Drug & supplement interaction

Cesium + Trilaciclib Dihydrochloride

Trilaciclib Dihydrochloride brand name: Cosela.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Cesium has a major interaction with Trilaciclib Dihydrochloride. Theoretically, taking cesium concomitantly with other drugs that prolong the QT interval may increase the risk of ventricular arrhythmias and death.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cesium and Trilaciclib Dihydrochloride

Here is the interaction we found between these two, with the evidence behind it.

Major

QT INTERVAL-PROLONGING DRUGS

Why this applies to Trilaciclib Dihydrochloride

Trilaciclib Dihydrochloride falls under QT INTERVAL-PROLONGING DRUGS — the group Cesium interacts with.

Theoretically, taking cesium concomitantly with other drugs that prolong the QT interval may increase the risk of ventricular arrhythmias and death.
Taking cesium can prolong the QT interval on electrocardiogram (ECG). In many cases, cesium-induced QT prolongation has led to serious adverse effects, including torsades de pointes, cardiac arrest, and death.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with combining cesium and trilaciclib (Cosela). Cesium itself can stretch out the heart's electrical cycle, something doctors call QT prolongation on an ECG. When you stack it with another medicine that can also affect that same heart rhythm, the worry is an additive effect that raises the chance of a dangerous irregular heartbeat (like torsades de pointes), which can be life-threatening.

I want to be straight with you: this is a theoretical caution based mostly on case reports, not strong studies. But cesium chloride has genuinely caused cardiac arrest and death on its own, so it's simply not a supplement I'd recommend, with or without your cancer treatment. Please don't add it without talking to your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Lyon AW, Mayhew WJ. Cesium toxicity: A case of self-treatment by alternate therapy gone awry. Ther Drug Monit 2003;25:114-6. PubMed
  2. Vyas H, Johnson K, Houlihan R, et al. Acquired long QT syndrome secondary to cesium chloride supplement. J Altern Complement Med 2006;12:1011-4. PubMed
  3. Pinter A, Dorian P, Newman D. Cesium-induced torsades de pointes. N Engl J Med 2002;346:383-4. PubMed
  4. O'Brien CE, Harik N, James LP, et al. Cesium-induced QT-interval prolongation in an adolescent. Pharmacotherapy 2008;28:1059-65. PubMed
  5. FDA alerts health care professionals of significant safety risks associated with cesium chloride. FDA: Human Drug Compounding. July 23,2018. Available at: https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-professionals-significant-sa
  6. Public Health Alert Concerning Dietary Supplements Containing Cesium Salts. FDA Dietary Supplement Products & Ingredients. February 5, 2020. Available at: https://www.fda.gov/food/dietary-supplement-products-ingredients/public-health-alert-concerning-diet

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cesium Also Interacts With Other Medications

Cesium has 160 major, 94 moderate known drug interactions in our database — the Trilaciclib Dihydrochloride one above is one of them. If you take anything else, check it against the full list below.

Major 160 Moderate 94 No known interaction 2,576 (incl. Trilaciclib Dihydrochloride)
Taking anything else?

Check Another of Your Medications Against Cesium

Covers the 2,830 medications we’ve checked against Cesium. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Trilaciclib Dihydrochloride

This page covers Cesium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Trilaciclib Dihydrochloride page lists 13 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), Arsenic (major), Ephedra (major), Grapefruit (major) and Sida Cordifolia (major).

By severity: 6 major · 7 moderate.

From our pharmacist’s overview on the Trilaciclib Dihydrochloride page

“Trilaciclib (Cosela) is an infusion given before chemotherapy to shield bone marrow in people with small cell lung cancer, and its supplement list deserves genuine attention because all 13 flagged ingredients press on the same weak point, the heart's electrical rhythm. Each can lengthen the QT interval, the pause between beats on an EC…”

Reviewed by 2 · Jul 18, 2026

Open the Trilaciclib Dihydrochloride interaction page

One more smart check

Taking Cesium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 51 real supplement products containing Cesium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cesium. Your product may carry other ingredients that interact with Trilaciclib Dihydrochloride too, on top of Cesium — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cesium and Trilaciclib Dihydrochloride Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cesium
Steady interest

#994 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Trilaciclib Dihydrochloride
Steady interest

#2,549 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cesium

What is Cesium?

  • Marketed as an alternative cancer treatment ('high pH therapy')
  • Claimed to alter tumor pH
  • General 'alkaline' health claims

Cesium chloride is a mineral salt sold as an alternative cancer therapy ('high pH therapy'), but there is no reliable scientific evidence that it treats cancer or any other disease. It can cause dangerous heart rhythm problems and even death, so it should not be used. Talk to your doctor or pharmacist before taking any supplement, and never use cesium in place of proven medical care.

Read the full Cesium monograph & all interactions
Medication

About Trilaciclib Injection

What Is Trilaciclib Injection Used For?

Brand name: Cosela

Cosela (trilaciclib) is given to adults with extensive-stage small cell lung cancer (ES-SCLC) to decrease chemotherapy-induced myelosuppression — meaning it helps protect the bone marrow from the blood-cell-lowering effects of certain chemotherapy regimens.

Cosela is approved for use before platinum/etoposide-containing chemotherapy regimens or topotecan-containing regimens in ES-SCLC. It is given as an intravenous infusion before chemotherapy on each day that chemotherapy is administered.

See full Trilaciclib Injection drug information
Keep checking

Other Drugs & Cesium

Browse every other medication we’ve checked against Cesium — both the ones with a known interaction and the ones without. Select any drug for the full detail.

160Major
94Moderate
0Minor
2,575No known interaction
160 Major 94 Moderate 2,575 No interaction
Major

160 interactions

Showing 60 of 160 major interactions — see all 160 on the Cesium page.

Moderate

94 interactions

Showing 60 of 94 moderate interactions — see all 94 on the Cesium page.

No interaction 2,575 drugs checked — show the list

We also checked Cesium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,575 medications checked with no known interaction — see the full Cesium list.

See the full Cesium interactions page
See every supplement checked against Trilaciclib Dihydrochloride, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Cesium monograph › Uses, safety, and every drug interaction in one place Trilaciclib Dihydrochloride supplement interactions › Every supplement checked against Trilaciclib Dihydrochloride, ranked by severity Trilaciclib Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Cesium and Trilaciclib Dihydrochloride Together: Common Questions

Can you take Cesium with Trilaciclib Dihydrochloride?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cesium and Trilaciclib Dihydrochloride interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Trilaciclib Dihydrochloride and Cesium?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.