The short answer
The sources checked do not establish that St. John’s wort lowers selinexor exposure or effectiveness. Have the supplement reviewed, but do not assume that another cancer medicine’s enzyme-interaction rule applies.
What this answer covers
Oral selinexor with Hypericum perforatum. Exact selinexor clinical CYP3A-interaction null findings take precedence over a generic substrate assumption.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- selinexor
Check the prescribed treatment
This review concerns oral selinexor. Its schedule and combination medicines depend on the cancer treatment plan. The drug can cause low platelets, dizziness or confusion, and other medicines and hydration status may contribute. Keep the complete regimen and monitoring plan under the cancer team’s direction.
The exact medicine has contrary data
The current selinexor product information reports no clinically significant exposure change with clarithromycin, a strong CYP3A inhibitor, or carbamazepine, a strong CYP3A inducer. This differs from several other cancer medicines and limits an argument based only on selinexor being metabolized partly by CYP3A.
St. John’s wort still affects other medicines
A human probe study confirms that some St. John’s wort preparations induce CYP3A, with effects varying by hyperforin content. It did not test selinexor or the complete cancer regimen. Other prescribed medicines can still matter even though the specific selinexor claim is not established.
Review the whole regimen
Show the cancer team your supplement ingredients and recent changes. Do not change selinexor doses, stop combination partners or invent a separation interval. The team should review the entire treatment rather than treating a general enzyme warning as a demonstrated loss of selinexor effectiveness.
Evidence and practical considerations
Absorption & effectiveness
The current selinexor label reports no clinically significant exposure change with tested strong CYP3A inhibition or induction; the exact Hypericum claim remains insufficient.
- Exact scope
- Oral selinexor with Hypericum perforatum. Exact selinexor clinical CYP3A-interaction null findings take precedence over a generic substrate assumption. with RxNorm 2178390 IN selinexor. Exact current oral product: XPOVIO oral selinexor tablets. Salt, formulation and regimen distinctions explicit.
- Medication form and route
- Oral
What remains uncertain
- No direct Hypericum-selinexor study. Exact current strong inhibitor/inducer clinical null data retained; absence of a demonstrated pair effect is not universal supplement safety.
Factors that may matter: Exact oral formulation and supplement preparation; Drug exposure versus clinical outcomes; Dose and duration; Platelet count and neurological symptoms.
Read the supporting source summaries
Source 1: Current original prescribing information
dailymed.nlm.nih.gov · Source check Sep 11, 2026
Population: Patients prescribed the exact oral formulation.
Thrombocytopenia and neurological toxicity; clinical CYP3A inhibitor and inducer PK null results.
How this applies: RxNorm 2178390 IN selinexor. Exact current oral product: XPOVIO oral selinexor tablets. Salt, formulation and regimen distinctions explicit.
Exact product source, not a direct study of every supplement. Population, active metabolites and formulation scope retained.
Source 2: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 11, 2026
Population: 42 healthy men receiving six Hypericum preparations.
CYP3A induction varied with hyperforin exposure.
How this applies: Exact preparation/population/endpoints only; applicability to selinexor independently assessed.
Abstract-only; no target drug or transferable exposure percentage.
Source 3: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 11, 2026
Population: Terminology.
selinexor is IN.
How this applies: Exact ingredient.
Not clinical evidence.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Sources checked and article drafted. |
Article revision: dbe8477bc99c2933
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.