitis viruses as well as alcohol and

> other substances. Compounds found in milk thistle — sylibin,

> sylimarin — act as antioxidants and also stimulate the repair of the

> liver. But now it appears that these and possibly other compounds in

> milk thistle can have other effects.

>

> Researchers at the University of Pittsburgh have suspected that milk

> thistle can slow down or reduce the activity of enzymes in the liver.

> What does this have to do with HIV? you might ask. Well, enzymes in

> the liver break down many of the substances that we eat and drink,

> including medications. If the activity of these enzymes are reduced,

> then drugs remain in the blood longer than they otherwise might. This

> could lead to having higher-than-expected levels of drugs in the

> body, causing side effects or intensifying already-existing side

> effects. Indeed, in recent experiments using milk thistle and human

> liver cells, the researchers found that relatively small

> concentrations of milk thistle did significantly slow down the

> activity of the liver enzyme CYP3A4 by 50% to 100%.

>

> Many medications taken by people with HIV/AIDS (PHAs) — such as

> protease inhibitors and non-nukes — are processed by this liver

> enzyme. If milk thistle is taken by someone using protease inhibitors

> or non-nukes, it has the potential to raise levels of these drugs,

> causing unpleasant or even dangerous side effects. Below is a short

> list of some other medications that are processed through the CYP3A4

> enzyme. Levels of these medications may increase if taken by people

> who are also using milk thistle. This list is not exhaustive:

>

> [*] methadone

> [*] heart drugs – Tambocor (flecainide), Rythmol (propafenone)

> [*] antibiotics – erythromycin, rifampin

> [*] anti-seizure drugs – carbamazepine (Tegretol)

> [*] antidepressants – St. 's wort, Zyban/Wellbutrin

> (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox

> (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor

> (venlafaxine)

> [*] antihistamines – Hismanal (astemizole), Seldane (terfenadine)

> [*] antifungals – itraconazole (Sporanox), Ketoconazole (Nizoral)

> [*] gastrointestinal motility agents – Prepulsid (Cisapride)

> [*] ergot drugs – Ergonovine, Ergomar (ergotamine)

> [*] anti-psychotics – Clozaril (clozapine), Orap (pimozide)

> [*] sedatives/sleeping pills – Ambien (zolpidem), Halcion

> (triazolam), Versed (midazolam)

> [*] lipid-lowering drugs (statins) – Lescol (fluvastatin), Mevacor

>

> (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol

>

> (cerivastatin)

> [*] transplant drugs – cyclosporine (Neoral, Sandimmune), ProGraf

> (tacrolimus)

>

> Milk thistle also has the potential to lower levels of the following

> drugs:

>

> [*] anti-parasite drugs – Mepron (atovaquone)

> [*] sedatives/sleeping pills – Ativan (lorazepam)

> [*] hormones – estrogen

>

> The research by the scientists in Pittsburgh should emphasize to

> readers that simply because a product is " natural " it does not mean

> it is safe when taken with other substances. This research also shows

> the need to conduct further research on herb-drug interactions on

> liver cells as well as in people. Such studies may find combinations

> of herbs and drugs that can be safely used together.

>

> The Pittsburgh researchers noted that " patients and health care

> professionals must be encouraged to discuss the use of herbs and be

> educated about the potential interactions between herbs and drugs. "

> This cannot be stressed enough.

>

> REFERENCE

>

> Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle,

> a herbal supplement, decreases the activity of CYP3A4 and uridine

> diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug

> Metabolism and Disposition 2000;28(11):1270-1273.

>

> This information was provided by the Community AIDS Treatment

> Information

> Exchange (CATIE). For more information, contact CATIE at

> 1-800-263-1638.

>

> __________________________________________________

>

[Guest guest]

Claudine....is this warning just for HIV or for HCV too? I am taking some

meds on the list. I know this subject came up before....but of course, I

can't remember the answer.

Carol

claudine intexas wrote:

> A Warning about Milk Thistle and Drug Interactions

>

> <http://www.hcvadvocate.org/Medical_Writers_Circle/printer.gif>

>

> The seeds of the milk thistle plant are commonly used to protect the

> liver from damage caused by hepatitis viruses as well as alcohol and

> other substances. Compounds found in milk thistle — sylibin,

> sylimarin — act as antioxidants and also stimulate the repair of the

> liver. But now it appears that these and possibly other compounds in

> milk thistle can have other effects.

>

> Researchers at the University of Pittsburgh have suspected that milk

> thistle can slow down or reduce the activity of enzymes in the liver.

> What does this have to do with HIV? you might ask. Well, enzymes in

> the liver break down many of the substances that we eat and drink,

> including medications. If the activity of these enzymes are reduced,

> then drugs remain in the blood longer than they otherwise might. This

> could lead to having higher-than-expected levels of drugs in the

> body, causing side effects or intensifying already-existing side

> effects. Indeed, in recent experiments using milk thistle and human

> liver cells, the researchers found that relatively small

> concentrations of milk thistle did significantly slow down the

> activity of the liver enzyme CYP3A4 by 50% to 100%.

>

> Many medications taken by people with HIV/AIDS (PHAs) — such as

> protease inhibitors and non-nukes — are processed by this liver

> enzyme. If milk thistle is taken by someone using protease inhibitors

> or non-nukes, it has the potential to raise levels of these drugs,

> causing unpleasant or even dangerous side effects. Below is a short

> list of some other medications that are processed through the CYP3A4

> enzyme. Levels of these medications may increase if taken by people

> who are also using milk thistle. This list is not exhaustive:

>

> [*] methadone

> [*] heart drugs – Tambocor (flecainide), Rythmol (propafenone)

> [*] antibiotics – erythromycin, rifampin

> [*] anti-seizure drugs – carbamazepine (Tegretol)

> [*] antidepressants – St. 's wort, Zyban/Wellbutrin

> (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox

> (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor

> (venlafaxine)

> [*] antihistamines – Hismanal (astemizole), Seldane (terfenadine)

> [*] antifungals – itraconazole (Sporanox), Ketoconazole (Nizoral)

> [*] gastrointestinal motility agents – Prepulsid (Cisapride)

> [*] ergot drugs – Ergonovine, Ergomar (ergotamine)

> [*] anti-psychotics – Clozaril (clozapine), Orap (pimozide)

> [*] sedatives/sleeping pills – Ambien (zolpidem), Halcion

> (triazolam), Versed (midazolam)

> [*] lipid-lowering drugs (statins) – Lescol (fluvastatin), Mevacor

>

> (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol

>

> (cerivastatin)

> [*] transplant drugs – cyclosporine (Neoral, Sandimmune), ProGraf

> (tacrolimus)

>

> Milk thistle also has the potential to lower levels of the following

> drugs:

>

> [*] anti-parasite drugs – Mepron (atovaquone)

> [*] sedatives/sleeping pills – Ativan (lorazepam)

> [*] hormones – estrogen

>

> The research by the scientists in Pittsburgh should emphasize to

> readers that simply because a product is " natural " it does not mean

> it is safe when taken with other substances. This research also shows

> the need to conduct further research on herb-drug interactions on

> liver cells as well as in people. Such studies may find combinations

> of herbs and drugs that can be safely used together.

>

> The Pittsburgh researchers noted that " patients and health care

> professionals must be encouraged to discuss the use of herbs and be

> educated about the potential interactions between herbs and drugs. "

> This cannot be stressed enough.

>

> REFERENCE

>

> Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle,

> a herbal supplement, decreases the activity of CYP3A4 and uridine

> diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug

> Metabolism and Disposition 2000;28(11):1270-1273.

>

> This information was provided by the Community AIDS Treatment

> Information

> Exchange (CATIE). For more information, contact CATIE at

> 1-800-263-1638.

>

> __________________________________________________

>

[Guest guest]

Claudine....is this warning just for HIV or for HCV too? I am taking some

meds on the list. I know this subject came up before....but of course, I

can't remember the answer.

Carol

claudine intexas wrote:

> A Warning about Milk Thistle and Drug Interactions

>

> <http://www.hcvadvocate.org/Medical_Writers_Circle/printer.gif>

>

> The seeds of the milk thistle plant are commonly used to protect the

> liver from damage caused by hepatitis viruses as well as alcohol and

> other substances. Compounds found in milk thistle — sylibin,

> sylimarin — act as antioxidants and also stimulate the repair of the

> liver. But now it appears that these and possibly other compounds in

> milk thistle can have other effects.

>

> Researchers at the University of Pittsburgh have suspected that milk

> thistle can slow down or reduce the activity of enzymes in the liver.

> What does this have to do with HIV? you might ask. Well, enzymes in

> the liver break down many of the substances that we eat and drink,

> including medications. If the activity of these enzymes are reduced,

> then drugs remain in the blood longer than they otherwise might. This

> could lead to having higher-than-expected levels of drugs in the

> body, causing side effects or intensifying already-existing side

> effects. Indeed, in recent experiments using milk thistle and human

> liver cells, the researchers found that relatively small

> concentrations of milk thistle did significantly slow down the

> activity of the liver enzyme CYP3A4 by 50% to 100%.

>

> Many medications taken by people with HIV/AIDS (PHAs) — such as

> protease inhibitors and non-nukes — are processed by this liver

> enzyme. If milk thistle is taken by someone using protease inhibitors

> or non-nukes, it has the potential to raise levels of these drugs,

> causing unpleasant or even dangerous side effects. Below is a short

> list of some other medications that are processed through the CYP3A4

> enzyme. Levels of these medications may increase if taken by people

> who are also using milk thistle. This list is not exhaustive:

>

> [*] methadone

> [*] heart drugs – Tambocor (flecainide), Rythmol (propafenone)

> [*] antibiotics – erythromycin, rifampin

> [*] anti-seizure drugs – carbamazepine (Tegretol)

> [*] antidepressants – St. 's wort, Zyban/Wellbutrin

> (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox

> (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor

> (venlafaxine)

> [*] antihistamines – Hismanal (astemizole), Seldane (terfenadine)

> [*] antifungals – itraconazole (Sporanox), Ketoconazole (Nizoral)

> [*] gastrointestinal motility agents – Prepulsid (Cisapride)

> [*] ergot drugs – Ergonovine, Ergomar (ergotamine)

> [*] anti-psychotics – Clozaril (clozapine), Orap (pimozide)

> [*] sedatives/sleeping pills – Ambien (zolpidem), Halcion

> (triazolam), Versed (midazolam)

> [*] lipid-lowering drugs (statins) – Lescol (fluvastatin), Mevacor

>

> (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol

>

> (cerivastatin)

> [*] transplant drugs – cyclosporine (Neoral, Sandimmune), ProGraf

> (tacrolimus)

>

> Milk thistle also has the potential to lower levels of the following

> drugs:

>

> [*] anti-parasite drugs – Mepron (atovaquone)

> [*] sedatives/sleeping pills – Ativan (lorazepam)

> [*] hormones – estrogen

>

> The research by the scientists in Pittsburgh should emphasize to

> readers that simply because a product is " natural " it does not mean

> it is safe when taken with other substances. This research also shows

> the need to conduct further research on herb-drug interactions on

> liver cells as well as in people. Such studies may find combinations

> of herbs and drugs that can be safely used together.

>

> The Pittsburgh researchers noted that " patients and health care

> professionals must be encouraged to discuss the use of herbs and be

> educated about the potential interactions between herbs and drugs. "

> This cannot be stressed enough.

>

> REFERENCE

>

> Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle,

> a herbal supplement, decreases the activity of CYP3A4 and uridine

> diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug

> Metabolism and Disposition 2000;28(11):1270-1273.

>

> This information was provided by the Community AIDS Treatment

> Information

> Exchange (CATIE). For more information, contact CATIE at

> 1-800-263-1638.

>

> __________________________________________________

>

[Guest guest]

Claudine....is this warning just for HIV or for HCV too? I am taking some

meds on the list. I know this subject came up before....but of course, I

can't remember the answer.

Carol

claudine intexas wrote:

> A Warning about Milk Thistle and Drug Interactions

>

> <http://www.hcvadvocate.org/Medical_Writers_Circle/printer.gif>

>

> The seeds of the milk thistle plant are commonly used to protect the

> liver from damage caused by hepatitis viruses as well as alcohol and

> other substances. Compounds found in milk thistle — sylibin,

> sylimarin — act as antioxidants and also stimulate the repair of the

> liver. But now it appears that these and possibly other compounds in

> milk thistle can have other effects.

>

> Researchers at the University of Pittsburgh have suspected that milk

> thistle can slow down or reduce the activity of enzymes in the liver.

> What does this have to do with HIV? you might ask. Well, enzymes in

> the liver break down many of the substances that we eat and drink,

> including medications. If the activity of these enzymes are reduced,

> then drugs remain in the blood longer than they otherwise might. This

> could lead to having higher-than-expected levels of drugs in the

> body, causing side effects or intensifying already-existing side

> effects. Indeed, in recent experiments using milk thistle and human

> liver cells, the researchers found that relatively small

> concentrations of milk thistle did significantly slow down the

> activity of the liver enzyme CYP3A4 by 50% to 100%.

>

> Many medications taken by people with HIV/AIDS (PHAs) — such as

> protease inhibitors and non-nukes — are processed by this liver

> enzyme. If milk thistle is taken by someone using protease inhibitors

> or non-nukes, it has the potential to raise levels of these drugs,

> causing unpleasant or even dangerous side effects. Below is a short

> list of some other medications that are processed through the CYP3A4

> enzyme. Levels of these medications may increase if taken by people

> who are also using milk thistle. This list is not exhaustive:

>

> [*] methadone

> [*] heart drugs – Tambocor (flecainide), Rythmol (propafenone)

> [*] antibiotics – erythromycin, rifampin

> [*] anti-seizure drugs – carbamazepine (Tegretol)

> [*] antidepressants – St. 's wort, Zyban/Wellbutrin

> (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox

> (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor

> (venlafaxine)

> [*] antihistamines – Hismanal (astemizole), Seldane (terfenadine)

> [*] antifungals – itraconazole (Sporanox), Ketoconazole (Nizoral)

> [*] gastrointestinal motility agents – Prepulsid (Cisapride)

> [*] ergot drugs – Ergonovine, Ergomar (ergotamine)

> [*] anti-psychotics – Clozaril (clozapine), Orap (pimozide)

> [*] sedatives/sleeping pills – Ambien (zolpidem), Halcion

> (triazolam), Versed (midazolam)

> [*] lipid-lowering drugs (statins) – Lescol (fluvastatin), Mevacor

>

> (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol

>

> (cerivastatin)

> [*] transplant drugs – cyclosporine (Neoral, Sandimmune), ProGraf

> (tacrolimus)

>

> Milk thistle also has the potential to lower levels of the following

> drugs:

>

> [*] anti-parasite drugs – Mepron (atovaquone)

> [*] sedatives/sleeping pills – Ativan (lorazepam)

> [*] hormones – estrogen

>

> The research by the scientists in Pittsburgh should emphasize to

> readers that simply because a product is " natural " it does not mean

> it is safe when taken with other substances. This research also shows

> the need to conduct further research on herb-drug interactions on

> liver cells as well as in people. Such studies may find combinations

> of herbs and drugs that can be safely used together.

>

> The Pittsburgh researchers noted that " patients and health care

> professionals must be encouraged to discuss the use of herbs and be

> educated about the potential interactions between herbs and drugs. "

> This cannot be stressed enough.

>

> REFERENCE

>

> Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle,

> a herbal supplement, decreases the activity of CYP3A4 and uridine

> diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug

> Metabolism and Disposition 2000;28(11):1270-1273.

>

> This information was provided by the Community AIDS Treatment

> Information

> Exchange (CATIE). For more information, contact CATIE at

> 1-800-263-1638.

>

> __________________________________________________

>

[Guest guest]

Carol,

It's just info - for ANYONE who is on or may take any of these

medications. If someone is taking medications for HIV or has had a

transplant then this info is of particular importance. But it is just

information - not necessarily bad info either. Just useful. For

example, I recently was prescribed Paxil, a full normal adult dose. I

couldn't handle the side effects, all I wanted to do was sleep. So my

doctor switched me to a low dose of Prozac. It's working fine, with

none of the nasty side effects some people have. Did the milk thistle

I take make me have too much of the Paxil in my system? Who knows. Is

the milk thistle keeping the Prozac at a better level for me? ??? I

do know that when I ran out of milk thistle and didn't take it for

about a week I was more irritable than I had been. I thought the

Prozac wasn't working anymore - then I was ok. I didn't connect the

two until I read this article. What it comes down to is if you are

taking any of these medications the dose may need to be adjusted. If

you are on Protease inhibitors for HIV, or taking anti-rejection

medications for a transplant, then you should probably avoid milk

thistle - at least I would. But I have no plans to quit taking it

because of this info. I will just keep this info in mind when taking

any other medications.

Claudine

__________________________________________________

[Guest guest]

Carol,

It's just info - for ANYONE who is on or may take any of these

medications. If someone is taking medications for HIV or has had a

transplant then this info is of particular importance. But it is just

information - not necessarily bad info either. Just useful. For

example, I recently was prescribed Paxil, a full normal adult dose. I

couldn't handle the side effects, all I wanted to do was sleep. So my

doctor switched me to a low dose of Prozac. It's working fine, with

none of the nasty side effects some people have. Did the milk thistle

I take make me have too much of the Paxil in my system? Who knows. Is

the milk thistle keeping the Prozac at a better level for me? ??? I

do know that when I ran out of milk thistle and didn't take it for

about a week I was more irritable than I had been. I thought the

Prozac wasn't working anymore - then I was ok. I didn't connect the

two until I read this article. What it comes down to is if you are

taking any of these medications the dose may need to be adjusted. If

you are on Protease inhibitors for HIV, or taking anti-rejection

medications for a transplant, then you should probably avoid milk

thistle - at least I would. But I have no plans to quit taking it

because of this info. I will just keep this info in mind when taking

any other medications.

Claudine

__________________________________________________

[Guest guest]

Carol,

It's just info - for ANYONE who is on or may take any of these

medications. If someone is taking medications for HIV or has had a

transplant then this info is of particular importance. But it is just

information - not necessarily bad info either. Just useful. For

example, I recently was prescribed Paxil, a full normal adult dose. I

couldn't handle the side effects, all I wanted to do was sleep. So my

doctor switched me to a low dose of Prozac. It's working fine, with

none of the nasty side effects some people have. Did the milk thistle

I take make me have too much of the Paxil in my system? Who knows. Is

the milk thistle keeping the Prozac at a better level for me? ??? I

do know that when I ran out of milk thistle and didn't take it for

about a week I was more irritable than I had been. I thought the

Prozac wasn't working anymore - then I was ok. I didn't connect the

two until I read this article. What it comes down to is if you are

taking any of these medications the dose may need to be adjusted. If

you are on Protease inhibitors for HIV, or taking anti-rejection

medications for a transplant, then you should probably avoid milk

thistle - at least I would. But I have no plans to quit taking it

because of this info. I will just keep this info in mind when taking

any other medications.

Claudine

__________________________________________________

[Guest guest]

Carol,

It's just info - for ANYONE who is on or may take any of these

medications. If someone is taking medications for HIV or has had a

transplant then this info is of particular importance. But it is just

information - not necessarily bad info either. Just useful. For

example, I recently was prescribed Paxil, a full normal adult dose. I

couldn't handle the side effects, all I wanted to do was sleep. So my

doctor switched me to a low dose of Prozac. It's working fine, with

none of the nasty side effects some people have. Did the milk thistle

I take make me have too much of the Paxil in my system? Who knows. Is

the milk thistle keeping the Prozac at a better level for me? ??? I

do know that when I ran out of milk thistle and didn't take it for

about a week I was more irritable than I had been. I thought the

Prozac wasn't working anymore - then I was ok. I didn't connect the

two until I read this article. What it comes down to is if you are

taking any of these medications the dose may need to be adjusted. If

you are on Protease inhibitors for HIV, or taking anti-rejection

medications for a transplant, then you should probably avoid milk

thistle - at least I would. But I have no plans to quit taking it

because of this info. I will just keep this info in mind when taking

any other medications.

Claudine

__________________________________________________

[Guest guest]

Claudine,

The link you posted does not work. I would really like to read this one.

It sounds suspicious to me in that the real meaning might be to discourage

herbs and not about herb-drug interactions. Please see the section I took

out of your e-mail.

" The research by the scientists in Pittsburgh should emphasize to

readers that simply because a product is " natural " it does not mean

it is safe when taken with other substances. This research also shows

the need to conduct further research on herb-drug interactions on

liver cells as well as in people. Such studies may find combinations

of herbs and drugs that can be safely used together. "

Thanks,

Mer

----------

>From: claudine intexas <claudineintexas@...>

>gi <giworld-hepatitis >, Web Warriors

< >

>Subject: [ ] A Warning about Milk Thistle and Drug Interactions

>Date: Mon, May 20, 2002, 3:05 PM

>

>

[Guest guest]

Try accessing the article this way:

http://www.hcvadvocate.org/ Type in or 'copy and paste' the title of

the article in the 'search' box. You should find it easily.

I don't see anything 'suspicious' about this at all. Like it or not,

just because something is " natural " does not mean it is safe, either

alone or when combined with other medications or herbs. It's just a

fact of life. A castor bean is natural, but if you eat one it will

kill you. On the other hand, processed properly it's oil has many

good uses. Bupleurum is considered one of the best chinese herbs for

the liver but should never be used with interferon - deaths have

resulted. Licorice is a very useful herb and is used frequently in

many herbal combinations, but in some people it can cause high blood

pressure. You have to be smart about herbs just like you have to be

smart about medicines. I just see this article as info, not

necessarily bad or good info, just INFO - for ANYONE who is on or may

take any of these medications. If someone is taking medications for

HIV or has had a transplant then this info is of particular

importance. But it is just information - not necessarily bad info.

Just useful. For example, I recently was prescribed Paxil, a full

normal adult dose. I couldn't handle the side effects, all I wanted

to do was sleep. So my doctor switched me to a very low dose of

Prozac. It's working fine, with none of the nasty side effects some

people have. Did the milk thistle I take make me have too much of the

Paxil in my system? Who knows. Is the milk thistle keeping the low

dose of Prozac at a better level for me? ??? I do know that when I

ran out of milk thistle and didn't take it for about a week I was

more irritable than I had been. I thought the Prozac wasn't working

anymore - but when I began taking the milk thistle again I was ok. I

didn't connect the two until I read this article. What it comes down

to is if you are taking any of these medications the dose may need to

be adjusted. If you are on Protease inhibitors for HIV, or taking

anti-rejection medications for a transplant, then you should probably

avoid milk thistle - at least I would. But I have no plans to quit

taking it because of this info. I will just keep this info in mind

when taking any other medications.

Claudine

__________________________________________________

[Guest guest]

This appears to be in regards to HIV and NOT HCV... I suppose it 'could' be the same but this is ONE study,, I'd be interested in hearing about more studies if this is indeed true for HEP as well as HIV.. the meds are different so I wonder if its the same,,,elizabethnv1 <elizabethnv1@...> wrote: A Warning about Milk Thistle and Drug InteractionsThe seeds of the milk thistle plant are commonly used to protect the liver from damage caused by hepatitis viruses as well as alcohol and other substances.

Compounds found in milk thistle - sylibin, sylimarin - act as antioxidants and also stimulate the repair of the liver. But now it appears that these and possibly other compounds in milk thistle can have other effects. Researchers at the University of Pittsburgh have suspected that milk thistle can slow down MF reduce the activity of enzymes in the liver. What does this have to do with HIV? you might ask. Well, enzymes in the liver break down many of the substances that we eat and drink, including medications. If the activity of these enzymes are reduced, then drugs remain in the blood longer than they otherwise might. This could lead to having higher-than-expected levels of drugs in the body, causing side effects MF intensifying already-existing side effects. Indeed, in recent experiments using milk thistle and human liver cells, the researchers found that relatively small concentrations of milk thistle did

significantly slow down the activity of the liver enzyme CYP3A4 by 50% to 100%. Many medications taken by people with HIV/AIDS (PHAs) - such as protease inhibitors and non-nukes - are processed by this liver enzyme. If milk thistle is taken by someone using protease inhibitors MF non-nukes, it has the potential to raise levels of these drugs, causing unpleasant MF even dangerous side effects. Below is a short list of some other medications that are processed through the CYP3A4 enzyme. Levels of these medications may increase if taken by people who are also using milk thistle. This list is not exhaustive: methadone heart drugs - Tambocor (flecainide), Rythmol (propafenone) antibiotics - erythromycin, rifampin anti-seizure drugs - carbamazepine (Tegretol) antidepressants - St. 's wort, Zyban/Wellbutrin (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxetine) Serzone

(nefazodone), Zoloft (sertraline), Effexor (venlafaxine) antihistamines - Hismanal (astemizole), Seldane (terfenadine) antifungals - itraconazole (Sporanox), Ketoconazole (Nizoral) gastrointestinal motility agents - Prepulsid (Cisapride) ergot drugs - Ergonovine, Ergomar (ergotamine) anti-psychotics - Clozaril (clozapine), Orap (pimozide) sedatives/sleeping pills - Ambien (zolpidem), Halcion (triazolam), Versed (midazolam) lipid-lowering drugs (statins) - Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol (cerivastatin) transplant drugs - cyclosporine (Neoral, Sandimmune), ProGraf (tacrolimus) Milk thistle also has the potential to lower levels of the following drugs: anti-parasite drugs - Mepron (atovaquone) sedatives/sleeping pills - Ativan (lorazepam) hormones - estrogen The research by the scientists in

Pittsburgh should emphasize to readers that simply because a product is "natural" it does not mean it is safe when taken with other substances. This research also shows the need to conduct further research on herb-drug interactions on liver cells as well as in people. Such studies may find combinations of herbs and drugs that can be safely used together. The Pittsburgh researchers noted that "patients and health care professionals must be encouraged to discuss the use of herbs and be educated about the potential interactions between herbs and drugs." This cannot be stressed enough. Jackie

[Guest guest]

"POTENTIAL" interactions,, remember,, its NOT absolute,, its POTENTIAL,,,elizabethnv1 <elizabethnv1@...> wrote: A Warning about Milk Thistle and Drug InteractionsThe seeds of the milk thistle plant are commonly used to protect the liver from damage caused by hepatitis viruses as well as alcohol and other substances. Compounds found in milk thistle - sylibin, sylimarin - act as antioxidants and also stimulate the repair of the liver. But now it appears that these and possibly other compounds in

milk thistle can have other effects. Researchers at the University of Pittsburgh have suspected that milk thistle can slow down MF reduce the activity of enzymes in the liver. What does this have to do with HIV? you might ask. Well, enzymes in the liver break down many of the substances that we eat and drink, including medications. If the activity of these enzymes are reduced, then drugs remain in the blood longer than they otherwise might. This could lead to having higher-than-expected levels of drugs in the body, causing side effects MF intensifying already-existing side effects. Indeed, in recent experiments using milk thistle and human liver cells, the researchers found that relatively small concentrations of milk thistle did significantly slow down the activity of the liver enzyme CYP3A4 by 50% to 100%. Many medications taken by people with HIV/AIDS (PHAs) - such as protease inhibitors and

non-nukes - are processed by this liver enzyme. If milk thistle is taken by someone using protease inhibitors MF non-nukes, it has the potential to raise levels of these drugs, causing unpleasant MF even dangerous side effects. Below is a short list of some other medications that are processed through the CYP3A4 enzyme. Levels of these medications may increase if taken by people who are also using milk thistle. This list is not exhaustive: methadone heart drugs - Tambocor (flecainide), Rythmol (propafenone) antibiotics - erythromycin, rifampin anti-seizure drugs - carbamazepine (Tegretol) antidepressants - St. 's wort, Zyban/Wellbutrin (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor (venlafaxine) antihistamines - Hismanal (astemizole), Seldane (terfenadine) antifungals - itraconazole (Sporanox),

Ketoconazole (Nizoral) gastrointestinal motility agents - Prepulsid (Cisapride) ergot drugs - Ergonovine, Ergomar (ergotamine) anti-psychotics - Clozaril (clozapine), Orap (pimozide) sedatives/sleeping pills - Ambien (zolpidem), Halcion (triazolam), Versed (midazolam) lipid-lowering drugs (statins) - Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol (cerivastatin) transplant drugs - cyclosporine (Neoral, Sandimmune), ProGraf (tacrolimus) Milk thistle also has the potential to lower levels of the following drugs: anti-parasite drugs - Mepron (atovaquone) sedatives/sleeping pills - Ativan (lorazepam) hormones - estrogen The research by the scientists in Pittsburgh should emphasize to readers that simply because a product is "natural" it does not mean it is safe when taken with other substances. This research also shows the

need to conduct further research on herb-drug interactions on liver cells as well as in people. Such studies may find combinations of herbs and drugs that can be safely used together. The Pittsburgh researchers noted that "patients and health care professionals must be encouraged to discuss the use of herbs and be educated about the potential interactions between herbs and drugs." This cannot be stressed enough. Jackie

[Guest guest]

It's actually written for both , they mention HIV allot cause of the number of different meds these patients have to take ...But all in all we all need to be aware of any medication that can potentially cause a problem . Just like the FDA warnings about procrit

Re: A Warning about Milk Thistle and Drug Interactions

This appears to be in regards to HIV and NOT HCV... I suppose it 'could' be the same but this is ONE study,, I'd be interested in hearing about more studies if this is indeed true for HEP as well as HIV.. the meds are different so I wonder if its the same,,,elizabethnv1 <elizabethnv1earthlink (DOT) net> wrote:

A Warning about Milk Thistle and Drug InteractionsThe seeds of the milk thistle plant are commonly used to protect the liver from damage caused by hepatitis viruses as well as alcohol and other substances. Compounds found in milk thistle - sylibin, sylimarin - act as antioxidants and also stimulate the repair of the liver. But now it appears that these and possibly other compounds in milk thistle can have other effects. Researchers at the University of Pittsburgh have suspected that milk thistle can slow down MF reduce the activity of enzymes in the liver. What does this have to do with HIV? you might ask. Well, enzymes in the liver break down many of the substances that we eat and drink, including medications. If the activity of these enzymes are reduced, then drugs remain in the blood longer than they otherwise might. This could lead to having higher-than-expected levels of drugs in the body, causing side effects MF intensifying already-existing side effects. Indeed, in recent experiments using milk thistle and human liver cells, the researchers found that relatively small concentrations of milk thistle did significantly slow down the activity of the liver enzyme CYP3A4 by 50% to 100%. Many medications taken by people with HIV/AIDS (PHAs) - such as protease inhibitors and non-nukes - are processed by this liver enzyme. If milk thistle is taken by someone using protease inhibitors MF non-nukes, it has the potential to raise levels of these drugs, causing unpleasant MF even dangerous side effects. Below is a short list of some other medications that are processed through the CYP3A4 enzyme. Levels of these medications may increase if taken by people who are also using milk thistle. This list is not exhaustive: methadone heart drugs - Tambocor (flecainide), Rythmol (propafenone) antibiotics - erythromycin, rifampin anti-seizure drugs - carbamazepine (Tegretol) antidepressants - St. 's wort, Zyban/Wellbutrin (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor (venlafaxine) antihistamines - Hismanal (astemizole), Seldane (terfenadine) antifungals - itraconazole (Sporanox), Ketoconazole (Nizoral) gastrointestinal motility agents - Prepulsid (Cisapride) ergot drugs - Ergonovine, Ergomar (ergotamine) anti-psychotics - Clozaril (clozapine), Orap (pimozide) sedatives/sleeping pills - Ambien (zolpidem), Halcion (triazolam), Versed (midazolam) lipid-lowering drugs (statins) - Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol (cerivastatin) transplant drugs - cyclosporine (Neoral, Sandimmune), ProGraf (tacrolimus) Milk thistle also has the potential to lower levels of the following drugs: anti-parasite drugs - Mepron (atovaquone) sedatives/sleeping pills - Ativan (lorazepam) hormones - estrogen The research by the scientists in Pittsburgh should emphasize to readers that simply because a product is "natural" it does not mean it is safe when taken with other substances. This research also shows the need to conduct further research on herb-drug interactions on liver cells as well as in people. Such studies may find combinations of herbs and drugs that can be safely used together. The Pittsburgh researchers noted that "patients and health care professionals must be encouraged to discuss the use of herbs and be educated about the potential interactions between herbs and drugs." This cannot be stressed enough. Jackie