Drug & supplement interaction

Puravive + Selumetinib Sulfate

Selumetinib Sulfate brand name: Koselugo.

Moderate Interaction
Medically reviewed by · Updated February 2024
The bottom line Moderate

Selumetinib Sulfate falls into 2 drug categories that Puravive can interact with; the most serious is rated moderate. Puravive, a dietary supplement, contains several ingredients that may interact with anticoagulant drugs due to their potential mild anticoagulant effects.

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

Puravive and Selumetinib Sulfate

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

Why Are There 2 Interactions?

Puravive interacts with whole categories of medication. Selumetinib Sulfate falls into 2 of those categories, so it can interact with Puravive 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 Puravive interacts with.

Puravive, a dietary supplement, contains several ingredients that may interact with anticoagulant drugs due to their potential mild anticoagulant effects. These ingredients include Kudzu, Panax ginseng, Phellodendron, and Propolis. Ginsenosides in Panax ginseng may decrease platelet aggregation in lab studies, but human studies have not confirmed this effect. Animal studies suggest low oral bioavailability of certain compounds in ginseng, which could explain differences between lab and human research. Propolis water extract and caffeic acid phenethyl ester, found in propolis, have also been shown to inhibit platelet aggregation in lab studies. Additionally, in an animal model, propolis taken with warfarin reduced the effectiveness of warfarin, suggesting a potential interaction with anticoagulant drugs. Lastly, Phellodendron contains berberine, which studies show may inhibit platelet aggregation.
Severity Moderate Likelihood Possible Evidence C

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 something worth flagging if your child takes Koselugo (selumetinib) for NF1. A few ingredients in Puravive, like Panax ginseng, propolis, kudzu, and phellodendron (berberine), have shown mild blood-thinning or anti-platelet activity in lab tests. Selumetinib itself can already affect bleeding in some patients, so layering a supplement that may nudge platelets in the same direction is the concern here.

The evidence is on the weaker side, mostly lab and animal studies, and human data hasn't really confirmed it. Still, watch for things like easy bruising, nosebleeds, bleeding gums, or cuts that are slow to stop. Before adding Puravive, please run it past your pharmacist or your child's oncology team first.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 3A4 (Cyp3A4) Substrates

2 of 2

Selumetinib Sulfate also falls under Cytochrome P450 3A4 (Cyp3A4) Substrates.

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.
Severity Minor 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 situation with Koselugo (selumetinib). Your body relies on a liver enzyme called CYP3A4 to break it down. Puravive contains Panax ginseng, which has shown mixed effects on this enzyme in studies, sometimes slowing it and sometimes speeding it up. Because of that, we can't predict cleanly which way things would tip.

If ginseng slowed the enzyme, more selumetinib could build up, raising the odds of side effects like diarrhea, rash, mouth sores, fatigue, or (less commonly) heart or eye changes. If it sped the enzyme up, the drug might clear too fast and work less well against the tumors. This is a real, active cancer therapy, so please loop in your child's oncologist or pharmacist before adding Puravive.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Puravive Also Interacts With Other Medications

Puravive has 356 moderate, 881 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.

Moderate 356 Minor 881 No known interaction 1,593 (incl. Selumetinib Sulfate)
Taking anything else?

Check Another of Your Medications Against Puravive

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

From our Q&A

Questions About Puravive or Selumetinib Sulfate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Puravive or Selumetinib Sulfate, 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 Selumetinib Sulfate

This page covers Puravive 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 Puravive 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 Puravive
Steady interest

#1,082 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 Puravive

What is Puravive?

Puravive
  • Weight management
  • Metabolism support
  • Energy levels
  • General wellness
  • Stress and brain health

Puravive is a branded, multi-ingredient capsule marketed mainly for weight loss by claiming to boost brown fat activity, but there is no published, independent clinical research showing the product itself works for this purpose. Some individual ingredients have been studied in laboratory or small human studies, but those results do not prove the finished blend is safe or effective. Talk to a pharmacist or doctor before trying it, especially if you have health conditions or take medications.

Read the full Puravive 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 & Puravive

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

0Major
356Moderate
881Minor
1,592No known interaction
356 Moderate 881 Minor 1,592 No interaction
Moderate

356 interactions

Showing 60 of 356 moderate interactions — see all 356 on the Puravive page.

Minor

881 interactions

Showing 60 of 881 minor interactions — see all 881 on the Puravive page.

No interaction 1,592 drugs checked — show the list

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

Showing the 60 most looked-up of 1,592 medications checked with no known interaction — see the full Puravive list.

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

Can you take Puravive 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 Puravive and Selumetinib Sulfate?
Selumetinib Sulfate belongs to more than one drug category, and Puravive 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 Puravive 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 Puravive?

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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.