Can I take Atorvastatin and Milk thistle extract together?

Why this happens

Milk thistle contains a compound called silymarin. Silymarin can interfere with certain proteins (transporters) and enzymes in the liver that are responsible for breaking down and removing atorvastatin from your body. If the liver cannot process the statin as quickly as usual, the drug levels can rise.

What you should do

Use caution if combining these two. If you decide to take milk thistle, monitor yourself closely for any new or unusual muscle pain, tenderness, or weakness, as well as any yellowing of the skin or eyes (jaundice). It is best to inform your doctor or pharmacist before starting milk thistle so they can ensure your statin dose remains appropriate for you.

Important precautions

Pregnancy

You must not take atorvastatin if you are pregnant or planning to become pregnant, as it can cause serious harm to an unborn baby. Use effective contraception while taking this medicine.

Muscle disorders

You must report any unexplained muscle pain, tenderness, or weakness to your doctor immediately, as this can rarely lead to serious kidney damage.

Hormone-sensitive conditions (e.g. breast cancer, endometriosis)

Avoid milk thistle if you have a history of hormone-sensitive cancers or conditions, as it may have oestrogen-like effects that could worsen these conditions.

Food and drink warnings

Grapefruit juice

Grapefruit juice contains compounds that can increase the level of atorvastatin in your blood. This can increase your risk of side effects, such as muscle pain or liver problems. You should avoid drinking large quantities (more than 1.2 litres daily), but it is safest to avoid it altogether while taking this medicine.

Alcohol

While alcohol does not directly interact with atorvastatin, drinking large amounts of alcohol can increase the risk of liver damage and may raise triglyceride levels, which can counteract the benefits of the medicine. It is advised to keep alcohol intake within recommended limits.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.