Drug Interactions With Panax Ginseng
Diabetes medications, "blood-thinning" medicines, and medications that are metabolized by enzymes in the liver may cause drug interactions with Panax ginseng. These interactions can make certain drugs more toxic and increase your risk of bleeding or low blood sugar. Since so many medications can cause Panax ginseng drug interactions, you should check with your healthcare provider before combining any drugs with ginseng supplements.
Even though Panax ginseng is a natural product, it can potentially interact with several medications. In fact, Panax ginseng may cause significant interactions with many medications, too many to list in this article. Most drug interactions with Panax ginseng fall into the following categories:
- Interactions that can cause excessive bleeding
- Interactions with diabetes medications
- Interactions that affect the way liver enzymes metabolize other drugs
- Other miscellaneous drug interactions.
This article specifically refers to Panax ginseng (also known as Asian ginseng, Chinese ginseng, and Korean ginseng). This type of ginseng should not be confused with American ginseng or Siberian ginseng, which are entirely different herbs.
Panax Ginseng Interactions and Bleeding
Theoretically, Panax ginseng could decrease the ability of blood platelets to stick together. While this may be a beneficial action in many situations, it can also increase the risk of bleeding. It is not clear if this is a significant problem in humans.
Until more information is available, it should be assumed that combining Panax ginseng with medications that increase the risk of bleeding could lead to dangerous problems, such as internal bleeding. Some of the "blood-thinning" medicines that may lead to Panax ginseng drug interactions include:
- Antithrombin (ATryn®, Thrombate III®)
- Aspirin (Bayer® and others)
- Bivalirudin (Angiomax®)
- Cilostazol (Pletal®)
- Clopidogrel (Plavix®)
- Dabigatran etexilate mesylate (Pradaxa®)
- Dipyridamole (Persantine®)
- Drotrecogin alfa (Xigris®)
- Eptifibatide (Integrilin®)
- Fondaparinux (Arixtra®)
- Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)
- Lepirudin (Refludan®)
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- Celecoxib (Celebrex®)
- Diclofenac (Cambia™, Cataflam®, Flector®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®, Zipsor™)
- Ibuprofen (Motrin®, Advil®, Nuprin®)
- Indomethacin (Indocin®, Indocin SR®)
- Ketoprofen (Orudis®, Actron®, Oruvail®)
- Ketorolac (Toradol®)
- Meloxicam (Mobic®)
- Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)
- Several others (see List of NSAIDs for a more complete list of these medications)
- Alteplase (Activase®)
- Reteplase (Retavase®)
- Streptokinase (Streptase®)
- Tenecteplase (TNKase®)
- Ticagrelor (Brilinta™)
- Ticlopidine (Ticlid®)
- Tirofiban (Aggrastat®)
- Warfarin (Coumadin®, Jantoven®).
Do not combine Panax ginseng with any such medications without your healthcare provider's approval and supervision. There have been reports that Panax ginseng could actually make warfarin less effective (which is the opposite of what would be expected), increasing the risk of blood clots.
Due to the unpredictability of interactions between Panax ginseng and "blood-thinning" medications, your healthcare provider may recommend against combining them at all or may recommend increased monitoring to detect any problems.