Drug & supplement interaction

Rabdosia Rubescens + Selumetinib Sulfate

Selumetinib Sulfate brand name: Koselugo.

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

Rabdosia Rubescens has a moderate interaction with Selumetinib Sulfate. In vitro research shows that oridonin, a constituent of Rabdosia rubescens, induces cytochrome P450 3A4 (CYP3A4) enzyme.

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

Rabdosia Rubescens and Selumetinib Sulfate

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Selumetinib Sulfate

Selumetinib Sulfate falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Rabdosia Rubescens interacts with.

In vitro research shows that oridonin, a constituent of Rabdosia rubescens, induces cytochrome P450 3A4 (CYP3A4) enzyme. Also, in an animal model, oridonin induces a gene homologous to CYP3A4. So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking Rabdosia rubescens. Some drugs metabolized by CYP3A4 that might be affected are some benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), triazolam (Halcion); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, others), felodipine (Plendil), verapamil (Calan, Verelan, others); cyclosporine (Neoral, Sandimmune); some HIV antivirals such as indinavir (Crixivan), ritonavir (Norvir), saquinavir (Fortovase, Invirase); some HMG CoA reductase inhibitors such as atorvastatin (Lipitor), lovastatin (Mevacor); some macrolide antibiotics such as erythromycin and clarithromycin (Biaxin); quinidine; and many 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

Here's the concern with pairing this herb and Koselugo (selumetinib). Your body relies on a liver enzyme called CYP3A4 to break down selumetinib. Lab and animal studies suggest oridonin, a compound in Rabdosia rubescens, may speed that enzyme up. If that happens in people, your body could clear selumetinib faster, leaving lower levels in the blood and potentially making it work less well against the nerve tumors it's prescribed to control.

I want to be honest about the evidence here: this comes only from test-tube and animal research and has never actually been seen in humans, so it's more of a theoretical caution than a proven problem. Still, with a cancer-related medicine you don't want to risk weakening, it's worth a quick chat with your child's oncologist or pharmacist before adding this supplement.

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

Rabdosia Rubescens Also Interacts With Other Medications

Rabdosia Rubescens has 713 moderate, 69 minor 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 713 Minor 69 No known interaction 2,048 (incl. Selumetinib Sulfate)
Taking anything else?

Check Another of Your Medications Against Rabdosia Rubescens

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

Everything else you take

See Every Supplement That Interacts With Selumetinib Sulfate

This page covers Rabdosia Rubescens 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 Rabdosia Rubescens 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 Rabdosia Rubescens
Steady interest

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

29 days ago today
Medication Selumetinib Sulfate
Top half

#1,174 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 Rabdosia Rubescens

What is Rabdosia Rubescens?

Rabdosia Rubescens
  • Sore throat and respiratory complaints
  • Inflammation
  • Antimicrobial support
  • Digestive complaints
  • Traditional cancer support

Rabdosia rubescens is a Chinese herb traditionally used for sore throats, inflammation, and infections, and its compound oridonin has drawn lab interest for possible anticancer effects. However, strong human evidence is lacking for any use, and safety has not been well studied, so talk with your pharmacist or doctor before trying it.

Read the full Rabdosia Rubescens 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 & Rabdosia Rubescens

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

0Major
713Moderate
69Minor
2,047No known interaction
713 Moderate 69 Minor 2,047 No interaction
Moderate

713 interactions

Showing 60 of 713 moderate interactions — see all 713 on the Rabdosia Rubescens page.

Minor

69 interactions

Showing 60 of 69 minor interactions — see all 69 on the Rabdosia Rubescens page.

No interaction 2,047 drugs checked — show the list

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

Showing the 60 most looked-up of 2,047 medications checked with no known interaction — see the full Rabdosia Rubescens list.

See the full Rabdosia Rubescens 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
Rabdosia Rubescens 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 Rabdosia Rubescens and Selumetinib Sulfate Together: Common Questions

Can you take Rabdosia Rubescens 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 Rabdosia Rubescens 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 Rabdosia Rubescens?

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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.