Drug & supplement interaction

Selenium + Omalizumab

Omalizumab brand name: Xolair.

Moderate Interaction
The bottom line Moderate

Selenium has a moderate interaction with Omalizumab. Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.

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

Selenium and Omalizumab

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

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Omalizumab

Omalizumab falls under IMMUNOSUPPRESSANTS — the group Selenium interacts with.

Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
In vitro research and preliminary clinical evidence suggests that selenium may stimulate the immune system.
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 thinking behind this pairing. Selenium isn't broken down by Xolair and doesn't change its blood levels. The concern is the opposite direction: selenium may give your immune system a small nudge upward, and Xolair (omalizumab) works by quieting part of your immune response (it binds IgE antibodies). In theory, a more active immune system could work against what Xolair is trying to calm down, possibly making it a bit less effective for your asthma, nasal polyps, or hives.

Honestly, this is a theoretical worry based mostly on lab and early research, not strong human studies, so I wouldn't lose sleep over it. Normal dietary selenium is very unlikely to matter. If you're taking a concentrated selenium supplement, just mention it to your pharmacist or doctor so they can keep an eye on how well your Xolair is working.

References
  1. Peretz, A., Neve, J., Desmedt, J., Duchateau, J., Dramaix, M., and Famaey, J. P. Lymphocyte response is enhanced by supplementation of elderly subjects with selenium-enriched yeast. Am.J Clin.Nutr. 1991;53(5):1323-1328. PubMed
  2. Kiremidjian-Schumacher, L., Roy, M., Wishe, H. I., Cohen, M. W., and Stotzky, G. Supplementation with selenium and human immune cell functions. II. Effect on cytotoxic lymphocytes and natural killer cells. Biol.Trace Elem.Res. 1994;41(1-2):115-127. 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

Selenium Also Interacts With Other Medications

Selenium has 287 moderate, 33 minor known drug interactions in our database — the Omalizumab one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Selenium

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

From our Q&A

Questions About Selenium or Omalizumab

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

This page covers Selenium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Omalizumab page lists 53 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), American Ginseng (moderate), Andrographis (moderate) and Ashwagandha (moderate).

By severity: 52 moderate · 1 minor.

From our pharmacist’s overview on the Omalizumab page

“None of the 53 supplements on file for omalizumab (Xolair) carries a major rating, so this is a list to read with steady attention rather than alarm. Xolair treats allergic asthma and chronic hives by calming part of the immune system, and every entry here pulls the other way: these are immune-stimulating products, echinacea and astrag…”

Reviewed by 2 · Jul 18, 2026

Open the Omalizumab interaction page

One more smart check

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

We hold 16,942 real supplement products containing Selenium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Selenium. Your product may carry other ingredients that interact with Omalizumab too, on top of Selenium — 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 Selenium and Omalizumab 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 Selenium
Top 1%

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

29 days ago today
Medication Omalizumab
Steady interest

#2,212 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 Selenium

What is Selenium?

  • Thyroid health support
  • Antioxidant support
  • Immune support
  • General nutrient supplementation
  • Reproductive/fertility support

Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supplements are mainly useful for those who are deficient. Because too much selenium can be toxic, stick to recommended amounts and check with your pharmacist or doctor before supplementing.

Read the full Selenium monograph & all interactions
Medication

About Omalizumab Injection

What Is Omalizumab Injection Used For?

Brand name: Xolair

Xolair is used for several allergy-driven conditions. It treats moderate to severe persistent asthma in adults and children 6 and older whose symptoms aren't controlled by inhaled corticosteroids alone and who test positive for a perennial allergen (like dust mites or pet dander). It also treats chronic rhinosinusitis with nasal polyps (ongoing sinus inflammation with polyp growth) in adults 18 and older when nasal corticosteroids haven't worked well enough.

Xolair is approved to help reduce allergic reactions — including anaphylaxis (severe, life-threatening allergic reactions) — from accidental food exposures in adults and children as young as 1 year old with IgE-mediated food allergy. It is always used alongside food allergen avoidance, not as a substitute. Finally, Xolair treats chronic spontaneous urticaria (CSU — ongoing hives with no known cause) in adults and adolescents 12 and older who still have symptoms despite taking antihistamines. It is not for emergency treatment of allergic reactions and not for other forms of hives.

See full Omalizumab Injection drug information
Keep checking

Other Drugs & Selenium

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

0Major
287Moderate
33Minor
2,509No known interaction
Moderate

287 interactions

Showing 60 of 287 moderate interactions — see all 287 on the Selenium page.

Minor

33 interactions

No interaction 2,509 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 Selenium and Omalizumab Together: Common Questions

Can you take Selenium with Omalizumab?
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 Selenium and Omalizumab 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 Omalizumab and Selenium?

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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.