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Ginseng Side Effects, Interactions and Warnings

Products containing ginseng varied greatly in their herb content as well as recommendations for use.
- Evid Based Complement Alternat Med. 2004 Dec;1(3):305-313. Epub 2004 Oct 6. -- Phytochemical Assays of Commercial Botanical Dietary Supplements. -- Krochmal R, Hardy M, Bowerman S, Lu QY, Wang HJ, Elashoff R, Heber D.

Since ginseng is considered to be a stimulant, caution should be exercised if you ingest caffeine, products containing pseudoephedrine or other stimulants.

Vitamin C can interfere with or increase the absorption of ginseng.
- Mol Cell Biochem. 2000 Jan;204(1-2):77-82. -- Interactions between Panax quinquefolium saponins and vitamin C are observed in vitro. -- Li JP, Huang M, Teoh H, Man RY.

Reports include reactions such as headache, insomnia, anxiety and breast soreness or tenderness. It is also possible that skin rashes may develop as well as asthma attacks, increased blood pressure, diarrhea, euphoria, nervousness, skin eruptions, heart palpitations, or post-menopausal uterine bleeding. Stop using ginseng and consult your pharmacist or doctor if you suffer any side effects.

Use ginseng only under the direction of an herbalist or a licensed healthcare professional if you have any of the following conditions: pregnancy, insomnia, hay fever, fibrocystic breasts, asthma, emphysema, high blood pressure, blood-clotting problems, heart disorders, hypoglycemia or diabetes.

This article advises against using ginseng in pregnant women in the first trimester because of possible birth defects.
- Birth Defects Res B Dev Reprod Toxicol. 2005 Apr;74(2):207-9. -- Developmental toxicity research of ginsenoside Rb1 using a whole mouse embryo culture model. -- Liu P, Xu Y, Yin H, Wang J, Chen K, Li Y.

Ginseng reinforces warfarin action by heterogeneous mechanisms. It should thus not be used in patients on oral anticoagulant and/or antiplatelet therapy.
- Oral anticoagulants and medicinal plants. An emerging interaction -- Argento A, Tiraferri E, Marzaloni M. -- Ann Ital Med Int. 2000 Apr;15(2):139-43.

Ginseng has been associated with documented reports of potential interactions with warfarin.
- Am J Health Syst Pharm 2000 Jul 1;57(13):1221-7; quiz 1228-30 -- Potential interactions between alternative therapies and warfarin. -- Heck AM, DeWitt BA, Lukes AL.

Lowers blood concentrations of alcohol and warfarin, and induces mania if used concomitantly with phenelzine.
- Drugs 2001;61(15):2163-75 -- Interactions between herbal medicines and prescribed drugs: a systematic review. -- Izzo AA, Ernst E.

Ginseng and amlodipine may cause an adverse interaction.
- Drugs Aging 2002;19(11):879-86 -- Potential Interactions between Herbal Medicines and Conventional Drug Therapies Used by Older Adults Attending a Memory Clinic. -- Dergal JM, Gold JL, Laxer DA, Lee MS, Binns MA, Lanctot KL, Freedman M, Rochon PA.

Ginseng may exacerbate seizures although the evidence for this is similarly anecdotal and uncertain.
- 2001 Dec;2(6):524-532 -- Herbal Medicines and Epilepsy: The Potential for Benefit and Adverse Effects. -- Spinella M.

Ginseng may affect blood glucose levels and should not be used in patients with diabetes mellitus.
- Arch Intern Med 1998 Nov 9;158(20):2200-11 -- Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. -- Miller LG.

Ginseng may cause headache, tremulousness, and manic episodes in patients treated with phenelzine sulfate. Ginseng should also not be used with estrogens or corticosteroids because of possible additive effects.
- Arch Intern Med 1998 Nov 9;158(20):2200-11 -- Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. -- Miller LG.

Ginseng may interfere with either digoxin pharmacodynamically or with digoxin monitoring.
- Arch Intern Med 1998 Nov 9;158(20):2200-11 -- Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. -- Miller LG.

The analgesic effect of opioids may be inhibited by ginseng.
- J Clin Pharm Ther 2002 Dec;27(6):391-401 -- Herbal medication: potential for adverse interactions with analgesic drugs. -- Abebe W.

Report describes the case of a 32-year-old woman who suffered a phototoxic reaction after taking a dietary supplement containing ginseng, goldenseal, bee pollen, and other ingredients. Although the individual ingredients in this dietary supplement have not been associated with cases of photosensitivity, it is possible that the combination of ingredients may have interacted to cause this toxic reaction.
- J Toxicol Clin Toxicol. 2003;41(6):865-7. -- Photosensitivity reaction in a woman using an herbal supplement containing ginseng, goldenseal, and bee pollen. -- Palanisamy A, Haller C, Olson KR.

last update: March 2009

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