Is Milk Thistle Safe with Codeine?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Use caution combining Milk Thistle with Codeine. Milk Thistle may mildly slow Codeine metabolism via CYP3A4. Monitor for increased side effects.
Why this interaction occurs
Silymarin weak CYP3A4 inhibition. Result: minimal drug level change. Generally low clinical risk
Evidence
Evidence level: limited.
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 100,795 reports mentioning Codeine. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Codeine + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Milk Thistle interactions → · All Codeine interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.