Drug & supplement interaction

Kratom + Selexipag

Selexipag brand name: Uptravi.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Kratom and Selexipag in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Selexipag states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Kratom and Selexipag

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Selexipag and Kratom in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Kratom safety at a glance

Kratom overall Avoid Kratom carries risks of dependence, serious side effects, and contaminated products, and is not regulated as a safe supplement.
Pregnancy Possibly Unsafe When used orally. There have been multiple case reports of neonatal abstinence syndrome in the infants of those who used kratom during pregnancy. Animal researc... Read the full pregnancy detail
Breastfeeding Avoid Kratom compounds may pass into breast milk and should be avoided while nursing.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Selexipag and Kratom? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Selexipag

Interactions in our licensed database are recorded against drug classes, not just single drug names. Selexipag is filed under 4 classifications — including cytochrome p450 2c8 (cyp2c8) substrates, anticoagulant/antiplatelet drugs, antihypertensive drugs. Kratom has documented interactions with 11 drug classes — the most serious being cns depressants (moderate), cytochrome p450 1a2 (cyp1a2) substrates (moderate) and cytochrome p450 2d6 (cyp2d6) substrates (moderate) — and none of Selexipag’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Kratom Does Interact With Other Medications

Kratom has 983 moderate, 12 minor known drug interactions in our database — Selexipag isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Kratom

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

What to actually watch for

No Interaction Found — But Data Suggests Kratom and Selexipag May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • A change in thyroid levels Worth acting on Additional detail

    Kratom

    “A case of primary hypothyroidism has been reported for an individual who regularly consumed kratom. However, a causal link between kratom use and thyroid dysfunction has not yet been determined.”

    Kratom · Natural Medicines adverse-effect record, reported in hypothyroidism.

    1 source cited
    1. 27132. Sheleg SV, Collins GB. A coincidence of addiction to "Kratom" and severe primary hypothyroidism. J Addict Med 2011;5(4):300-301. PubMed

    Selexipag

    Listed in the ADVERSE REACTIONS section of the FDA label for Selexipag. Read the label on DailyMed ›

  • Headache / Flushing reported in 26.4% of FDA reports for Selexipag Additional detail

    Kratom

    “In one Poison Control Center report of 3484 exposures to kratom, the majority of which involved oral single-substance exposures, 75% of cases reported neurologic effects, including agitation, coma, confusion, dizziness, drowsiness, hallucinations, seizures, and tremor.”

    Kratom · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 108565. Graves JM, Dilley JA, Terpak L, et al. Kratom exposures among older adults reported to U.S. poison centers, 2014-2019. J Am Geriatr Soc 2021;69(8):2176-2184. PubMed
    2. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
    3. 101707. Eggleston W, Stoppacher R, Suen K, Marraffa JM, Nelson LS. Kratom Use and Toxicities in the United States. Pharmacotherapy. 2019 Jul;39(7):775-777. doi: 10.1002/phar.2280. Epub 2019 Jun 13. PubMed
    4. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    5. 113071. Peran D, Stern M, Cernohorsky P, Sykora R, Popela S, Duska F. Mitragyna speciosa (Kratom) poisoning: Findings from ten cases. Toxicon 2023;225:107054. PubMed
    6. 103214. Afzal H, Esang M, Rahman S. A case of kratom-induced seizures. Cureus. 2020;12(1):e6588. PubMed

    Selexipag

    Listed in the ADVERSE REACTIONS section of the FDA label for Selexipag, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Diarrhea / Reduced appetite reported in 20.3% of FDA reports for Selexipag Additional detail

    Kratom

    “Kratom ingestion has been associated with nausea, vomiting, dry mouth, tongue numbness, increased appetite, and constipation. In one Poison Control Center report of 3484 exposures to kratom, the majority of which involved oral single-substance exposures, 25% of cases reported gastrointestinal effects.”

    Kratom · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 27130. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
    2. 27136. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
    3. 95797. Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. PubMed
    4. 95818. Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. PubMed
    5. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    6. 113067. Li X, Ndungu P, Taneja SB, et al. An evaluation of adverse drug reactions and outcomes attributed to kratom in the US Food and Drug Administration Adverse Event Reporting System from January 2004 through September 2021. Clin Transl Sci 2023.

    Selexipag

    Listed in the ADVERSE REACTIONS section of the FDA label for Selexipag, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Muscle pain Additional detail

    Kratom

    “Observational research has found that habitual intake of kratom is associated with withdrawal symptoms, including arthralgias, lower extremity hyperreflexia, muscle pain, rigidity, spasms, and tremors.

    In a case report, a 45-year-old adult who had used kratom intermittently for 10 months experienced mild rhabdomyolysis and generalized seizures.”

    Kratom · Natural Medicines adverse-effect record, reported in epilepsy.

    6 sources cited
    1. 27115. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. PubMed
    2. 27130. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
    3. 104637. Davidson C, Cao D, King T, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2020:1-10. PubMed
    4. 113061. Hong S, Zimmerman PE, Rao V, Markwalter DW. Buprenorphine-Naloxone in the Setting of Kratom Withdrawal, Opioid Use Disorder, and Stage IV Lung Adenocarcinoma. J Palliat Med 2023;26(5):734-736. PubMed
    5. 113080. Smith KE, Feldman JD, Dunn KE, et al. Examining the paradoxical effects of kratom: a narrative inquiry. Front Pharmacol 2023;14:1174139. PubMed
    6. 95798. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed

    Selexipag

    Listed in the ADVERSE REACTIONS section of the FDA label for Selexipag. Read the label on DailyMed ›

  • Nausea / Vomiting reported in 16.1% of FDA reports for Selexipag Additional detail

    Kratom

    Recorded for Kratom in the same Natural Medicines adverse-effect record shown under A change in thyroid levels above.

    Selexipag

    Listed in the ADVERSE REACTIONS section of the FDA label for Selexipag, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Kratom but not commonly for Selexipag: liver problems, raised blood pressure, dependence or withdrawal symptoms and confusion.

Effects for Selexipag come from the ADVERSE REACTIONS section of its FDA label; effects for Kratom come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 25,258 voluntary FDA FAERS reports for Selexipag that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Kratom in Pregnancy & Breastfeeding

Pregnancy Possibly Unsafe

When used orally. There have been multiple case reports of neonatal abstinence syndrome in the infants of those who used kratom during pregnancy. Animal research suggests that kratom crosses the placenta.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Selexipag Products Have a Food Rule — Kratom Should Not Break It

At least one FDA label for a product containing Selexipag says to take it with food. If you take Kratom on an empty stomach out of habit, keep them separate — and take Selexipag with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Selexipag products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Tolerability may be improved when taken with food [see Clinical Pharmacology (12.3) ] .

From the Dosage and Administration section of the FDA label we read for Selexipag — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Selexipag Is Prescribed For, and What Kratom Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Selexipag is a prescription medicine with approved uses on its FDA label. Kratom is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Selexipag is prescribed for: Selexipag tablets are used to treat pulmonary arterial hypertension (PAH, WHO Group I) — a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to reduce the chances of being hospitalized because of PAH. Uptravi (selexipag) tablets are approved for both adults and children aged 2 years and older. Uptravi for injection (intravenous) is also available for adult patients who are already on Uptravi tablets but temporarily cannot take medicine by mouth.

Kratom has been studied for:

  • Hypertension studied, not established Kratom has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Kratom for hypertension

    Although there has been interest in using oral kratom for hypertension, there is insufficient reliable information about the clinical effects of kratom for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Selexipag on your own; if you are taking Kratom for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Kratom or Selexipag

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Kratom or Selexipag, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Selexipag

This page covers Kratom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selexipag page lists 291 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Selexipag page

“People take selexipag (Uptravi) for pulmonary arterial hypertension, dangerously high pressure in the arteries of the lungs, and that diagnosis raises the stakes on this list of 291 interacting supplements. I would treat it with real vigilance.”

Reviewed by 2 · Jul 18, 2026

Open the Selexipag interaction page

One more smart check

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

We hold 8 real supplement products containing Kratom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Kratom. Even though Kratom itself has no known interaction with Selexipag, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Kratom and Selexipag 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 Kratom
Top half

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

29 days ago today
Medication Selexipag
Top 10%

#274 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Kratom reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Kratom and Selexipag records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Kratom

What is Kratom?

Kratom
  • Pain relief
  • Opioid withdrawal symptoms
  • Anxiety and stress
  • Low energy or fatigue
  • Mood enhancement

Kratom is a Southeast Asian plant whose leaves act on the brain's opioid receptors and can produce both stimulant-like and opioid-like effects. It is not approved or proven safe by health regulators, carries real risks of dependence and serious harm, and its legal status varies widely. Talk to a pharmacist or doctor before considering it.

Mitragyna speciosa · Rubiaceae · Leaves · Dried leaf powder, capsules, tablets, brewed tea, liquid extracts, and concentrated gummies

An interaction check asks whether these two react with each other — it does not ask whether Kratom is a good idea for someone in your situation. Here is what our Kratom record says about it on its own.

Kratom: dosing

There is no established safe or standardized dose for kratom. The strength of products varies widely, and the amount of active compounds can differ greatly from one batch to another, even within the same brand.Because of these unknowns and the real risks of dependence and harm, we cannot recommend a specific amount. Avoid mixing it with alcohol, opioids, sedatives, or other substances.

From our Kratom monograph — the full record covers uses, side effects and every documented interaction.

Read the full Kratom monograph & all interactions
Medication

About Selexipag

What Is Selexipag Used For?

Brand name: Uptravi

Selexipag tablets are used to treat pulmonary arterial hypertension (PAH, WHO Group I) — a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to reduce the chances of being hospitalized because of PAH.

Uptravi (selexipag) tablets are approved for both adults and children aged 2 years and older. Uptravi for injection (intravenous) is also available for adult patients who are already on Uptravi tablets but temporarily cannot take medicine by mouth.

Most-Reported Side Effects for Selexipag

From FAERS, the FDA’s public side-effect reporting system (25,685 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Headache 6,740 reports
Diarrhea 5,173 reports
Dyspnea 4,774 reports
Nausea 4,103 reports
Fatigue 2,601 reports
See full Selexipag drug information
Keep checking

Other Drugs & Kratom

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

0Major
983Moderate
12Minor
1,834No known interaction
Moderate

983 interactions

Showing 60 of 983 moderate interactions — see all 983 on the Kratom page.

Minor

12 interactions

No interaction 1,834 drugs checked — show the list
Evidence & sources

Kratom References

The 77 references that drive our Kratom monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend 2014 Jun 1;139:132-7. PubMed
  2. Backstrom BG, Classon G, Lowenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen 2010;107(50):3196-3197.
  3. Kronstrand R, Roman M, Thelander G, Eriksson A. Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton. J Anal Toxicol 2011;35(4):242-247. PubMed
  4. Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction 2008;103(6):1048-1050.
  5. Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988;23(1):115-119. PubMed
  6. Nelsen JL, Lapoint J, Hodgman MJ, Aldous KM. Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure. J Med Toxicol 2010;6(4):424-426. PubMed
  7. Sheleg SV, Collins GB. A coincidence of addiction to "Kratom" and severe primary hypothyroidism. J Addict Med 2011;5(4):300-301. PubMed
  8. Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). J Med Toxicol 2011;7(3):227-231. PubMed
  9. Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356. PubMed
  10. US Food and Drug Administration (2014). SNI National is Voluntarily recalling Kratom XL 4 Pack, Maeng Da Kratom 10 Pack, Max Kratom 20 Pack, and Bali Kratom 40 pack Due to Undeclared Drug Ingredients [Press Release].
  11. Castillo A, Payne JD, Nugent K. Posterior reversible leukoencephalopathy syndrome after kratom ingestion. Proc (Bayl Univ Med Cent). 2017;30(3):355-357. PubMed
  12. Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. PubMed
  13. FDA Adverse Event Reporting System: Kratom Deaths. February 6, 2018. https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/CDERFOIAElectronicReadingRoom/UCM595575.pdf. Accessed March 6, 2018.
  14. Trakulsrichai S, Sathirakul K, Auparakkitanon S, et al. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther. 2015;9:2421-9. PubMed
  15. Kruegel AC, Grundmann O. The medicinal chemistry and neuropharmacology of kratom: A preliminary discussion of a promising medicinal plant and analysis of its potential for abuse.Neuropharmacology. 2017. pii: S0028-3908(17)30393-3. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Kratom and Selexipag Together: Common Questions

Is it safe to take Kratom with Selexipag?
We do not list a known interaction between Kratom and Selexipag. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Kratom and Selexipag have any of the same side effects?
Yes — our sources link each of them separately to 8 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Kratom and Selexipag at the same time of day?
At least one FDA label for a product containing Selexipag says to take it with food. If you take Kratom on an empty stomach out of habit, keep them separate and take Selexipag with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Selexipag products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Kratom and Selexipag used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Kratom in each. That is a conversation for your prescriber, especially if Selexipag is being adjusted to a target.
How was the Kratom and Selexipag combination checked?
Interactions in our licensed database are recorded against drug classes. Selexipag is filed under 4 classifications, and Kratom has documented interactions with 11 drug classes — none of Selexipag's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Kratom interact with any other medications?
Yes. Kratom has 995 documented drug interactions in our database — Selexipag is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Selexipag interact with any supplements?
Yes. Selexipag has documented interactions with 291 supplements in our database — Kratom is not one of them. The Selexipag interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Selexipag and Kratom?

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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.