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Selenium (trace element): Drug information

Selenium (trace element): Drug information
(For additional information see "Selenium (trace element): Patient drug information" and see "Selenium (trace element): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Aqueous Selenium [OTC];
  • Oceanic Selenium [OTC];
  • Se-100 [OTC];
  • Selenicaps-200 [OTC] [DSC];
  • Selenimin [OTC] [DSC];
  • Selenimin-200 [OTC] [DSC]
Brand Names: Canada
  • Micro-Se
Pharmacologic Category
  • Trace Element, Parenteral
Dosing: Adult

Parenteral nutrition additive (Vanek 2012): IV: 60 to 100 mcg/day

Deficiency from prolonged parenteral nutrition: IV: 100 mcg/day

Dosing: Pediatric

(For additional information see "Selenium (trace element): Pediatric drug information")

Parenteral nutrition additive, maintenance requirement:

ASPEN recommendations:

Infants <10 kg: IV: 2 mcg/kg/day (ASPEN [Corkins 2015]; ASPEN [Mirtallo 2004]; ASPEN [Vanek 2012]; ASPEN [Vanek 2015]).

Infants and Children weighing 10 to 40 kg: IV: 1 to 2 mcg/kg/day (ASPEN [Corkins 2015]; ASPEN [Mirtallo 2004]); maximum daily dose: 100 mcg/day (ASPEN [Vanek 2012]; ASPEN [Vanek 2015]).

Children and Adolescents weighing >40 kg: IV: 2 mcg/kg/day; maximum daily dose: 100 mcg/day (ASPEN [Corkins 2015]; ASPEN [Vanek 2012]); ASPEN [Vanek 2015]).

ESPGHAN/ESPEN/ESPR/CSPEN recommendations (Demellöf 2018): Infants, Children, and Adolescents: IV: 2 to 3 mcg/kg/day; maximum daily dose: 100 mcg/day.

Dosing: Kidney Impairment: Pediatric

Infants, Children, and Adolescents: Use with caution; dose reduction or discontinuation may be necessary.

Dosing: Hepatic Impairment: Pediatric

Infants, Children, and Adolescents: There are no dosage adjustments in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Selenicaps-200: 200 mcg [DSC] [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 [DSC])

Solution, Intravenous [preservative free]:

Generic: 12 mcg/2 mL (2 mL); 40 mcg/mL (10 mL); 60 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]

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

Selenimin-200: 200 mcg [DSC] [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 [DSC]

Generic Equivalent Available: US

May be product dependent

Dosage Forms: Canada

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

Solution, Intravenous:

Micro-Se: 40 mcg/mL (10 mL)

Administration: Adult

Oral: Bariatric surgery: Tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. ER tablets should be swallowed whole. Do not break, crush, or chew. IR tablet, capsule, oral solution, and injectable formulations are available. If safety and efficacy can be effectively monitored, no change in formulation or administration is required after bariatric surgery. Bariatric vitamin supplementation is recommended on a lifelong basis after surgery; may consider integration of daily selenium regimen into the bariatric vitamin regimen.

Administration: Pediatric

IV infusion: Not for direct IV or IM injection; must be diluted; direct administration of solution causes tissue irritation.

Use: Labeled Indications

Trace metal supplement

Adverse Reactions

There are no adverse reactions listed in the manufacturer's labeling.

Contraindications

Undiluted administration into peripheral vein

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.

Metabolism/Transport Effects

None known.

Drug Interactions

Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. Risk X: Avoid combination

Bictegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Bictegravir. Management: Administer bictegravir under fasting conditions at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Risk D: Consider therapy modification

Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Risk D: Consider therapy modification

Cabotegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Cabotegravir. Management: Administer polyvalent cation containing products at least 2 hours before or 4 hours after oral cabotegravir. Risk D: Consider therapy modification

Deferiprone: Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider therapy modification

Dolutegravir: Selenium may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral selenium. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral selenium. Risk D: Consider therapy modification

Eltrombopag: Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider therapy modification

Elvitegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Elvitegravir. Management: Administer elvitegravir 2 hours before or 6 hours after the administration of polyvalent cation containing products. Risk D: Consider therapy modification

PenicillAMINE: Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider therapy modification

Raltegravir: Polyvalent Cation Containing Products may decrease the serum concentration of Raltegravir. Management: Administer raltegravir 2 hours before or 6 hours after administration of the polyvalent cations. Dose separation may not adequately minimize the significance of this interaction. Risk D: Consider therapy modification

Trientine: Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant use of trientine and polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. For other oral polyvalent cations, give trientine 1 hour before, or 1 to 2 hours after the polyvalent cation. Risk D: Consider therapy modification

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).

Breastfeeding Considerations

Selenium is found in breast milk. Concentrations vary based on maternal intake and time postpartum. Adverse events have not been observed with nontoxic maternal intake in humans (IOM, 2000).

Dietary Considerations

Dietary adequate intake (AI): Note: Breast milk, formula, and food should be the only sources of selenium for infants (NIH 2019).

1 to 6 months: 15 mcg/day.

7 to 12 months: 20 mcg/day.

Dietary recommended daily allowance (RDA) (IOM 2000):

1 to 3 years: 20 mcg/day.

4 to 8 years: 30 mcg/day.

9 to 13 years: 40 mcg/day.

≥14 years: 55 mcg/day.

Pregnancy: 60 mcg/day.

Lactation: 70 mcg/day.

Monitoring Parameters

Plasma selenium concentration for patients receiving long-term PN (every 3 to 6 months; some patients (ie, HSCT) may require more frequent monitoring) (ASPEN Pediatric Nutrition Support Core Curriculum [Corkins 2010])

Mechanism of Action

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

Pharmacokinetics

Excretion: Urine, feces, lungs, skin

Pricing: US

Liquid (Aqueous Selenium Oral)

95 mcg/drop (per mL): $0.86

Solution (Selenious Acid Intravenous)

40 mcg/mL (per mL): $23.91

60 mcg/mL (per mL): $41.16

Tablets (Selenium Oral)

50 mcg (per each): $0.02 - $0.04

200 mcg (per each): $0.06

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • Cerosel (PL);
  • Heweselen (DE);
  • Plexium (FR);
  • San-druff (SY);
  • Scintadren (GB);
  • Selebound (AR);
  • Selenion (FR);
  • Seleno Forte (AU);
  • Selifid (SY);
  • Tinasel (EG)


For country abbreviations used in Lexicomp (show table)
  1. Aluminum in large and small volume parenterals used in total parenteral nutrition. Fed Regist. 2002;67(244):77792-77793. To be codified at 21 CFR §201.323.
  2. Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guideline Recommendations. In US Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans, 8th Edition. December 2015. Pp 97-98. Available at http://health.gov/dietaryguidelines/2015/guidelines/
  3. Corkins MR, Balint J, Bobo E, et al, eds. The A.S.P.E.N Pediatric Nutrition Support Core Curriculum, Silver Spring: MD: American Society of Parenteral and Enteral Nutrition, 2010.
  4. Corkins MR, Balint J, Corkins KG, Bobo E, Plogsted S, Yaworski, JA, eds. A.S.P.E.N. Pediatric Nutrition Support Handbook. 2nd ed. Silver Spring, MD: American Society for Enteral and Parenteral Nutrition; 2015.
  5. Domellöf M, Szitanyi P, Simchowitz V, Franz A, Mimouni F; ESPGHAN/ESPEN/ESPR/CSPEN working group on pediatric parenteral nutrition. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Iron and trace minerals. Clin Nutr. 2018;37(6 Pt B):2354-2359. [PubMed 30078716]
  6. IOM (Institute of Medicine), Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids, Washington, DC: National Academy Press, 2000.
  7. Mirtallo J, Canada T, Johnson D, et al. Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr. 2004; 28(6):S39-70. [PubMed 15568296]
  8. National Institutes of Health (NIH) Office of Dietary Supplements. Selenium: fact sheet for health professionals. Available at: https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/. Updated July 9, 2019. Accessed September 30, 2019.
  9. Selenious acid injection solution [prescribing information]. Shirley, NY: American Regent Inc; August 2021.
  10. Selenium 40 mcg/mL injection [prescribing information]. Shirley, NY: American Regent Inc; August 2021.
  11. Selenium 60 mcg/mL injection [prescribing information]. Shirley, NY: American Regent Inc; August 2021.
  12. Vanek VW, Borum P, Buchman A, et al. A call to action to bring safer parenteral micronutrient products to the U.S. market. Nutr Clin Pract. 2015;30(4):559-569. [PubMed 26113560]
  13. Vanek VW, Borum P, Buchman A, et al; Novel Nutrient Task Force, Parenteral Multi-Vitamin and Multi–Trace Element Working Group; American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27(4):440-491. doi: 10.1177/0884533612446706. [PubMed 22730042]
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