Does Ginseng interact with any drugs?

There are many different origins of ginseng, and many types of drug interactions. Over 100 drugs are known to interact with ginseng. Some may be clinically important such as with the blood thinner warfarin, medicines used for type 2 diabetes medicine, and some cancer treatments.

Be sure to check with your pharmacist or doctor if you use ginseng as an herbal supplement. While usually well-tolerated, important drug interactions can occur. Do not stop using any medications without first talking to your doctor.

Ginseng has been used in Asian countries for its therapeutic effects for centuries. Today, ginseng use is reported to improve the body's resistance to stress and increase vitality, among other uses.

Use of ginseng may decrease the effectiveness of warfarin, a blood thinner, and increase the risk for a blood clot.

• In general, ginseng or ginseng-containing herbal tea should not be used with anticoagulants.
• One study suggested that the vitamin K present in Korean red ginseng may be a contributing factor. Ask your doctor about this interaction.

Ginseng may also affect diabetic medications like insulin or oral hypoglycemics, leading to low blood sugar.

• Your doctor may need to adjust your dose or monitoring your blood sugar more frequently.
• Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, confusion, tremor, nausea, hunger, weakness, perspiration, palpitation, and rapid heartbeat.

If you take Gleevec (imatinib), tell your doctor before you consume ginseng. Using imatinib together with ginseng may increase the side effects of imatinib. Ginseng may inhibit enzymes needed for breakdown and excretion of imatinib from the body. Ginseng is known to inhibit CYP3A4, the main enzyme involved in the metabolism of imatinib.

• A case report described a case of hepatitis (severe liver inflammation) and elevated liver enzymes in a person who ingested Panax ginseng daily via energy drinks.
• He had previously taken imatinib for 7 years without complications, but in the 3 months prior had started ingesting Panax ginseng daily via energy drinks. After the ginseng was stopped, imatinib was later restarted at the same dose with no recurrent elevations of liver enzymes.
• Contact your doctor if you experience nausea, stomach pain, fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), severe muscle cramps, fever, chills, body aches, flu-like symptoms, easy bruising or bleeding, or weakness.

Do not take ginseng without medical advice if you are using any of the following medications:

• any diabetes medicine
• warfarin (Coumadin, Jantoven)
• medicine for depression
• any cancer treatment
• immunosuppressants (for example: such as azathioprine (Imuran), cyclosporine (Neoral, Sandimmune), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).

This list is not a complete list of drug interactions or all the safety information you need to know about ginseng. Other drugs may interact with ginseng, including prescription and over-the-counter medicines, vitamins, and herbal products.

Learn more: Drug Interactions with Ginseng (in detail)

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