Interactions with Ginseng, American

There have been reports of a possible interaction between ginseng and phenelzine (Jones and Runikis 1987). This interaction has resulted in symptoms ranging from manic-like episodes to headache and tremulousness. While the mechanism for this suspected interaction remains unclear, it is thought that ginsenosides inhibit cyclic AMP phosphodiesterase and affect cortical steroid secretion. This activity may explain the psychoactive effects of ginsenosides either alone or in combination with monoamine oxidase inhibitors.

Warfarin

There is a case report of an interaction between ginseng and warfarin in a 47-year-old heart valve replacement patient (Cheng 2000; Janetsky and Morreale 1997). Within two weeks of adding ginseng to his medication regimen, his INR declined from 3.1 to 1.5. Upon discontinuing the ginseng, his INR value rose to 3.3 over a two week period. INR values should be monitored carefully in patients taking ginseng with warfarin. Studies confirming this interaction have not been performed and the mechanism remains unclear.

References

Cheng TO. Ginseng-warfarin interaction. ACC Curr J Rev. 2000;9(1):84.

Janetsky K, Morreale A. Probable interaction between warfarin and ginseng. Am J Health-Syst Pharm. 1997;54:692-693.

Jones BD, Runikis AM. Interaction of ginseng with phenelzine [letter]. J Clin Psychopharmacol. 1987;7(3):201-202.

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