Drug & supplement interaction

Jequirity + Selumetinib Sulfate

Selumetinib Sulfate brand name: Koselugo.

Moderate Interaction
The bottom line Moderate

Selumetinib Sulfate falls into 2 drug categories that Jequirity can interact with; the most serious is rated moderate. Evidence from in vitro research suggests that constituents of jequirity beans can inhibit platelet aggregation.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Jequirity and Selumetinib Sulfate

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Jequirity interacts with whole categories of medication. Selumetinib Sulfate falls into 2 of those categories, so it can interact with Jequirity in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Selumetinib Sulfate

Selumetinib Sulfate falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Jequirity interacts with.

Evidence from in vitro research suggests that constituents of jequirity beans can inhibit platelet aggregation. Theoretically, jequirity might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
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

First things first: jequirity seeds are genuinely poisonous (they contain abrin, a toxin in the same family as ricin), so this isn't something I'd ever want you taking as a supplement, full stop. Please don't use it.

On the bleeding concern specifically: lab studies hint that compounds in jequirity may slow platelets from clumping together, which in theory could add to a bleeding risk. This is theoretical and based only on test-tube work, not real patient cases. With selumetinib (Koselugo), the worry is overlap, since this medicine can already lower platelet counts and cause easy bruising, bleeding gums, or nosebleeds. Combining the two could make bleeding more likely. Please keep jequirity away from your child entirely and check any new product with your pharmacist or oncologist first.

References
  1. Kuo SC, Chen SC, Chen LH, et al. Potent antiplatelet, anti-inflammatory and antiallergic isoflavanquinones from the roots of Abrus precatorius. Planta Med 1995;61:307-12.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

In vitro research shows that jequirity extract inhibits CYP3A4 enzymes. Theoretically, taking jequirity may inhibit the metabolism of CYP3A4 substrates.
Severity Minor 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

Let me start with the most important point: jequirity seeds are genuinely poisonous (they contain abrin, a toxin in the same family as ricin), so they should never be taken as a supplement in the first place. Please don't use them at all.

On the specific interaction with selumetinib (Koselugo): your body clears this drug using a liver enzyme called CYP3A4. In lab dish studies, jequirity appears to slow that enzyme down. In theory, that could let selumetinib build up and make its side effects worse, things like nausea, vomiting, diarrhea, rash, mouth sores, or fatigue. But this is only test-tube evidence, not human data, so the real-world risk is uncertain. If you have any concerns, talk with your doctor or pharmacist.

References
  1. Ai C, Miao X, Wang L, He J. Discovery and Activity Evaluation of the Inhibitory Effect of Four Kinds Traditional Chinese Medicine Extracts on the CYP3A4 Enzyme. Comb Chem High Throughput Screen 2022.

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

Jequirity Also Interacts With Other Medications

Jequirity has 207 moderate, 603 minor known drug interactions in our database — the Selumetinib Sulfate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Jequirity

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

Everything else you take

See Every Supplement That Interacts With Selumetinib Sulfate

This page covers Jequirity 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 Jequirity 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 Jequirity
Steady interest

#1,080 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Selumetinib Sulfate
Top 25%

#671 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 Jequirity

What is Jequirity?

Jequirity
  • Asthma and cough
  • Fever
  • Sore throat and bronchitis
  • Liver complaints (hepatitis)
  • Constipation
  • Traditional infectious-disease remedies

Jequirity (Abrus precatorius) is a tropical plant whose bright red, black-tipped seeds contain abrin, one of the most toxic plant proteins known. Despite a long history in traditional medicine, the seeds are dangerously poisonous and there is no reliable evidence that it is safe or effective. It should not be used as a supplement or medicine.

Read the full Jequirity 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 & Jequirity

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

0Major
207Moderate
603Minor
2,019No known interaction
Moderate

207 interactions

Showing 60 of 207 moderate interactions — see all 207 on the Jequirity page.

Minor

603 interactions

Showing 60 of 603 minor interactions — see all 603 on the Jequirity page.

No interaction 2,019 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 Jequirity and Selumetinib Sulfate Together: Common Questions

Can you take Jequirity 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.
Why are there 2 interactions listed for Jequirity and Selumetinib Sulfate?
Selumetinib Sulfate belongs to more than one drug category, and Jequirity 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 Jequirity 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

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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.