Drug & supplement interaction

Chaparral + Selpercatinib

Selpercatinib brand name: Retevmo.

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

Chaparral has a moderate interaction with Selpercatinib. Theoretically, chaparral might have additive adverse effects on the liver when used with hepatotoxic drugs.

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

Chaparral and Selpercatinib

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

Moderate

HEPATOTOXIC DRUGS

Why this applies to Selpercatinib

Selpercatinib falls under HEPATOTOXIC DRUGS — the group Chaparral interacts with.

Theoretically, chaparral might have additive adverse effects on the liver when used with hepatotoxic drugs.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the concern with pairing chaparral and selpercatinib (Retevmo). This isn't about chaparral changing how your cancer drug is broken down. Instead, it's about both being hard on the liver. Selpercatinib can already raise your liver enzymes (your oncology team usually checks these with regular blood work), and chaparral has been tied to serious, sometimes lasting liver damage. Stack them together and you may add extra strain on the same organ.

To be fair, this is a theoretical warning based on weak, anecdotal reports, not hard proof. Still, given that the FDA has flagged chaparral for liver harm, I'd steer clear of it while on selpercatinib. Please loop in your oncologist or pharmacist before taking any supplement.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Smith BC, Desmond PV. Acute hepatitis induced by ingestion of the herbal medication chaparral. Aust N Z J Med 1993;23:526.. PubMed
  2. Gordon DW, Rosenthal G, Hart J, et al. Chaparral ingestion: the broadening spectrum of liver injury caused by herbal medications. JAMA 1995;273:489-90.
  3. Batchelor WB, Heathcote J, Wanless IR. Chaparral-induced hepatic injury. Am J Gastroenterol 1995;90:831-3.
  4. Katz M, Saibil F. Herbal hepatitis: subacute hepatic necrosis secondary to chaparral leaf. J Clin Gastroenterol 1990;12:203-6.
  5. Sheikh NM, Philen RM, Love LA. Chaparral-associated hepatotoxicity. Arch Intern Med 1997;157:913-9. DOI
  6. Chaparral-induced toxic hepatitis-California and Texas, 1992. MMWR Morb Mortal Wkly Rep 1992;41:812-4.. DOI
  7. Estes JD, Stolpman D, Olyaei A, et al. High prevalence of potentially hepatotoxic herbal supplement use in patients with fulminant hepatic failure. Arch Surg 2003;138:852-8.. PubMed

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

Chaparral Also Interacts With Other Medications

Chaparral has 369 moderate known drug interactions in our database — the Selpercatinib one above is one of them. If you take anything else, check it against the full list below.

Moderate 369 No known interaction 2,461 (incl. Selpercatinib)
Taking anything else?

Check Another of Your Medications Against Chaparral

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

Everything else you take

See Every Supplement That Interacts With Selpercatinib

This page covers Chaparral only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selpercatinib page lists 178 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 11 major · 132 moderate · 35 minor.

From our pharmacist’s overview on the Selpercatinib page

“People facing a RET-driven lung or thyroid cancer often add supplements for strength, sleep, or immune support, and with selpercatinib (Retevmo) that instinct needs a careful check. Eleven of the 178 ingredients here carry a major rating, and the largest cluster affects how the drug is cleared by the CYP3A4 enzyme: St.”

Reviewed by 2 · Jul 18, 2026

Open the Selpercatinib interaction page

One more smart check

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

We hold 83 real supplement products containing Chaparral, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chaparral. Your product may carry other ingredients that interact with Selpercatinib too, on top of Chaparral — 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 Chaparral and Selpercatinib 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 Chaparral
Steady interest

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

29 days ago today
Medication Selpercatinib
Steady interest

#1,562 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 Chaparral

What is Chaparral?

Chaparral
  • Pain and inflammation
  • Skin conditions
  • Antioxidant/general wellness
  • Infections
  • Traditional 'detox' remedies

Chaparral is a desert shrub long used in traditional medicine, but there is no reliable proof it treats any condition. It has been linked to serious and sometimes irreversible liver and kidney damage, and the FDA has warned against using it. Because of these safety concerns, we recommend avoiding chaparral.

Read the full Chaparral monograph & all interactions
Medication

About Selpercatinib

What Is Selpercatinib Used For?

Brand name: Retevmo

Selpercatinib treats cancers driven by changes in the RET gene — either a gene fusion (where RET joins abnormally with another gene) or a RET mutation (a change in the gene itself). Your doctor will confirm one of these changes with an FDA-approved test before prescribing it.

It is approved for adults with RET fusion-positive non-small cell lung cancer; adults and children 2 and older with RET-mutant medullary thyroid cancer or RET fusion-positive thyroid cancer; and adults and children 2 and older with other advanced solid tumors that have a RET gene fusion and have not responded to prior treatment.

See full Selpercatinib drug information
Keep checking

Other Drugs & Chaparral

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

0Major
369Moderate
0Minor
2,460No known interaction
369 Moderate 2,460 No interaction
Moderate

369 interactions

Showing 60 of 369 moderate interactions — see all 369 on the Chaparral page.

No interaction 2,460 drugs checked — show the list

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

Showing the 60 most looked-up of 2,460 medications checked with no known interaction — see the full Chaparral list.

See the full Chaparral interactions page
See every supplement checked against Selpercatinib, 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
Chaparral monograph › Uses, safety, and every drug interaction in one place Selpercatinib supplement interactions › Every supplement checked against Selpercatinib, ranked by severity Selpercatinib 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 Chaparral and Selpercatinib Together: Common Questions

Can you take Chaparral with Selpercatinib?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Chaparral and Selpercatinib interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Selpercatinib and Chaparral?

Our pharmacists answer your medication & supplement questions — free.

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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.