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Selenium

Pronunciation

Pronunciation

(se LEE nee um)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule, Oral:

Selenicaps-200: 200 mcg [corn free, no artificial color(s), rye free, sugar free, wheat free, yeast free]

Capsule, Oral [preservative free]:

Se-100: 100 mcg [dye free, yeast free]

Liquid, Oral:

Aqueous Selenium: 95 mcg/drop (15 mL) [contains sodium benzoate]

Solution, Intravenous:

Generic: 40 mcg/mL (10 mL)

Tablet, Oral:

Oceanic Selenium: 50 mcg, 200 mcg [animal products free, gelatin free, gluten free, kosher certified, lactose free, no artificial color(s), no artificial flavor(s), starch free, sugar free, yeast free]

Se Aspartate: 50 mcg

Se-Plus Protein: 200 mcg

Selenimin: 125 mcg [corn free, rye free, starch free, sugar free, wheat free]

Selenimin-200: 200 mcg [corn free, rye free, starch free, sugar free, wheat free, yeast free]

Generic: 50 mcg, 200 mcg

Tablet, Oral [preservative free]:

Generic: 50 mcg, 200 mcg

Tablet Extended Release, Oral [preservative free]:

Generic: 200 mcg

Brand Names: U.S.

  • Aqueous Selenium [OTC]
  • Oceanic Selenium [OTC]
  • Se Aspartate [OTC]
  • Se-100 [OTC]
  • Se-Plus Protein [OTC]
  • Selenicaps-200 [OTC]
  • Selenimin [OTC]
  • Selenimin-200 [OTC]

Pharmacologic Category

  • Trace Element, Parenteral

Pharmacology

Part of glutathione peroxidase which protects cell components from oxidative damage due to peroxidases produced in cellular metabolism

Excretion

Urine, feces, lungs, skin

Use: Labeled Indications

Trace metal supplement

Contraindications

Undiluted administration into peripheral vein

Dosing: Adult

Nutritional supplement:

Oral:

Recommended daily allowance (RDA):

Adults: 55 mcg/day

Pregnancy: 60 mcg/day

Lactation: 70 mcg/day

IV in TPN solutions:

Metabolically stable: 20-40 mcg/day

Deficiency from prolonged TPN support: 100 mcg/day

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Nutritional supplement:

Oral:

Adequate intake (AI):

1-6 months: 15 mcg/day

7-12 months: 20 mcg/day

Recommended daily allowance (RDA):

1-3 years: 20 mcg/day

4-8 years: 30 mcg/day

9-13 years 40 mcg/day

≥14 years: 55 mcg/day

IV in TPN solutions: 3 mcg/kg/day

Storage

Prior to use, store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).

Drug Interactions

Dolutegravir: Selenium may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral selenium. Consider therapy modification

Eltrombopag: Selenium may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any selenium-containing product. Consider therapy modification

Adverse Reactions

Frequency not defined: Local: Irritation

Warnings/Precautions

Disease-related concerns:

• Gastrointestinal dysfunction: Use with caution in patients with GI impairment.

• Renal impairment: Use with caution in patients with renal impairment.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer’s labeling.

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events were seen with high doses in animal studies. Selenium is found in the placenta and cord blood. Teratogenic effects have not been observed with nontoxic doses in humans (IOM, 2000).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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