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Panax ginseng

What is it?

Panax ginseng is an herbal medicine used to increase physical and mental well being. It may also be used to treat tiredness, weakness, and mild depression.

Other names for Panax ginseng include: Asiatic ginseng, Chinese ginseng, Japanese ginseng, Korean ginseng, Oriental ginseng, Jintsam, Ninjin, and Panax.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

  • are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement).
  • are pregnant or plan to become pregnant while using this medicine.
  • are breastfeeding.
  • have diabetes or problems with hyperactivity (14,15).
  • have any other health problems, such as high blood pressure or heart or blood vessel disease (6).

Dosage:

Talk with your doctor, pharmacist, or nurse about how much Panax ginseng you should take. The amount depends on the strength of the medicine and the reason you are taking Panax ginseng. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more Panax ginseng or take it more often than what is written on the directions.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take Panax ginseng without talking to your doctor first if you are taking:

  • Blood thinning medicine (anticoagulants, examples: warfarin (Coumadin(R)); aspirin; clopidogrel (Plavix(R))) (7,16,23)
  • Medicine to treat diabetes (hypoglycemics, examples: insulin; glyburide; glipizide; metformin (Glucophage(R))) (14,17,18)
  • Nifedipine (Adalat(R), Procardia(R)) (13)
  • Medicine to treat high blood pressure or swelling (water pills or diuretics, examples: furosemide (Lasix(R)); torsemide (Demadex(R))) (3)
  • Caffeine or other mild stimulants (15)
  • Alcohol, including medicines that contain alcohol (such as cough and cold medicines) (19)
  • Medicines for depression or Parkinson's disease (monoamine oxidase inhibitors, examples: phenelzine (Nardil(R)); selegiline (Eldepryl(R), Emsam(R), Zelapar(R)); isocarboxazid (Marplan(R)); tranylcypromine (Parnate(R))) (20,21)
  • Hormone replacement therapy (estrogen, examples: conjugated estrogens (Premarin(R)); estradiol (Alora(R), Climara(R), Depogen(R)); esterified estrogens (Estratab(R), Menest(R)); estropipate (Ogen(R), Ortho-Est(R)); ethinyl estradiol (Estinyl(R)) (5,10,22)
  • Medicine used to treat pain (codeine; hydrocodone (Vicodin(R)); oxycodone (Percocet(R), Roxicodone(R)); morphine) (2)

Warnings:

  • Before taking Panax ginseng, tell your doctor if you are pregnant or breastfeeding.
  • Before having any surgery or medical procedure, tell your doctor that you take ginseng. Ginseng may cause bleeding problems, so you may need to stop taking ginseng before surgery (7).
  • Panax ginseng may cause ginseng abuse syndrome. Symptoms may include high blood pressure, nervousness, trouble sleeping, morning diarrhea (loose stools), and skin itching and rash. Any of these symptoms may occur 1 to 3 weeks after using 3 grams of ginseng root per day (11).

Side Effects:

Call your doctor right away if you have any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash.

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

  • Diarrhea, nausea
  • Feeling much happier or having much more energy than usual
  • Lightheadedness or fainting
  • Nervousness or trouble sleeping
  • Rapid weight gain, swelling in your hands, ankles, or feet
  • Vaginal bleeding

References:

1. ABDA-Datenbank: Ginseng monograph. Wu V: Eschborn & Micromedex, Inc, Englewood, CO; 1997.

2. Abebe W: Herbal medication: potential for adverse effects with analgesic drugs. J Clin Pharm Ther 2002; 27:391-401.

3. Becker B, Greene J, Evanson J et al: Ginseng-induced diuretic resistance. JAMA 1996; 276:606-607.

4. Cleland T: The Herbalist. Indiana Botanic Gardens, Hammond, IN; 1997: 7.

5. Greenspan EM: Ginseng and vaginal bleeding. JAMA 1983; 249:2018.

6. Hammond T & Whitworth J: Adverse reactions to ginseng. (letter) Med J Aust 1981; 1:492.

7. Janetzky K & Morreale AP: Probable interaction between warfarin and ginseng. Am J Health-Syst Pharm 1997; 54: 692-693.

8. Kim SH, Lee SR, Do JH et al: Effects of Korean red ginseng and western ginseng on body temperature, pulse rate, clinical symptoms and the hematological changes in humans. Korean J Ginseng Sci 1995; 19:1-16.

9. Newall C, Anderson L, & Phillipson J. Ginseng, Panax. Herbal Medicines: A Guide for Health-Care Professionals. The Pharmaceutical Press, London, UK; 1996.

10. Punnonen R & Lukola A: Estrogen-like effect of ginseng. Lancet 1980; 181:1110PE 0082.

11. Ryu S & Chien Y: Ginseng-associated cerebral arteritis. Neurology 1995; 45:829 830.

12. Schulz V & Haensel R: Rationale Phytotherapie, 3rd ed. Springer-Verlag, New York, NY; 1996: 302-305.

13. Smith M, Lin KM & Zheng YP: An open trial of nifedipine-herb interactions: nifedipine with St John's wort, ginseng, or Ginkgo biloba (abstract). Clin Pharmacol Ther 2001; 69(2):P86.

14. Sotaniemi E, Haapakoski E & Rautio A: Ginseng therapy in non-insulin dependent diabetic patients. Diabetes Care 1995; 18:1373-1375.

15. Baranov AI: Medicinal uses of ginseng and related plants in the Soviet Union: recent trends in the Soviet literature. J Ethopharmacol 1982; 6:339-359.

16. Rosado MF: Thrombosis of a prosthetic aortic valve disclosing a hazardous interaction between warfarin and a commercial ginseng product. Cardiology 2003; 99:111.

17. Hallstrom C, Fulder S & Carruthers M: Effects of ginseng on the performance of nurses on night duty. Comp Med East West 1982; 6:277-282.

18. Liberti LE & Der Marderosian A: Evaluation of commercial ginseng products. J Pharm Sci 1978; 10:1487-1489.

19. Lee FC, Ko JH & Lee JS: Effects of Panax ginseng on blood alcohol clearance in man. Clin Experimental Pharmacol Physiol 1987; 14:543-546.

20. Jones BD &Runikis AM: Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987; 7:201-202.

21. Shader RI & Greenblatt DJ: Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985; 5:65.

22. Palmer BV, Montgomery ACV & Monteiro JCMP: Gin Seng and mastalgia. Br Med J 1978; 1:1284.

23. Yuan C-S, Wei G, Dey L, et al: Brief communication: american ginseng reduces warfarin's effect in healthy patients: a randomized, controlled trial. Ann Intern Med 2004; 141:23-27.


Last Updated: 10/4/2010
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