Drug & supplement interaction

Selenium + Sorafenib

Sorafenib brand name: Nexavar.

Moderate Interaction
The bottom line Moderate

Selenium has a moderate interaction with Sorafenib. Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

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

Selenium and Sorafenib

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Sorafenib

Sorafenib falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Selenium interacts with.

Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that taking selenium 10 mcg/kg/day can increase bleeding times by increasing prostacyclin production, which inhibits platelet activity. Other clinical research suggests that taking selenium 75 mcg daily, in combination with ascorbic acid 600 mg, alpha-tocopherol 300 mg, and beta-carotene 27 mg, reduces platelet aggregation.
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 something worth knowing if you're on Sorafenib (Nexavar). This cancer medicine can already make you bleed or bruise more easily, since it affects how blood vessels and platelets behave. Selenium, especially in larger supplement doses, may add to that by gently nudging your platelets to be less sticky. So the concern isn't that selenium changes how your body processes sorafenib, it's that the two together could tip you toward more bleeding.

To be fair, this is based mostly on lab work and small studies, so it's a possible rather than proven problem. The selenium you get from food is very unlikely to matter. Concentrated supplements are where I'd be more cautious. Watch for unusual bruising, nosebleeds, or bleeding gums, and please run any selenium supplement by your oncology team first.

References
  1. Schiavon R, Freeman GE, Guidi GC, et al. Selenium enhances prostacyclin production by cultured endothelial cells: possible explanation for increased bleeding times in volunteers taking selenium as a dietary supplement. Thromb Res 1984;34:389-96. PubMed
  2. Salonen, J. T., Salonen, R., Seppanen, K., Rinta-Kiikka, S., Kuukka, M., Korpela, H., Alfthan, G., Kantola, M., and Schalch, W. Effects of antioxidant supplementation on platelet function: a randomized pair-matched, placebo-controlled, double-blind trial

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 Sorafenib 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 Sorafenib

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 Sorafenib, 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 Sorafenib

This page covers Selenium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sorafenib page lists 285 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 · 241 moderate · 39 minor.

From our pharmacist’s overview on the Sorafenib page

“If you're on sorafenib (Nexavar) for cancer, be genuinely careful here, and learn the five major-rated entries first. Most of the 285 ingredients listed either have blood-thinning effects that stack onto sorafenib's bleeding risk (more than 200 do) or affect CYP3A4, the liver enzyme that clears the drug, pushing its level too high or t…”

Reviewed by 2 · Jul 18, 2026

Open the Sorafenib 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 Sorafenib 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 Sorafenib 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 Sorafenib
Steady interest

#2,492 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 Sorafenib

What Is Sorafenib Used For?

Brand name: Nexavar

Sorafenib tablets are approved to treat three types of cancer. The first is unresectable hepatocellular carcinoma (HCC) — liver cancer that cannot be removed with surgery. The second is advanced renal cell carcinoma (RCC) — kidney cancer that has spread or progressed. Both the brand Nexavar and generic sorafenib tablets are approved for these two uses.

The third use is for locally recurrent or metastatic, progressive differentiated thyroid carcinoma (DTC) — thyroid cancer that has spread or worsened and no longer responds to radioactive iodine treatment. Nexavar and sorafenib tablets are both approved for this use as well.

See full Sorafenib 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 Sorafenib Together: Common Questions

Can you take Selenium with Sorafenib?
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 Sorafenib 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

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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.