Panax Ginseng and medications.
Panax Ginseng is in the Distil supplement database, evidence Grade B. The page below lists every medication we have explicitly assessed it against.
Panax ginseng, also sold as Korean or red ginseng, is taken as a standardised extract of 200 to 400mg with 3 to 5% ginsenosides, or 1 to 2g of whole root. It is a stimulating adaptogen with Grade B evidence for fatigue reduction (Jin 2020), erectile dysfunction (Lee 2021, Ho 2026) and blood glucose regulation (Shishtar 2014), and Grade C for cognition: the supportive cognition evidence is a single-dose study in healthy young adults (Reay 2005), and the Cochrane review of ginseng for cognition concluded the evidence for a cognitive benefit in healthy people is not convincing. The honest read on the rest: the fatigue trials were mostly in people with a chronic illness, the erectile-function improvements are consistent across trials but modest, sitting below the threshold usually taken as clinically important on the standard questionnaires, and the blood glucose effect is a small drop in fasting glucose. Real, moderate, and mostly from small trials. Several interactions matter. It may modestly affect warfarin, so INR should be monitored. It should be avoided with MAOIs. It is best left out by anyone with atrial fibrillation or another heart rhythm problem, or taking a medicine for one: in a small trial, a single dose slightly lengthened the QT interval, the heart's electrical recovery time, and several heart rhythm medicines lengthen it too. Because it is stimulating, it is best avoided or used cautiously in anyone with a history of bipolar disorder or mania, and watched alongside stimulant medication. Practical notes: take it earlier in the day, since it can disturb sleep, and start at the lower end given the mild stimulant effect.
Below are the 19 documented pairs we have explicitly assessed for Panax Ginseng: 19 caution. The pairs cluster around 7 mechanisms: Additive QT prolongation (heart rhythm), Blood-test (assay) interference, CYP induction, Additive glucose lowering, MAOI pressor (blood-pressure surge), Narrow-therapeutic-index prescriber awareness, and Additive sympathomimetic activity. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 30 October 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive QT prolongation (heart rhythm)
Caution Does Panax Ginseng interact with Amiodarone?
Amiodarone lengthens the QT interval, the heart's electrical recovery time, and in a small trial in healthy adults a dose of Panax ginseng lengthened it slightly too, so the two may add up. With amiodarone, which is taken for a heart rhythm condition, it is safest not to take Panax ginseng unless your cardiologist agrees.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Sotalol hydrochloride?
Sotalol lengthens the QT interval, the heart's electrical recovery time, and in a small trial in healthy adults a dose of Panax ginseng lengthened it slightly too, so the two may add up. With sotalol, which is taken for a heart rhythm condition, it is safest not to take Panax ginseng unless your cardiologist agrees.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Blood-test (assay) interference
Caution Does Panax Ginseng interact with Digoxin?
Asian (Panax) ginseng can throw off the blood test that measures your digoxin level, making the reading look higher or lower than it really is rather than changing the actual amount of digoxin in your body. Because digoxin has a narrow safe range and doses are adjusted from that blood test, a misleading result matters. If you take Panax ginseng, tell whoever checks your digoxin level so the result can be read correctly, and do not adjust your digoxin dose yourself.
Evidence: Supported by human study data.
CYP induction
Caution Does Panax Ginseng interact with Acenocoumarol?
Ginseng may work against warfarin-type blood thinners like acenocoumarol and lower your INR, which would reduce protection against clots. The evidence is mixed between ginseng types: the trial that found an INR reduction used AMERICAN ginseng, and a separate trial of Asian Panax ginseng found no effect on warfarin at all. If you take acenocoumarol, discuss ginseng with your anticoagulant clinic and keep your INR monitored rather than starting it on your own.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Warfarin sodium?
Ginseng tends to work against warfarin rather than with it. Some people on warfarin see their INR drop when they add ginseng, which can leave them under-protected against clots. The evidence is mixed between ginseng types, so if you take warfarin, tell your anticoagulation clinic before starting ginseng and ask for an INR check a couple of weeks in.
Evidence: Supported by human study data.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive glucose lowering
Caution Does Panax Ginseng interact with Gliclazide?
Ginseng can lower blood sugar a little on its own. Gliclazide already lowers blood sugar and can cause hypos, so adding ginseng may push your glucose lower than expected. The combination is usually manageable, but monitor your blood sugar, especially in the first few weeks, and your doctor may need to adjust the gliclazide dose.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Insulin glargine?
Ginseng can lower blood sugar a little on its own. Insulin is a strong blood-sugar-lowering medicine, so adding ginseng may increase the chance of a hypo. If you use insulin, monitor your blood sugar more closely when you start or stop ginseng, and your doctor may need to adjust your insulin dose.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Metformin?
Ginseng can lower blood sugar a little, and metformin lowers it too, so the two may add up. Metformin on its own rarely causes hypos, so the combination is generally low risk, but it is still worth monitoring your blood sugar when you start ginseng or change the dose.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
MAOI pressor (blood-pressure surge)
Caution Does Panax Ginseng interact with Isocarboxazid?
Ginseng has been reported in a few old case reports to clash with the MAOI phenelzine, though we have not been able to read their detail. Isocarboxazid is the same type of irreversible MAOI, so the same caution applies. If you take isocarboxazid, do not start ginseng without talking to the doctor who manages your antidepressant.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Linezolid?
Ginseng has been reported to clash with the older MAOI phenelzine, and linezolid is an antibiotic that also acts as an MAOI. Ginseng's mild stimulant-like effects could add to that. If you are taking linezolid, check with the doctor who prescribed it before starting ginseng.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Moclobemide?
Ginseng has been reported in a few old case reports to clash with the older MAOI phenelzine, though we have not been able to read their detail. Moclobemide acts on the same enzyme but reversibly, so we apply a lighter version of the same caution. Moclobemide is much less prone to the blood-pressure reactions that make the older MAOIs risky: in a human comparison it took about sixteen times more dietary tyramine to push blood pressure up on moclobemide than on phenelzine. If you take moclobemide, it is still worth checking with the doctor who manages your antidepressant before starting ginseng.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Phenelzine?
There are a few old published case reports of an interaction between ginseng and the MAOI phenelzine. They are short letters and editorials with no abstract we can check, so we do not repeat the symptoms often quoted from them, and a later systematic review records only that the two may interact. The reason is not understood, but ginseng has mild stimulant-like effects on the nervous system that can clash with MAOIs. If you take phenelzine, do not start ginseng without talking to the doctor who manages your antidepressant.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Rasagiline?
Ginseng has been reported in a few old case reports to clash with the older MAOI phenelzine, and rasagiline is a more selective MAO inhibitor used for Parkinson's, so any concern is weaker than with the older MAOIs, but ginseng has not been studied with rasagiline. Ginseng has mild stimulant effects, and the UK product information for rasagiline still advises against stimulant-type decongestants and cold remedies alongside it. Check with the doctor who prescribes your rasagiline before starting ginseng, and keep to the rasagiline dose they set.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Selegiline?
Ginseng has been reported to clash with the older MAOI phenelzine. Selegiline is a more selective MAOI, so the concern is weaker, but ginseng's mild stimulant-like effects could still add up. If you take selegiline, check with the doctor who prescribed it before starting ginseng.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Tranylcypromine?
If you take tranylcypromine, discuss ginseng with your prescriber rather than starting it on your own: panax ginseng has been linked to reactions in a few old case reports involving the MAOI phenelzine, and those reports are short letters and editorials with no abstract we can check, so we do not repeat the symptoms usually quoted from them; tranylcypromine is the same drug class, so it is worth caution.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Narrow-therapeutic-index prescriber awareness
Caution Does Panax Ginseng interact with Flecainide acetate?
Flecainide slows electrical conduction through the heart, which shows as a longer QT interval on an ECG, and in a small trial in healthy adults a dose of Panax ginseng lengthened the QT interval slightly too, so the two may add up. With flecainide, which is taken for a heart rhythm condition and has a narrow safe range, it is safest not to take Panax ginseng unless your cardiologist agrees.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive sympathomimetic activity
Caution Does Panax Ginseng interact with Dexamfetamine sulfate?
Panax ginseng has a mild stimulant-like effect on the nervous system, so taking it alongside dexamfetamine could add to that stimulation. In practice that might mean more trouble sleeping, jitteriness or a faster heartbeat. This has not been tested directly, so it is a cautious flag rather than a strong warning. If you take dexamfetamine, it is worth telling the doctor who manages it before you start ginseng, and keeping an eye on your sleep, restlessness and heart rate.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Lisdexamfetamine dimesylate?
Panax ginseng has a mild stimulant-like effect on the nervous system, so taking it alongside lisdexamfetamine could add to that stimulation. In practice that might mean more trouble sleeping, jitteriness or a faster heartbeat. This has not been tested directly, so it is a cautious flag rather than a strong warning. If you take lisdexamfetamine, it is worth telling the doctor who manages it before you start ginseng, and keeping an eye on your sleep, restlessness and heart rate.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Methylphenidate hydrochloride?
Panax ginseng has a mild stimulant-like effect on the nervous system, so taking it alongside an ADHD stimulant like methylphenidate could add to that stimulation. In practice that might mean more trouble sleeping, jitteriness or a faster heartbeat. This has not been tested directly, so it is a cautious flag rather than a strong warning. If you take methylphenidate, it is worth telling the doctor who manages it before you start ginseng, and keeping an eye on your sleep, restlessness and heart rate.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
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How the checker decides
Every result has a source
Each pair we have assessed is cited to a published study (PMID) or the British National Formulary, so you can read the source yourself.
Four kinds of answer
Severe, caution, no known interaction, and not yet assessed. A pair we have not assessed is never shown as clear.
- Severe
- Caution
- No known interaction
- Not yet assessed
Nothing in our data is not a clearance
When nothing in our data records a problem with a pair, the result says no known interaction at typical doses, which is not a clearance: your pharmacist or GP can check the pair against your full medical history.
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