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Drug Interactions between Evista and milk thistle

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

raloxifene milk thistle

Applies to: Evista (raloxifene) and milk thistle

MONITOR: Coadministration with milk thistle constituents silibinin and silymarin may increase raloxifene systemic exposure (AUC). The mechanism involves inhibition of raloxifene glucuronidation in the intestines by milk thistle flavonolignans silybin A and silybin B. Silibinin and silymarin were predicted to increase raloxifene AUC by 4- to 5-fold in a study that used human intestinal microsomes and human embryonic kidney cell lysates.

MANAGEMENT: Patients should be monitored for adverse effects from raloxifene if coadministered with milk thistle or its constituents.

References (1)
  1. Gufford BT, Chen G, Vergara AG, Lazarus P, Oberlies NH, Paine MF (2015) "Milk Thistle Constituents Inhibit Raloxifene Intestinal Glucuronidation: A Potential Clinically Relevant Natural Product-Drug Interaction." Drug Metab Dispos, 43, p. 1353-9

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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