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Milk Thistle, Dandelion Tea, Multivitamin


I started 4gr of Milk thistle daily after 1 month of Bosulif. I also increased drinking Dandelion tea (6 to 8 cups daily) both to detox the liver and kidneys while on TKI.
2 months later i get my PCR test and get 100%. Two months earlier was 53%. I want to know if there is any interaction of these two herbs with TKI.

Hi Mayita,

Regarding Bosulif interaction with other herbs, you may want to check the prescribing information in the following link:

There’s no direct mention to milk thistle nor dandelion tea.

I would research whether milk thistle, dandelion tea, and multivitamin in the doses you mentioned could be overworking your liver and kidneys instead of helping them. It is debatable If this has any side effects on Bosulif absorption.

Make sure with your doctor that Bosulif is working well for you before implementing detox protocols.

Best regards, and I hope this information helps in your future research.

I found Bosulif metabolizes via liver enzyme CYPA3A4.

Milk thistle is Cyp3a4 is an inhibitor of this
this enzyme, according to

My PCR went from 53.26% to 100% after i started Milk thistle. The doctor does not know about Milk Thistle.

I am not sure about Dandelion tea. I found it is a mild inhibitor in vitro, but there seems to be evidence in vivo may not. I am still researching.

Hello Mayita,

Thanks for the info.

If I understand correctly from your post, 1- Bosulif metabolizes via  enzyme CYP3A4.

                                                                 2- Milk Thistle is a CYP3A4 inhibitor.

Therefore, Milk Thistle does not seem to be such a good idea after all....

In fact your PCR shot up from 53.26% to 100% after you started Milk Thistle!

That fact by itself may indicate that Milk Thistle is not recommended.

Please correct me if I got it wrong? I only quoted the info from your links.

All the best, and thanks again for your research.




Hi Israel,

see under "Drug interactions"; from the link you sent. It says:


•Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF.

Interesting find Mayita.


Concomitant use with a strong or moderate CYP3A inhibitor increased bosutinib Cmax and AUC compared to BOSULIF alone/[see Clinical Pharmacology (12.3)]/which may increase the risk of toxicities. Avoid the concomitant use of strong or moderate CYP3A inhibitors with BOSULIF.

I can't say for sure that your latest PCR result was heavily influenced by milk thistle in your diet. In doubt, discontinue milk thistle and have another PCR test done. I will be curious to know the outcome of this.

Because your PCR result went from 56% to 100%, it sounds that you are at the beginning of CML treatment. Is this correct? At this phase, I would favor being adherent to the TKI, take it every day, at the same time, and make sure it is working for me. By the way, what did your doctor say about your latest PCR? Did he/she give you any insights or mentioned future possibilities for your treatment?

Correct, I stopped Milk thistle (I was also overdosing), and the chemo pills too (doctor requested). The oncologist did a Resistant Panel Mutation test to rule out mutation. He said the Bosulif is not working due to 2 reasons: either my supplements were blocking it, or, I developed a mutation. I am currently waiting for test results.