Drug & supplement interaction

German Chamomile + Selinexor

Selinexor brand name: Xpovio.

Moderate Interaction
The bottom line Moderate

German Chamomile has a moderate interaction with Selinexor. Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.

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

German Chamomile and Selinexor

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Selinexor

Selinexor falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group German Chamomile interacts with.

Theoretically, German chamomile might inhibit CYP3A4 and increase levels of drugs metabolized by these enzymes.
In vitro evidence shows that German chamomile might inhibit CYP3A4. So far, this interaction has not been reported in humans. However, there might be an increase in the levels of drugs metabolized by CYP3A4 in patients taking German chamomile.
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 short version: your body uses an enzyme called CYP3A4 to help break down selinexor (Xpovio). German chamomile, in lab dish studies, looks like it might slow that enzyme down a bit. If that were to happen in real life, selinexor could clear more slowly and build up higher than expected. Selinexor isn't a prodrug, so more drug in your system usually means stronger effects and a greater chance of its tough side effects, like severe nausea, vomiting, poor appetite, fatigue, low blood counts, and low sodium.

The honest part: this is only a theoretical concern from test-tube data and hasn't been seen in actual patients. Still, because selinexor is a powerful cancer medicine, please run any chamomile tea or supplement by your oncology team or pharmacist before using it.

References
  1. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  2. Ganzera M, Schneider P, Stuppner H. Inhibitory effects of the essential oil of chamomile (Matricaria recutita L.) and its major constituents on human cytochrome P450 enzymes. Life Sci 2006;78(8):856-861. 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

German Chamomile Also Interacts With Other Medications

German Chamomile has 924 moderate, 35 minor known drug interactions in our database — the Selinexor one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against German Chamomile

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

Everything else you take

See Every Supplement That Interacts With Selinexor

This page covers German Chamomile only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selinexor page lists 138 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 94 moderate · 41 minor.

From our pharmacist’s overview on the Selinexor page

“Selinexor (Xpovio) treats multiple myeloma and certain lymphomas, and its side effects are rough enough at intended doses that any shift in its blood level deserves genuine caution. Almost all of the 138 supplements and herbs listed here, 121 of them, can change how a liver enzyme called CYP3A4 handles the drug, pushing its level up or…”

Reviewed by 2 · Jul 18, 2026

Open the Selinexor interaction page

One more smart check

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

We hold 782 real supplement products containing German Chamomile, each one broken down to its full ingredient list — and combination products often carry several ingredients besides German Chamomile. Your product may carry other ingredients that interact with Selinexor too, on top of German Chamomile — 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 German Chamomile and Selinexor 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 German Chamomile
Top 25%

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

29 days ago today
Medication Selinexor
Top 10%

#231 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 German Chamomile

What is German Chamomile?

German Chamomile
  • Anxiety and stress
  • Sleep and relaxation
  • Digestive upset
  • Skin irritation and inflammation
  • Mouth sores and gum irritation

German chamomile is a widely used herbal remedy taken mainly as a tea for calming, sleep, and digestive complaints. Early research suggests possible benefits for mild anxiety and some skin or digestive issues, but the evidence is limited and most uses are based on tradition rather than strong proof. It is generally well tolerated, but people allergic to ragweed or related plants and those who are pregnant should be cautious.

Read the full German Chamomile monograph & all interactions
Medication

About Selinexor

What Is Selinexor Used For?

Brand name: Xpovio

Xpovio (selinexor) is used to treat multiple myeloma in adults. When used together with bortezomib and dexamethasone, it is for adults who have had at least one prior treatment. This combination is sometimes called XVd.

Xpovio is also used with dexamethasone alone (called Xd) for adults with relapsed or refractory multiple myeloma — meaning the cancer came back or stopped responding — who have already tried at least four prior therapies and whose disease no longer responds to several other standard drug types.

See full Selinexor drug information
Keep checking

Other Drugs & German Chamomile

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

0Major
924Moderate
35Minor
1,870No known interaction
Moderate

924 interactions

Showing 60 of 924 moderate interactions — see all 924 on the German Chamomile page.

Minor

35 interactions

No interaction 1,870 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking German Chamomile and Selinexor Together: Common Questions

Can you take German Chamomile with Selinexor?
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 German Chamomile and Selinexor 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 Selinexor and German Chamomile?

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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.