Drug Interactions between ginseng and torsemide

GENERALLY AVOID: Ginseng has been reported to induce diuretic resistance in a patient treated with furosemide and cyclosporine. The patient was hospitalized for edema and hypertension approximately 10 days after initiating self-therapy with herbal supplements that included a fairly large quantity of ginseng. While in the hospital, all herbal products were withheld and the patient responded to intravenous furosemide. Following discharge, the patient resumed his herbal regimen and again experienced an episode of edema and hypertension shortly thereafter that was refractory to increases in the furosemide dosage. The patient was readmitted to the hospital, upon which herbal products were discontinued and the patient responded to intravenous furosemide over the next 48 hours. The temporal association of these events strongly suggests a potential drug interaction, however, the exact mechanism is unknown.

MANAGEMENT: Until further data are available, patients treated with furosemide or other loop diuretics should preferably avoid the use of ginseng supplements. The possibility of diuretic resistance should be considered and appropriately monitored if concomitant use is necessary.