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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.

Natural Medicines 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.

Alcohol

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.

Caffeine

Interaction Rating=Moderate Be cautious with this combination.

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

Furosemide (Lasix)

Interaction Rating=Moderate Be cautious with this combination.

Some scientists think that Panax ginseng might decrease how well furosemide (Lasix) works. But there isn't enough information to know if this is a big concern.

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.

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 decrease how quickly the liver breaks down some medications. Taking Panax ginseng along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking Panax ginseng talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

Medications for depression (MAOIs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might stimulate the body. Some medications used for depression can also stimulate the body. Taking Panax ginseng with these medications used for depression might cause too much stimulation. This might cause side effects such as anxiousness, headache, restlessness, and insomnia.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking Panax ginseng along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Medications that decrease the immune system (Immunosuppressants)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng increases the immune system. By increasing the immune system, Panax ginseng might decrease the effectiveness of medications that decrease the immune system.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

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 clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

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.
Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.

Warfarin (Coumadin)

Interaction Rating=Moderate Be cautious with this combination.

Warfarin (Coumadin) is used to slow blood clotting. There is some concern that Panax ginseng might decrease the effectiveness of warfarin (Coumadin). 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 (Coumadin) might need to be changed.

Herbs and supplements that might cause an irregular heartbeat (QT interval-prolonging drugs): 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.

There are no known interactions with foods.

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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