Milk Thistle

Reviewed on 8/19/2021

What Is Milk Thistle and How Does It Work?

Milk Thistle is used to treat alcoholic liver disease, gallbladder problems, hepatic cirrhosis, hepatitis (chronic), hepatotoxicity (chemical/drug-induced), jaundice, pleurisy, prostate cancer, and spleen diseases, and used as an appetite stimulant.

  • It is possibly effective in diabetes and indigestion (dyspepsia).
  • Extensively studied; effective in treatment of cirrhosis, hepatitis, chemical- or alcohol-induced fatty liver.
  • Effective in mushroom (Amanita phalloides) poisoning, if treatment begins early.
  • Intravenous (IV) form of silibinin approved in Europe for Amatoxin poisoning.
  • Milk Thistle is available under the following different brand and other names: carduus marianum, holy thistle, lady's thistle, legalon, Marian thistle, Mary thistle, silibinin, silybin, silybum marianum, silymarin, and St Mary thistle.

What Are Dosages of Milk Thistle?

Suggested Dosing

Dosages of Milk Thistle:

  • 140 mg silymarin taken orally three times per day
Hepatitis, Chronic Active
  • Silibinin constituent: 240 mg taken orally two times/day
Hepatic Cirrhosis
  • Silymarin 70-80% extract: 420 mg/d taken orally
  • 1 mL taken orally three times/day (Iberogast, Medical Futures, Inc)
  • Silymarin 200 mg taken orally three times/day in combination with conventional treatment
Dosage Considerations – Should be Given as Follows:
  • There are no dosage considerations for use of milk thistle.


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What Are Side Effects Associated with Using Milk Thistle?

Side effects of milk thistle include:

  • Abdominal bloating/pain
  • Allergic reactions
  • Diarrhea
  • Gas
  • Indigestion
  • Itching
  • Loss of appetite
  • Nausea
  • Rash
  • Severe allergic reaction (anaphylaxis)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Milk Thistle?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

  • Milk thistle may interact with other drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Milk Thistle?


  • This medication contains milk thistle. Do not take carduus marianum, holy thistle, lady's thistle, legalon, Marian thistle, Mary thistle, silibinin, silybin, silybum marianum, silymarin, or St Mary thistle if you are allergic to milk thistle or any ingredients contained in this drug.
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.


Effects of Drug Abuse

  • No information available

Short-Term Effects

  • No information available

Long-Term Effects

  • No information available


  • Concurrent CYP3A4 substrates, CYP2C9 substrates.
  • Silymarin has poor oral bioavailability and is sparsely water-soluble.

Pregnancy and Lactation

  • There is no information available about the use of milk thistle during pregnancy or lactation. Consult your doctor.
Medscape. Milk Thistle.

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