Drug & supplement interaction

Policosanol + Selumetinib Sulfate

Selumetinib Sulfate brand name: Koselugo.

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

Policosanol has a moderate interaction with Selumetinib Sulfate. Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.

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

Policosanol 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 Policosanol interacts with.

Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. Although, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response. Furthermore, a study in patients undergoing percutaneous coronary intervention with a drug-eluting stent found that taking policosanol 40 mg plus clopidogrel and aspirin daily for 30 days modestly reduced the risk for minor bleeding events when compared with taking clopidogrel and aspirin alone. Until more is known, use with caution.
Severity Moderate Likelihood Possible Evidence B

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 thing to know about pairing policosanol with selumetinib (Koselugo). Policosanol may make your platelets a little less sticky, which in theory can add to bleeding tendencies. Selumetinib itself isn't a classic blood thinner, but bleeding and easy bruising are known side effects of this medicine. So the concern is that stacking the two together could nudge up the chance of bruising, nosebleeds, or bleeding that's slow to stop.

This is mostly a theoretical caution based on modest research, and policosanol's blood effects aren't strong or consistent. Still, since selumetinib is used in children with NF1, I'd play it safe. Please check with your child's oncology team or pharmacist before adding policosanol, and watch for any unusual bruising or bleeding.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Carbajal D, Arruzazabala ML, Valdes S, Mas R. Effect of policosanol on platelet aggregation and serum levels of arachidonic acid metabolites in healthy volunteers. Prostaglandins Leukot Essent Fatty Acids 1998;58:61-4.
  2. Arruzazabala ML, Valdes S, Mas R, et al. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 1997;36:293-7. PubMed
  3. Valdes S, Arruzazabala ML, Fernandez L. Effect of policosanol on platelet aggregation in healthy volunteers. Int J Clin Pharmacol Res 1996;16:67-72.
  4. Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
  5. Xu K, Liu X, Li Y, Wang Y, Zang H, Guo L, et al. Safety and efficacy of policosanol in patients with high on-treatment platelet reactivity after drug-eluting stent implantation: two-year follow-up results. Cardiovasc Ther. 2016 Oct;34(5):337-42. doi: 10.1 PubMed
  6. Li C, Ding Y, Si Q, Li K, Xu K. Multiple functions of policosanol in elderly patients with dyslipidemia. J Int Med Res. 2020;48(7):300060520936082. 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

Policosanol Also Interacts With Other Medications

Policosanol has 241 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 241 No known interaction 2,589 (incl. Selumetinib Sulfate)
Taking anything else?

Check Another of Your Medications Against Policosanol

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

Everything else you take

See Every Supplement That Interacts With Selumetinib Sulfate

This page covers Policosanol 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

One more smart check

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

We hold 479 real supplement products containing Policosanol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Policosanol. Your product may carry other ingredients that interact with Selumetinib Sulfate too, on top of Policosanol — 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 Policosanol 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 Policosanol
Top half

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

29 days ago today
Medication Selumetinib Sulfate
Top half

#792 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 Policosanol

What is Policosanol?

Policosanol
  • High cholesterol
  • Heart and blood vessel health
  • Leg pain from poor circulation (intermittent claudication)
  • Physical stamina and energy

Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to lower cholesterol. Early studies from Cuba showed strong cholesterol-lowering effects, but independent studies in other countries have mostly failed to confirm these benefits. Talk with your pharmacist or doctor before using it, especially if you take cholesterol medicine.

Read the full Policosanol 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 & Policosanol

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

0Major
241Moderate
0Minor
2,588No known interaction
241 Moderate 2,588 No interaction
Moderate

241 interactions

Showing 60 of 241 moderate interactions — see all 241 on the Policosanol page.

No interaction 2,588 drugs checked — show the list

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

Showing the 60 most looked-up of 2,588 medications checked with no known interaction — see the full Policosanol list.

See the full Policosanol 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
Policosanol 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 Policosanol and Selumetinib Sulfate Together: Common Questions

Can you take Policosanol 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 Policosanol 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 Policosanol?

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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.