Meta Information
ID:panax-ginseng
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng possesses antiplatelet properties, which can add to the effects of blood-thinning medications, significantly increasing the risk of bleeding.
Actionable advice:
Panax ginseng should not be used when taking any blood-thinning medications like warfarin, clopidogrel, or aspirin, unless approved by a doctor.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We have studied the effect of dietary supplementation with 25 mg (0.0025% of the total diet) of a lipophilic fraction (LF) from Panax ginseng on rat platelet aggregation induced by collagen or thrombin, and on blood coagulation.
Label source:
PubMed: Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. (PMID 8951159)
Action type:
avoid
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng can lower blood glucose levels. When taken with other glucose-lowering medications, it can cause an additive effect, leading to dangerously low blood sugar (hypoglycemia).
Actionable advice:
It is important to talk to a doctor before using Panax ginseng with diabetes; frequent blood sugar monitoring is essential to avoid hypoglycemia.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We assessed the effect of eight popular ginseng types on postprandial plasma glucose (PG) and insulin (PI) indices, linking effects to ginsenoside profiles.
Label source:
PubMed: Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. (PMID 15190050)
Action type:
avoid
Target id:
/class/maois
Target name:
Monoamine Oxidase Inhibitors (MAOIs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining the stimulant-like properties of Panax ginseng with MAOI antidepressants has been reported to cause headaches, tremors, and manic-like symptoms.
Actionable advice:
Panax ginseng should not be taken concurrently with MAOI medications.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
ginseng reduced the blood levels of warfarin and alcohol as well as induced mania if taken concomitantly with phenelzine, a non-selective and irreversible monoamine oxidase inhibitor used as an antidepressant and anxiolytic agent.
Label source:
PubMed: Current medicinal chemistry (2011)
Source url:
Exact phrase from label:
induction of mania in depressed patients who mix antidepressants and Panax ginseng
Label source:
PubMed: Lancet (London, England) (2000)
Source url:
Exact phrase from label:
Case reports by herbal medicine (number of reports) comprised: St John's wort (Hypericum perforatum) (14); Ginseng (Panax ginseng) (5);
Label source:
PubMed: Frontiers in psychiatry (2018)
Action type:
avoid
Target id:
/class/immunosuppressants
Target name:
Immunosuppressant Medications
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng is known to stimulate the immune system, which can directly counteract the intended effects of medications designed to suppress immune activity.
Actionable advice:
Panax ginseng should be avoided completely when taking immunosuppressants for an autoimmune condition or after an organ transplant.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
These results suggest that P. ginseng berry can stimulate innate immune responses and help maintain a balanced immune condition, mostly due to the action of its key ginsenoside Re, along with other protopanaxadiol- and protopanaxatriol-type ginsenosides.
Label source:
PubMed: Upregulation of NK cell activity, cytokine expression, and NF-κB pathway by ginsenoside concentrates from Panax ginseng berries in healthy mice and macrophage cell lines. (PMID 39121929)
Action type:
separate
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The safety of Panax ginseng during pregnancy is not established, and some of its components have shown harmful effects on fetal development in animal studies.
Actionable advice:
Panax ginseng should be avoided completely during pregnancy.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
One of the chemicals in it has been found to cause birth defects in animals.
Label source:
Anecdotal: NCCIH
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown if components of Panax ginseng pass into breast milk or what effects they may have on a nursing infant; therefore, it should be avoided.
Actionable advice:
Panax ginseng should be avoided completely while breastfeeding.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
It is not known if Panax ginseng passes into breast milk.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/procedure/surgery
Target name:
Scheduled Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
168
Hours after target:
null
Description:
Panax ginseng can affect blood glucose levels and may increase the risk of bleeding, which can complicate surgical procedures and blood sugar control.
Actionable advice:
Panax ginseng should be discontinued at least 1 week before any scheduled surgery.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Direct effects include bleeding from garlic, ginkgo, and ginseng; cardiovascular instability from ephedra; and hypoglycemia from ginseng.
Label source:
PubMed: JAMA (2001)
Source url:
Exact phrase from label:
Potential adverse drug effects related to preoperative use of herbal medications involve the coagulation system (e.g., increasing the risk of perioperative bleeding), the cardiovascular system (e.g., arrhythmias, hypotension, hypertension), the central nervous system (e.g., sedation, confusion, seizures), pulmonary (e.g., coughing, bronchospasm), renal (e.g., diuresis) and endocrine-metabolic (e.g., hepatic dysfunction, altered metabolism of anesthetic drugs).
Label source:
PubMed: Journal of clinical anesthesia (2024)
Source url:
Exact phrase from label:
We present a case of massive perioperative bleeding due to severe coagulopathy following urgent aortic and mitral valve replacement. Bleeding was persistent despite prolonged and meticulous surgical haemostasis and required high-volume blood products transfusions. No obvious cause was found to justify the severity of the coagulopathy, which was later attributed to high preoperative intake of ginseng.
Label source:
PubMed: BMJ case reports (2017)
Action type:
avoid
Target id:
/condition/hormone-sensitive-cancers
Target name:
Hormone-Sensitive Conditions
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng may have weak estrogen-like effects, which could potentially stimulate the growth of hormone-sensitive cancers (e.g., breast, uterine) or worsen conditions like endometriosis.
Actionable advice:
Panax ginseng should be avoided with a history of hormone-sensitive cancers or conditions.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We have examined the possibility that a component of Panax ginseng, ginsenoside-Rb1, acts by binding to estrogen receptor.
Label source:
PubMed: Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells. (PMID 12568360)
Action type:
avoid
Target id:
/condition/bipolar-disorder
Target name:
Bipolar Disorder
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The stimulating properties of Panax ginseng may induce manic episodes or interfere with mood-stabilizing medications in individuals with bipolar disorder.
Actionable advice:
Panax ginseng should be avoided with bipolar disorder, especially during manic or mixed phases.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Panax ginseng, one of the most frequently used herbal medicines, has complex pharmacological activity, and can be associated with severe psychiatric symptoms.
Label source:
PubMed: Journal of dietary supplements (2015)
Source url:
Exact phrase from label:
A 56-year-old woman with previous affective disorder presented a manic episode during ginseng intake. Symptoms disappeared rapidly with low doses of neuroleptics and benzodiazepines after ginseng suppression.
Label source:
PubMed: Acta psychiatrica Scandinavica (2002)
Source url:
Exact phrase from label:
induction of mania in depressed patients who mix antidepressants and Panax ginseng
Label source:
PubMed: Lancet (London, England) (2000)
Action type:
avoid
Target id:
/class/stimulants
Target name:
Stimulant Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng has its own stimulant effects that can be additive with other stimulants, potentially causing overstimulation, rapid heart rate, nervousness, or insomnia.
Actionable advice:
Caution is warranted, and it is worth monitoring for overstimulation, when combining Panax ginseng with prescription stimulants or high doses of caffeine.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Thus, for the higher contents of Rg1, P ginseng is a stimulant, whereas the Rb1 contents of P quinquefolium are mainly calming to the CNS.
Label source:
PubMed: Acta pharmacologica Sinica (2008)
Source url:
Exact phrase from label:
Ginseng, widely used for its purported physical and mental effects, is generally well tolerated, but it has been implicated as a cause of decreased response to warfarin.
Label source:
PubMed: American family physician (1999)
Source url:
Exact phrase from label:
Commonly reported adverse effects seen with caffeine in the quantities present in most energy drinks are insomnia, nervousness, headache, and tachycardia.
Label source:
PubMed: Journal of the American Pharmacists Association : JAPhA (2008)
Action type:
monitor
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
moderate
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
8
Hours after target:
null
Description:
The stimulating, adaptogenic properties of Panax ginseng can interfere with sleep onset and quality if taken too close to bedtime.
Actionable advice:
Panax ginseng is best taken in the morning or early afternoon to avoid potential sleep disturbances.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The most commonly experienced adverse events are headache, sleep and gastrointestinal disorders.
Label source:
PubMed: Drug safety (2002)
Source url:
Exact phrase from label:
The amount of wakefulness and slow wave sleep (SWS) during the 12-h light period slightly but significantly decreased and increased, respectively, in freely behaving rats after continued 1-week intake of Panax ginseng extract through drinking water (15 mg/day).
Label source:
PubMed: Psychopharmacology (1990)
Source url:
Exact phrase from label:
Coffee and caffeine produced central stimulation and increased locomotor activity. Ginseng and ginsenosides were found to enhance exercise endurance and reduced the plasma level of ethanol.
Label source:
PubMed: Life sciences (1999)
Action type:
avoid
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng can affect blood pressure, sometimes increasing it, which may interfere with the effectiveness of medications intended to lower blood pressure.
Actionable advice:
Blood pressure should be monitored closely if combining Panax ginseng with blood pressure-lowering medications, and it is important to talk to a doctor.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Effects of P. ginseng on blood pressure and heart rate also were evaluated.
Label source:
PubMed: Electrocardiographic and hemodynamic effects of Panax ginseng. (PMID 11978148)
Action type:
monitor
Target id:
/class/qt-prolonging-agents
Target name:
QT-Prolonging Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is a theoretical risk that Panax ginseng could affect heart rhythm, potentially increasing the risk of arrhythmias when combined with other medications that prolong the QT interval.
Actionable advice:
Exercise caution and consult a healthcare provider before using Panax ginseng with any QT-prolonging medications.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
P. ginseng, at doses of 200 mg of the extract daily, increases the QTc interval and decreases diastolic blood pressure 2 hours after ingestion in healthy adults on the first day of therapy.
Label source:
PubMed: Electrocardiographic and hemodynamic effects of Panax ginseng. (PMID 11978148)
Action type:
informational_none
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng may increase the body's levels of digoxin, a heart medication with a narrow therapeutic window, potentially leading to toxicity.
Actionable advice:
Panax ginseng is best avoided when taking digoxin, unless under close medical supervision with drug level monitoring.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The results showed that three ginsenoside metabolites (CK, Ppd, and Ppt) formed by intestinal bacteria significantly enhanced rhodamine 123 retention in Caco-2 cells, increased the absorptive permeability of rhodamine 123, and decreased the efflux ratio of digoxin in two absorption models, which were comparable to the effects of the known P-glycoprotein inhibitor verapamil.
Label source:
PubMed: Ginsenoside metabolites inhibit P-glycoprotein in vitro and in situ using three absorption models. (PMID 24493631)
Action type:
avoid
Target id:
/class/herbal-anticoagulants
Target name:
Herbal Anticoagulants/Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining Panax ginseng with other supplements that have blood-thinning properties (like ginkgo, garlic, or high-dose fish oil) can increase the overall risk of bleeding.
Actionable advice:
Caution is warranted when combining multiple supplements that can affect blood clotting.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
We have studied the effect of dietary supplementation with 25 mg (0.0025% of the total diet) of a lipophilic fraction (LF) from Panax ginseng on rat platelet aggregation induced by collagen or thrombin, and on blood coagulation.
Label source:
PubMed: Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. (PMID 8951159)
Action type:
informational_none
Target id:
/class/glucose-lowering-supplements
Target name:
Glucose-Lowering Supplements
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng can lower blood sugar, and this effect can be additive with other supplements like berberine or chromium, increasing the risk of hypoglycemia.
Actionable advice:
Blood sugar should be monitored closely if combining Panax ginseng with other glucose-lowering supplements.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
For nondiabetic subjects, to prevent unintended hypoglycemia it may be important that the American ginseng be taken with the meal.
Label source:
PubMed: Archives of internal medicine (2000)
Source url:
Exact phrase from label:
Direct effects include bleeding from garlic, ginkgo, and ginseng; cardiovascular instability from ephedra; and hypoglycemia from ginseng.
Label source:
PubMed: JAMA (2001)
Source url:
Exact phrase from label:
This review will focus on the safety and efficacy data surrounding nicotinamide, ginseng, fenugreek, vitamin D, chromium, and cinnamon. These supplements are commonly listed in general circulation periodicals with claims to improve blood sugar management.
Label source:
PubMed: Journal of pharmacy practice (2017)
Action type:
monitor
Target id:
/class/cyp2d6-substrates
Target name:
CYP2D6 Substrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng may weakly inhibit the CYP2D6 enzyme, which could slightly increase the levels and side effects of drugs metabolized by this pathway (e.g., some antidepressants, beta-blockers).
Actionable advice:
This potential interaction is worth keeping in mind when taking medications metabolized by CYP2D6, though it is unlikely to be clinically significant for most.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Whereas CYP2D-catalysed dextromethorphan O-deethylation decreased in a dose- and time-dependent manner in vivo.
Label source:
PubMed: Characterization of red ginseng-drug interaction by CYP3A activity increased in high dose administration in mice. (PMID 32557706)
Action type:
informational_none
Target id:
/dietary/alcohol-acute
Target name:
Alcohol (Acute Consumption)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Panax ginseng may accelerate the metabolism and clearance of alcohol, which could unpredictably alter its intoxicating effects and the severity of hangover symptoms.
Actionable advice:
Taking Panax ginseng may change how the body processes and responds to alcohol.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Fourteen healthy male volunteers were studied to assess the effects of Panax ginseng on blood alcohol clearance, utilizing each subject as his own control.
Label source:
PubMed: Effects of Panax ginseng on blood alcohol clearance in man. (PMID 3677487)
Action type:
informational_none
Target id:
/class/loop-diuretics
Target name:
Loop Diuretics
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is limited case report evidence suggesting Panax ginseng might reduce the effectiveness of loop diuretics like furosemide, potentially leading to decreased fluid removal.
Actionable advice:
It is worth watching out for signs of reduced diuretic effectiveness (e.g., swelling) if Panax ginseng is taken with a loop diuretic.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Reference ID: 5673142
11 DESCRIPTION
Lasix ONYU (furosemide injection) for subcutaneous use is a loop diuretic.
Label source:
Action type:
monitor