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Panax ginseng, also known as Korean ginseng, is an herb that has been used for various health purposes. It should not be confused with other forms of ginseng.

Panax ginseng is a plant that grows in Korea, China, and Siberia. It's considered an adaptogen, which are natural substances that are believed to stimulate the body's resistance to stressors. Panax ginseng contains many active chemicals. The most important are called ginsenosides or panaxosides.

Panax ginseng is taken by mouth for memory and thinking skills, Alzheimer disease, depression, and many other conditions, but there is no good scientific evidence to support many of these uses.

Don't confuse Panax ginseng with other plants sometimes referred to as ginseng like American ginseng, Blue Cohosh, Canaigre, Codonopsis, Eleuthero, or Panax Notoginseng. These are different plants with different effects.

NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
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When taken by mouth: Panax ginseng is likely safe when taken for up to 6 months. Panax ginseng is possibly unsafe when taken for more than 6 months. It might have some hormone-like effects that could be harmful when used long-term. The most common side effect is trouble sleeping. Uncommon side effects that have been reported include severe rash, liver damage, and severe allergic reactions.

When applied to the skin: There isn't enough reliable information to know if Panax ginseng is safe. It might cause side effects such as irritation and burning.

Special Precautions & Warnings:

Pregnancy: Panax ginseng is possibly unsafe when taken by mouth during pregnancy. One of the chemicals in Panax ginseng has been found to cause birth defects in animals. Do not use Panax ginseng if you are pregnant.

Breast-feeding: There isn't enough reliable information to know if Panax ginseng is safe to use when breast-feeding. Stay on the safe side and avoid use.

Children: Panax ginseng is likely unsafe in infants and children. Panax ginseng has been linked to fatal poisoning in newborns. It's not clear if it's safe in older children. Until more is known, do not use Panax ginseng in children.

"Auto-immune diseases" such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Panax ginseng seems to increase the activity of the immune system. It might make auto-immune diseases worse. Don't use Panax ginseng if you have any auto-immune condition.

Bleeding conditions: Panax ginseng seems to interfere with blood clotting. Don't use Panax ginseng if you have a bleeding condition.

Heart conditions: Panax ginseng can affect heart rhythm and blood pressure slightly on the first day it is used. Use Panax ginseng with caution if you have heart disease.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Panax ginseng contains chemicals (ginsenosides) that can act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use Panax ginseng.

Trouble sleeping (insomnia): High doses of Panax ginseng have been linked with insomnia. If you have trouble sleeping, use Panax ginseng with caution.

Suppressed immune system: Panax ginseng might make the immune system more active. This could interfere with the effects of medications that suppress the immune system, such as those given after an organ transplant. If your immune system is suppressed, don't use Panax ginseng.

Schizophrenia: High doses of Panax ginseng have been linked with sleep problems and agitation in people with schizophrenia. Be careful when using Panax ginseng if you have schizophrenia.

Caffeine

Interaction Rating=Moderate Be cautious with this combination.

Caffeine can speed up the nervous system. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might increase the risk for side effects, including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.

Estrogens

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might have some of the same effects as estrogen. Taking Panax ginseng along with estrogen pills might decrease the effects of estrogen.

Fexofenadine (Allegra)

Interaction Rating=Minor Be watchful with this combination.

Fexofenadine is taken to treat seasonal allergies. Panax ginseng might reduce how much fexofenadine is available in the body. But there isn't enough information to know if this is a big concern.

Furosemide (Lasix)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease how well furosemide works. But there isn't enough information to know if this is a big concern.

Imatinib (Gleevec)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease how quickly the liver breaks down imatinib. Taking Panax ginseng with imatinib might increase the effects and side effects of imatinib.

Insulin

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease blood sugar. Insulin is also used to decrease blood sugar. Taking Panax ginseng along with insulin might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your insulin might need to be changed.

Lopinavir/Ritonavir (Kaletra)

Interaction Rating=Minor Be watchful with this combination.

Lopinavir/ritonavir is changed and broken down by the liver. Panax ginseng might affect how quickly the liver breaks down some medications. But Panax ginseng does not seem to affect how quickly the liver breaks down lopinavir/ritonavir in humans. So this interaction is probably not a big concern.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Panax ginseng might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Panax ginseng might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Medications for depression (MAOIs)

Interaction Rating=Moderate Be cautious with this combination.

Taking Panax ginseng with MAOIs might increase the risk for certain side effects, such as anxiousness, headache, restlessness, and insomnia.

Some common MAOIs include phenelzine (Nardil), selegiline (Zelapar), and tranylcypromine (Parnate).

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might lower blood sugar levels. Taking panax ginseng along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

Medications that can cause an irregular heartbeat (QT interval-prolonging drugs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might affect electrical currents in the heart. This can increase the risk of having an irregular heartbeat. Some medications can have this same effect. Taking panax ginseng with these medications might increase the risk for a serious heart issue.

Medications that decrease the immune system (Immunosuppressants)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking panax ginseng along with these medications might decrease the effects of these medications.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might slow blood clotting. Taking panax ginseng along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Midazolam (Versed)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might increase how quickly the liver breaks down midazolam. Taking Panax ginseng with midazolam may decrease the effects of midazolam.

Nifedipine (Procardia)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might affect how much nifedipine is available in the body. Taking Panax ginseng along with nifedipine might increase the effects and side effects of nifedipine.

Raltegravir (Isentress)

Interaction Rating=Moderate Be cautious with this combination.

Raltegravir has been associated with liver toxicity in some people. Taking Panax ginseng with raltegravir might increase the risk of liver toxicity in some people taking raltegravir.

Selegiline (Eldepryl)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease or increase how much selegiline is absorbed by the body. This might change the effects and side effects of selegiline.

Stimulant drugs

Interaction Rating=Moderate Be cautious with this combination.

Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with Panax ginseng.

Warfarin (Coumadin)

Interaction Rating=Moderate Be cautious with this combination.

Warfarin is used to slow blood clotting. Panax ginseng might decrease the effects of warfarin. But it's not clear if this interaction is a big problem. Be sure to have your blood checked regularly. The dose of your warfarin might need to be changed.

Herbs and supplements that might cause an irregular heartbeat (QT interval-prolonging products): Panax ginseng might affect electrical currents in the heart. This can increase the risk of having an irregular heartbeat. Taking Panax ginseng with other supplements with similar effects might increase the risk for a serious heart issue. Examples of supplements with this effect include bitter orange, ephedra, grapefruit, and iboga.
Herbs and supplements that might lower blood sugar: Panax ginseng might lower blood sugar. Taking it with other supplements with similar effects might lower blood sugar too much. Examples of supplements with this effect include aloe, bitter melon, cassia cinnamon, chromium, and prickly pear cactus.
Herbs and supplements that might slow blood clotting: Panax ginseng might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, and nattokinase.

Drinking caffeinated beverages such as coffee or tea while taking Panax ginseng can make you feel jittery and speed up your heartbeat. Avoid caffeinated beverages or caffeine-containing foods while taking panax ginseng.

Panax ginseng has most often been used by adults in doses of 200 mg to 3 grams by mouth daily for up to 12 weeks. Speak with a healthcare provider to find out what dose might be best for a specific condition.

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