Drug & supplement interaction

Serrapeptase + Selumetinib Sulfate

Selumetinib Sulfate brand name: Koselugo.

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

Serrapeptase has a moderate interaction with Selumetinib Sulfate. Theoretically, taking serrapeptase with drugs that have antiplatelet or anticoagulant effects might increase the risk of bruising and bleeding.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Serrapeptase 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 Serrapeptase interacts with.

Theoretically, taking serrapeptase with drugs that have antiplatelet or anticoagulant effects might increase the risk of bruising and bleeding.
In vitro research shows that serrapeptase has fibrinolytic activity.
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 honest picture with serrapeptase and Koselugo (selumetinib). This isn't about the enzymes that break selumetinib down. Instead, the concern is that serrapeptase may have mild blood-thinning, clot-busting activity in the body. Selumetinib itself can sometimes cause bleeding-related problems, so stacking it with something that further nudges you toward bleeding could, in theory, raise the chance of easy bruising, nosebleeds, or bleeding that's slower to stop.

I want to be clear that this is theoretical, based on lab studies rather than real patient reports, so I wouldn't panic over it. Still, since selumetinib is a serious medicine for NF1 tumors, please run any serrapeptase product past your child's oncology team or pharmacist before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Tachibana M, Mizukoshi O, Harada Y, et al. A multi-centre, double-blind study of serrapeptase versus placebo in post-antrotomy buccal swelling. Pharmatherapeutica 1984;3:526-30..
  2. Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res 1990;18:379-88.. 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

Serrapeptase Also Interacts With Other Medications

Serrapeptase has 121 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 121 No known interaction 2,709 (incl. Selumetinib Sulfate)
Taking anything else?

Check Another of Your Medications Against Serrapeptase

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

From our Q&A

Questions About Serrapeptase 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 Serrapeptase 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 Serrapeptase 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 Serrapeptase as Part of a Dietary Supplement Product? Check It for Interactions

We hold 9 real supplement products containing Serrapeptase, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Serrapeptase. Your product may carry other ingredients that interact with Selumetinib Sulfate too, on top of Serrapeptase — 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 Serrapeptase 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 Serrapeptase
Top half

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

29 days ago today
Medication Selumetinib Sulfate
Steady interest

#2,178 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 Serrapeptase

What is Serrapeptase?

  • Inflammation and swelling
  • Sinus and respiratory congestion
  • Pain after surgery or injury
  • Joint and back pain
  • Thinning mucus

Serrapeptase is an enzyme marketed to reduce inflammation, swelling, pain, and mucus, but the human evidence is limited and mostly low quality. If you want to try it, choose an enteric-coated product, follow the label, and check with your pharmacist or doctor first—especially if you are pregnant, breastfeeding, or take other medicines.

Read the full Serrapeptase 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 & Serrapeptase

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

0Major
121Moderate
0Minor
2,708No known interaction
121 Moderate 2,708 No interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Serrapeptase page.

No interaction 2,708 drugs checked — show the list

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

Showing the 60 most looked-up of 2,708 medications checked with no known interaction — see the full Serrapeptase list.

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

Can you take Serrapeptase 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 Serrapeptase 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 Serrapeptase?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.