The short answer
The eltrombopag label names selenium among the minerals to separate and says to take eltrombopag at least 2 hours before or 4 hours after selenium-containing supplements or multivitamins. No selenium-specific study was identified in the reviewed searches. The measured 70% reduction in exposure came from an aluminum and magnesium antacid, so it cannot establish the size of any effect from selenium. Follow the label's separation instruction and discuss whether your selenium product and dose are appropriate with your prescriber or pharmacist.
What this answer covers
Selenium supplements (selenomethionine, selenium yeast, sodium selenite or selenate) and selenium in multivitamin and mineral products, with eltrombopag tablets or oral suspension.
- Supplement or preparation
- selenium
- Medication ingredient
- eltrombopag
What the label says
The PROMACTA and ALVAIZ labels list selenium by name, alongside iron, calcium, aluminum, magnesium and zinc, as a polyvalent cation that eltrombopag chelates, and direct patients to take eltrombopag at least 2 hours before or 4 hours after supplements containing it. The Medication Guide gives patients the same list.
Selenium-specific evidence is limited
The reviewed Europe PMC searches for eltrombopag with selenium, selenite or selenomethionine did not identify a pharmacokinetic study, case report or clinical trial of this combination. The mineral-related studies reported in the label used an aluminum and magnesium antacid and calcium-rich meals. Those results do not quantify an effect from selenium.
Why selenium is chemically different
Common supplement forms include selenomethionine, selenium-enriched yeast, sodium selenite and sodium selenate. These are organic selenium compounds or selenium-containing anions, rather than the metal cations studied in the antacid. Selenium is generally provided in microgram quantities. These differences limit extrapolation from the antacid study, but they do not establish an exception to the label's separation instruction.
What to do
Take eltrombopag at least 2 hours before or 4 hours after a selenium-containing supplement, as the label directs. A multivitamin may also contain iron, calcium, magnesium or zinc, which require separation under the same rule. The spacing instruction does not establish whether a selenium supplement is needed or appropriate for every person; review the product and dose with your prescriber or pharmacist.
Evidence and practical considerations
Absorption & effectiveness
The label names selenium among the polyvalent cations that eltrombopag chelates and requires separation; no selenium-specific study was identified in the reviewed searches, and supplemental selenium is an organic or anionic form rather than a metal cation, so the size of any absorption effect is unknown.
- Exact scope
- Selenium supplements and multivitamins containing selenium in any form. with Oral eltrombopag olamine tablets and oral suspension (PROMACTA and generics) and eltrombopag choline tablets (ALVAIZ). Both product labels give the same mineral-separation instruction; the products have different strengths and are not interchangeable dose for dose.
- Medication form and route
- oral medication; oral supplement
What remains uncertain
- Label class statement only; no selenium-specific pharmacokinetic, clinical or case evidence identified in the reviewed searches; the chemical premise for selenium is not explained in the label.
Factors that may matter: Selenium form (selenomethionine versus selenite or selenate); Other cations in the same multivitamin; Timing relative to the eltrombopag dose.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 22, 2026
Population: People prescribed eltrombopag
The label lists selenium by name among the polyvalent cations that eltrombopag chelates in foods, mineral supplements and antacids, and directs taking eltrombopag at least 2 hours before or 4 hours after supplements containing selenium. The Medication Guide repeats selenium in its list. No selenium study is reported; the measured interactions used an aluminum and magnesium antacid and calcium-rich meals.
How this applies: Exact eltrombopag (RxCUI 711942) in every marketed oral form; the label names iron, calcium, aluminum, magnesium, selenium and zinc by element and gives one spacing rule for all of them.
Selenium appears only in the class list; the label gives no selenium-specific data and does not explain the chemical basis for including it.
Source 2: current product label
dailymed.nlm.nih.gov · Source check Sep 22, 2026
Population: People prescribed eltrombopag
The ALVAIZ label repeats the PROMACTA rule word for word: eltrombopag chelates polyvalent cations such as iron, calcium, aluminum, magnesium, selenium and zinc, and ALVAIZ is taken at least 2 hours before or 4 hours after antacids, dairy products and mineral supplements to avoid significant reduction in absorption.
How this applies: Confirms that the cation rule is unchanged for the newer eltrombopag choline product; it adds no element-specific data.
No new interaction study is reported for the choline salt; the wording is carried over from the innovator label.
Source 3: pharmacokinetic crossover study
pubmed.ncbi.nlm.nih.gov · Source check Sep 22, 2026
Population: Healthy adult volunteers (18 men in study A; 26 adults in study B).
The high-calcium breakfast reduced eltrombopag AUC by 59% (geometric mean ratio 0.41; 90% CI 0.36 to 0.46) and peak concentration by 65%. Low-calcium meals did not change exposure whatever their fat content (AUC ratios 0.87 to 1.03). The aluminum and magnesium antacid reduced AUC and peak concentration by about 70% (AUC ratio 0.30; 90% CI 0.24 to 0.36).
How this applies: Comparator cations (aluminum and magnesium in an antacid, calcium in food); selenium was not tested, so this shows the size of chelation effects for true cations rather than a selenium result.
Single doses in healthy volunteers read as an abstract; the antacid combined two cations plus sodium alginate, so the share of each is unknown; no mineral supplement product was tested.
Source 4: federal supplement fact sheet
ods.od.nih.gov · Source check Sep 22, 2026
Population: General consumer population; no eltrombopag co-use data
Supplemental selenium is supplied as selenomethionine, selenium-enriched yeast (mostly selenomethionine), sodium selenite or sodium selenate, absorbed up to about 90%; multivitamins commonly contain 55 micrograms and selenium-only products 100 to 400 micrograms; the only listed medication interaction is cisplatin.
How this applies: Establishes that supplemental selenium is an organic amino-acid form or an inorganic selenite or selenate anion rather than a metal cation, and that doses are in micrograms; the fact sheet does not list eltrombopag.
Consumer and professional summary; it does not mention eltrombopag or chelation.
Research assessment: · Open full citations ↗
Timing & monitoring
The label directs taking eltrombopag at least 2 hours before or 4 hours after selenium-containing supplements.
- Exact scope
- Any oral product containing selenium. with Oral eltrombopag olamine tablets and oral suspension (PROMACTA and generics) and eltrombopag choline tablets (ALVAIZ). Both product labels give the same mineral-separation instruction; the products have different strengths and are not interchangeable dose for dose.
- Medication form and route
- oral medication; oral supplement
- Timing or duration
- Every eltrombopag dose while the selenium product is used
What remains uncertain
- Labelled instruction applied to the whole cation class; not tested with selenium in the identified studies.
Factors that may matter: Order of dosing (before versus after); Once-daily eltrombopag schedule.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 22, 2026
Population: People prescribed eltrombopag
The label lists selenium by name among the polyvalent cations that eltrombopag chelates in foods, mineral supplements and antacids, and directs taking eltrombopag at least 2 hours before or 4 hours after supplements containing selenium. The Medication Guide repeats selenium in its list. No selenium study is reported; the measured interactions used an aluminum and magnesium antacid and calcium-rich meals.
How this applies: Exact eltrombopag (RxCUI 711942) in every marketed oral form; the label names iron, calcium, aluminum, magnesium, selenium and zinc by element and gives one spacing rule for all of them.
Selenium appears only in the class list; the label gives no selenium-specific data and does not explain the chemical basis for including it.
Source 2: current product label
dailymed.nlm.nih.gov · Source check Sep 22, 2026
Population: People prescribed eltrombopag
The ALVAIZ label repeats the PROMACTA rule word for word: eltrombopag chelates polyvalent cations such as iron, calcium, aluminum, magnesium, selenium and zinc, and ALVAIZ is taken at least 2 hours before or 4 hours after antacids, dairy products and mineral supplements to avoid significant reduction in absorption.
How this applies: Confirms that the cation rule is unchanged for the newer eltrombopag choline product; it adds no element-specific data.
No new interaction study is reported for the choline salt; the wording is carried over from the innovator label.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Editorial update | |
| Editorial source audit clarified label scope, evidence limits and practical wording. No clinical approval was recorded. | |
| Research summary published | |
| Article prepared | |
| Prepared exact eltrombopag and Selenium article from inspected current labeling and original sources, with uncertainty stated. |
Article revision: 80cf15bdda1d4ab1
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?
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Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.