September 5, 2015

Ginseng, Panax

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Are there any interactions with medications?



Alcohol
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.
Talk with your health provider.

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.



Estrogens
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Panax ginseng might have some of the same effects as estrogen. However, Panax ginseng is not as strong as estrogen pills. Taking Panax ginseng along with estrogen pills might decrease the effects of estrogen pills.

Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.



Furosemide (Lasix)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.
Talk with your health provider.

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.
Talk with your health provider.

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.
Talk with your health provider.

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.
Talk with your health provider.

Panax ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking Panax ginseng along with diabetes medications could add to the effects of diabetic medications and lower blood sugar too much. 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 can cause an irregular heartbeat (QT interval-prolonging drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Panax ginseng may cause an abnormal heartbeat when taken short-term. Taking Panax ginseng with drugs that can cause an irregular heartbeat might cause serious side effects, including heart rhythm problems (arrhythmias).

Some medications that affect the heartbeat include amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), ibutilide (Corvert), procainamide (Pronestyl), quinidine, sotalol (Betapace), thioridazine (Mellaril), and many others.



Medications that decrease the immune system (Immunosuppressants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.
Talk with your health provider.

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, cilostazol (Pletal), clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.



Nifedipine (Procardia)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Panax ginseng might affect how much nifedipine is available in the body. Taking Panax ginseng along with nifedipine might increase the blood pressure lowering effects of nifedipine.



Raltegravir
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Raltegravir is a drug used to treat people with HIV. 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.



Stimulant drugs
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.
Talk with your health provider.

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.



Fexofenadine (Allegra)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

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



Medications changed by the liver (Cytochrome P450 1A1 (CYP1A1) substrates)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Panax ginseng might increase how quickly the liver breaks down some medications. Taking Panax ginseng along with some medications that are changed by the liver can decrease 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 chlorzoxazone, theophylline, and bufuralol.

Dosing considerations for Ginseng, Panax.

The following doses have been studied in scientific research:

BY MOUTH:
  • For treating type 2 diabetes: 200 mg daily.
  • For erectile dysfunction: Panax ginseng 900 mg three times daily.
APPLIED TO THE SKIN:
  • For premature ejaculation: a cream (SS-Cream) containing Panax ginseng and other ingredients has been applied to the glans penis one hour before intercourse and washed off before intercourse.

Therapeutic Research Faculty copyright

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