selenium (OTC)

RDA

Male or female: 55 mcg/day

Pregnancy: 60 mcg/day

Lactating: 70 mcg/day

Supplementation

100-200 mcg/day PO with meals (preferably); may take 50 mcg PO qDay or q6hr

RDA

<6 months: 15 mcg/day

6-12 months: 20 mcg/day

1-3 years: 20 mcg/day

4-8 years: 30 mcg/day

8-13 years: 40 mcg/day

13-18 years: 55 mcg/day

Contraindicated (0)

Serious - Use Alternative (2)

• baloxavir marboxil

  selenium will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.

• eltrombopag

  selenium decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.

Monitor Closely (13)

• alendronate

  selenium will decrease the level or effect of alendronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or 30 min after alendronate.

• bictegravir

  selenium will decrease the level or effect of bictegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer bictegravir on an empty stomach at least 2 h before or 6 h after polyvalent cation containing drugs.

• deferiprone

  selenium will decrease the level or effect of deferiprone by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate deferiprone administration from ingestion of polyvalent cations by at least 4 h.

• dolutegravir

  selenium will decrease the level or effect of dolutegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer dolutegravir at least 2 h before or 6 h after polyvalent cations. Administer the dolutegravir/rilpivirine combination at least 4 h before or 6 h after polyvalent cations.

• eltrombopag

  selenium will decrease the level or effect of eltrombopag by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate eltrombopag administration from polyvalent cations by at least 2 h.

• etidronate

  selenium will decrease the level or effect of etidronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or after etidronate.

• ibandronate

  selenium will decrease the level or effect of ibandronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or 1 h after ibandronate.

• omadacycline

  selenium will decrease the level or effect of omadacycline by cation binding in GI tract. Modify Therapy/Monitor Closely. Do not take polyvalent cations within 4 hr before or after omadacycline.

• penicillamine

  selenium will decrease the level or effect of penicillamine by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate penicillamine administration from ingestion of polyvalent cations by at least 1 h.

• raltegravir

  selenium will decrease the level or effect of raltegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer raltegravir at least 2 h before or 6 h after polyvalent cations. Note: Dose separation may not adequately avoid this interaction.

• risedronate

  selenium will decrease the level or effect of risedronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or 30 min after risedronate.

• tiludronate

  selenium will decrease the level or effect of tiludronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or after tiludronate.

• trientine

  selenium will decrease the level or effect of trientine by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer trientine at least 1 hr before or after polyvalent cations (2 hr if oral iron administered).

Minor (0)

• alendronate

  Monitor Closely (1)selenium will decrease the level or effect of alendronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or 30 min after alendronate.

• baloxavir marboxil

  Serious - Use Alternative (1)selenium will decrease the level or effect of baloxavir marboxil by cation binding in GI tract. Avoid or Use Alternate Drug. Baloxavir may bind to polyvalent cations resulting in decreased absorption. Studies in monkeys showed concurrent use with calcium, aluminum, or iron caused significantly decreased plasma levels. Human studies not conducted.

• bictegravir

  Monitor Closely (1)selenium will decrease the level or effect of bictegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer bictegravir on an empty stomach at least 2 h before or 6 h after polyvalent cation containing drugs.

• deferiprone

  Monitor Closely (1)selenium will decrease the level or effect of deferiprone by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate deferiprone administration from ingestion of polyvalent cations by at least 4 h.

• dolutegravir

  Monitor Closely (1)selenium will decrease the level or effect of dolutegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer dolutegravir at least 2 h before or 6 h after polyvalent cations. Administer the dolutegravir/rilpivirine combination at least 4 h before or 6 h after polyvalent cations.

• eltrombopag

  Monitor Closely (1)selenium will decrease the level or effect of eltrombopag by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate eltrombopag administration from polyvalent cations by at least 2 h.Serious - Use Alternative (1)selenium decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.

• etidronate

  Monitor Closely (1)selenium will decrease the level or effect of etidronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or after etidronate.

• ibandronate

  Monitor Closely (1)selenium will decrease the level or effect of ibandronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or 1 h after ibandronate.

• omadacycline

  Monitor Closely (1)selenium will decrease the level or effect of omadacycline by cation binding in GI tract. Modify Therapy/Monitor Closely. Do not take polyvalent cations within 4 hr before or after omadacycline.

• penicillamine

  Monitor Closely (1)selenium will decrease the level or effect of penicillamine by cation binding in GI tract. Modify Therapy/Monitor Closely. Separate penicillamine administration from ingestion of polyvalent cations by at least 1 h.

• raltegravir

  Monitor Closely (1)selenium will decrease the level or effect of raltegravir by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer raltegravir at least 2 h before or 6 h after polyvalent cations. Note: Dose separation may not adequately avoid this interaction.

• risedronate

  Monitor Closely (1)selenium will decrease the level or effect of risedronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or 30 min after risedronate.

• tiludronate

  Monitor Closely (1)selenium will decrease the level or effect of tiludronate by cation binding in GI tract. Modify Therapy/Monitor Closely. Avoid administering polyvalent cations 2 hr before or after tiludronate.

• trientine

  Monitor Closely (1)selenium will decrease the level or effect of trientine by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer trientine at least 1 hr before or after polyvalent cations (2 hr if oral iron administered).