Drug & supplement interaction

Chinese Prickly Ash + Selumetinib Sulfate

Selumetinib Sulfate brand name: Koselugo.

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

Chinese Prickly Ash has a moderate interaction with Selumetinib Sulfate. Chinese prickly ash might inhibit platelet aggregation.

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

Chinese Prickly Ash and Selumetinib Sulfate

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Selumetinib Sulfate

Selumetinib Sulfate falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Chinese Prickly Ash interacts with.

Chinese prickly ash might inhibit platelet aggregation. Theoretically, combining Chinese prickly ash with anticoagulant or antiplatelet drugs might increase the risk of bleeding; avoid concomitant use. Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the honest picture: the interaction on file is really about blood thinners and antiplatelet drugs, and selumetinib (Koselugo) isn't one of those. So the warning doesn't line up cleanly with how Koselugo works. That said, selumetinib itself can sometimes lower blood counts and raise bleeding tendency. Lab studies hint that concentrated Chinese Prickly Ash extracts might make platelets a little less sticky, so in theory stacking the two could nudge bruising or bleeding risk up slightly.

This is weak, test-tube level evidence, and the sprinkle of Sichuan pepper in your cooking is very unlikely to matter. Concentrated supplement doses are a different story. Before adding any extract, please check with your child's oncology team or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Yang YP, Cheng MJ, Teng CM, et al. Chemical and anti-platelet constituents from Formosan Zanthoxylum simulans. Phytochemistry 2002;61:567-72.. 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

Chinese Prickly Ash Also Interacts With Other Medications

Chinese Prickly Ash has 121 moderate known drug interactions in our database — the Selumetinib Sulfate one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 No known interaction 2,709 (incl. Selumetinib Sulfate)
Taking anything else?

Check Another of Your Medications Against Chinese Prickly Ash

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

Everything else you take

See Every Supplement That Interacts With Selumetinib Sulfate

This page covers Chinese Prickly Ash only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selumetinib Sulfate page lists 282 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 236 moderate · 41 minor.

Open the Selumetinib Sulfate interaction page

How much people look this up

Where Chinese Prickly Ash and Selumetinib Sulfate 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 Chinese Prickly Ash
Steady interest

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

29 days ago today
Medication Selumetinib Sulfate
Top 25%

#685 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 Chinese Prickly Ash

What is Chinese Prickly Ash?

  • Digestive upset and stomach pain
  • Toothache and oral numbing
  • Antimicrobial and antiparasitic use
  • Cooking spice (Sichuan pepper)
  • Mild pain relief

Chinese Prickly Ash is the fruit husk of Zanthoxylum bungeanum, best known as the Sichuan pepper that creates a tingling, numbing sensation on the tongue. It is widely used in cooking and traditional Chinese medicine for digestive complaints and pain, but strong human evidence for medicinal benefits is limited. Use culinary amounts safely, but talk to a pharmacist or doctor before using concentrated extracts.

Read the full Chinese Prickly Ash monograph & all interactions
Medication

About Selumetinib

What Is Selumetinib Used For?

Brand name: Koselugo

Koselugo (selumetinib) is approved for adults and children 1 year of age and older who have neurofibromatosis type 1 (NF1) — a genetic condition that causes tumors to grow on nerve tissue — when they also have symptomatic, inoperable plexiform neurofibromas (large, deep nerve tumors that cannot be surgically removed and are causing problems).

Both the Koselugo capsule and Koselugo oral granule formulations are approved for this use. The oral granule form is intended for patients who have difficulty swallowing whole capsules.

See full Selumetinib drug information
Keep checking

Other Drugs & Chinese Prickly Ash

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Chinese Prickly Ash page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Chinese Prickly Ash list.

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

Can you take Chinese Prickly Ash with Selumetinib Sulfate?
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 Chinese Prickly Ash and Selumetinib Sulfate 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 Selumetinib Sulfate and Chinese Prickly Ash?

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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.