Ginseng, Siberian

Are there any interactions with medications?

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

Alcohol can cause sedative effects such as sleepiness and drowsiness. Siberian ginseng might also cause sleepiness and drowsiness. Taking large amounts of Siberian ginseng along with alcohol might cause you to become too sedated.

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

Digoxin (Lanoxin) helps the heart beat more strongly. One person had too much digoxin in their system while taking a natural product that might have had Siberian ginseng in it. But it is unclear if Siberian ginseng or other herbs in the supplement were the cause.

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

Siberian ginseng might have an effect like a "water pill" or diuretic. Taking Siberian ginseng might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.

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Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Siberian ginseng might decrease how quickly the liver breaks down these medications. Taking Siberian ginseng along with medications that are changed by the liver might increase the effects and side effects of some medications. Before taking Siberian ginseng, talk to your healthcare provider if you take any medications that are changed by the liver.

Some of these medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline (Slo-bid, Theo-Dur, others), zileuton (Zyflo), zolmitriptan (Zomig), and others.

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Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Siberian ginseng might decrease how quickly the liver breaks down these medications. Taking Siberian ginseng along with medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking Siberian 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), diazepam (Valium), zileuton (Zyflo), celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), warfarin (Coumadin), estradiol (Estrace), tacrine (Cognex), verapamil (Calan), and others.

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Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Siberian ginseng might affect blood sugar by lowering blood sugar levels. Diabetes medications are also used to lower blood sugar. Taking Siberian ginseng along with diabetes medications might cause your blood sugar to go too low or cause your diabetes medication to be less effective. 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.

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Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Siberian ginseng might slow blood clotting. Taking Siberian 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.

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Sedative medications (CNS depressants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Siberian ginseng might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking Siberian ginseng along with sedative medications might cause too much sleepiness.

Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

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Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Siberian ginseng might decrease how quickly the liver breaks down these medications. Taking Siberian ginseng along with medications that are changed by the liver can increase the effects and side effects of your medication. Before taking Siberian ginseng, talk to your healthcare provider if you take any medications that are changed by the liver. However, this interaction is not verified with certainty in humans yet.

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.

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Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Siberian ginseng might decrease how quickly the liver breaks down these medications. Taking Siberian ginseng along with medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking Siberian ginseng, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

Dosing considerations for Ginseng, Siberian.

The following doses have been studied in scientific research:

BY MOUTH:

• For herpes simplex type 2 infections: Siberian ginseng extract standardized to contain eleutheroside E 0.3% in doses of 400 mg per day.
• For the common cold: 400 mg of a combination of Siberian ginseng plus a specific andrographis extract, standardized to contain 4-5.6 mg andrographolide (Kan Jang, Swedish Herbal Institute) three times daily.