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For example, valproic acid treatment can exhaust carnitine in the body through various mechanisms, like increased removal via urine, reduced absorption in the kidneys, and decreased natural production

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Liver enzyme monitoring typically occurs every 3-6 months during the first year of treatment, then annually if results remain stable

According to the Mayo Clinic, some of these possible interactions include: Substrates for cytochrome P450 2C9, such as Valium (diazepam) and Jantoven (warfarin) Some diabetes medications Evista (raloxifene) Olysio (simeprevir) Rapamune (sirolimus) Other medications, such as those that treat allergies, high cholesterol, anxiety, and cancer, could also interact with milk thistle, according to Mount Sinai