Drug & supplement interaction

Evodia + Selpercatinib

Selpercatinib brand name: Retevmo.

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

Selpercatinib falls into 3 drug categories that Evodia can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of evodia.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Evodia and Selpercatinib

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Evodia interacts with whole categories of medication. Selpercatinib falls into 3 of those categories, so it can interact with Evodia in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 3

Why this applies to Selpercatinib

Selpercatinib falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Evodia interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of evodia.
Animal research shows that concomitant administration of ketoconazole, a known CYP3A4 inhibitor, with the alkaloid constituents of evodia significantly increases the area under the curve (AUC), maximum concentration (Cmax), and half-life of these constituents.
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 how this one actually works. The interaction on file says that drugs which block the liver enzyme CYP3A4 can raise the levels of evodia's active compounds, because that enzyme helps clear them. Selpercatinib (Retevmo) is a mild CYP3A4 inhibitor, so in theory it could slow how your body breaks down evodia and let it build up a bit. The direction here points at the supplement getting stronger, not your cancer medicine.

Keep in mind this is based only on lab and animal data, so it's theoretical and not well proven in people. Still, since evodia isn't a regulated product and you're on serious cancer therapy, I wouldn't add it on your own. Please run it by your oncologist or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhang W, Guo J, Wang D, et al. Effect of CYP3A inducer/inhibitor on pharmacokinetics of five alkaloids in Evodiae Fructus. Chem Biol Interact 2020;327:109146. PubMed
Moderate

QT INTERVAL-PROLONGING DRUGS

2 of 3

Selpercatinib also falls under QT INTERVAL-PROLONGING DRUGS.

Theoretically, evodia might have an additive effect with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias.
Evodia has demonstrated dose-dependent activity as a proarrhythmic agent in animal and in vitro studies. Evodia infusion in animals extends the action duration potential and induces prolongation of the QT interval and Torsade de pointes.
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 Evodia and Retevmo (selpercatinib). Selpercatinib is already known to affect your heart's electrical rhythm, something doctors call QT prolongation. Evodia, in lab and animal studies, has shown a similar effect on heart rhythm. Stacking two things that both stretch out the QT interval could, in theory, raise the risk of a dangerous irregular heartbeat.

I want to be honest about the evidence here: this is based on test tube and animal research, not human cases, so it's more of a caution than a proven problem. Still, because selpercatinib already carries this heart-rhythm risk on its own, I'd play it safe. Don't start or stop anything on your own. Just check with your oncologist or pharmacist before adding Evodia, especially since they often monitor your heart with EKGs during treatment.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Baburin I, Varkvisser R, Schramm A, et al. Dehydroevodiamine and hortiamine, alkaloids from the traditional Chinese herbal drug Evodia rutaecarpa, are IKr blockers with proarrhythmic effects in vitro and in vivo. Pharmacol Res. 2018 May;131:150-163. DOI
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Selpercatinib also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, evodia might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that evodia extract inhibits hepatic CYP3A4. This effect has not been reported in humans.
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 gist for selpercatinib (Retevmo): your liver uses an enzyme called CYP3A4 to clear it out of your body. In lab and test-tube studies, evodia seems to slow that same enzyme down. If that happened in people, your body might clear selpercatinib more slowly, letting levels creep up and possibly bumping up side effects like high blood pressure, liver enzyme changes, fatigue, swelling, diarrhea, or heart rhythm shifts (a longer QT interval).

I want to be straight with you, though: this is theoretical. It's only been seen in lab dishes, never confirmed in humans. Still, since selpercatinib is a serious cancer medicine, I'd skip evodia supplements unless your oncologist or pharmacist gives you the green light first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Iwata H, Tezuka Y, Kadota S, et al. Mechanism-based inactivation of human liver microsomal CYP3A4 by rutaecarpine and limonin from Evodia fruit extract. Drug Metab Pharmacokinet 2005;20:34-45. 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

Evodia Also Interacts With Other Medications

Evodia has 949 moderate known drug interactions in our database — the Selpercatinib one above is among them. If you take anything else, check it against the full list below.

Moderate 949 No known interaction 1,881 (incl. Selpercatinib)
Taking anything else?

Check Another of Your Medications Against Evodia

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

Everything else you take

See Every Supplement That Interacts With Selpercatinib

This page covers Evodia 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 Evodia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 182 real supplement products containing Evodia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Evodia. Your product may carry other ingredients that interact with Selpercatinib too, on top of Evodia — 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 Evodia 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 Evodia
Top half

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

29 days ago today
Medication Selpercatinib
Top 5%

#137 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 Evodia

What is Evodia?

  • Digestive upset and nausea
  • Headaches
  • Menstrual cramps
  • Abdominal pain
  • Diarrhea

Evodia is a fruit used in traditional Chinese medicine, most often for digestive complaints, headaches, and menstrual pain. Human evidence for these uses is very limited, and it is mostly studied in laboratory and animal research. Talk with a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Evodia 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 & Evodia

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

0Major
949Moderate
0Minor
1,880No known interaction
949 Moderate 1,880 No interaction
Moderate

949 interactions

Showing 60 of 949 moderate interactions — see all 949 on the Evodia page.

No interaction 1,880 drugs checked — show the list

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

Showing the 60 most looked-up of 1,880 medications checked with no known interaction — see the full Evodia list.

See the full Evodia 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
Evodia 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 Evodia and Selpercatinib Together: Common Questions

Can you take Evodia 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.
Why are there 3 interactions listed for Evodia and Selpercatinib?
Selpercatinib belongs to more than one drug category, and Evodia interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Evodia 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 Evodia?

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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.