with Ginseng, Asian|
A study conducted with 45 patients with class IV cardiac function examined
the effects of ginseng combined with digoxin for the treatment of congestive
heart failure (CHF) (Ding et al. 1995). Patients were randomized into three
groups of 15 to be treated with either digoxin alone, ginseng alone, or a
combination of digoxin and ginseng. The hemodynamic and biochemical results
obtained in the group receiving the combination of digoxin and ginseng were the
most significant compared with patients receiving either digoxin alone or
ginseng alone. The authors suggest that this herb acted synergistically with
digoxin and was a safe and effective treatment for CHF
Orally administered Panax ginseng may counter the effects of morphine
in mice with morphine-induced immune suppression by lowering plasma
corticosterone levels (Kim et al. 1999). Concomitant administration of ginseng
total saponin (100 mg/kg po for 9 days) blocked the elevations in serum
corticosterone levels associated with morphine (20 mg/kg subcutaneously for 4
days). In addition, it has been reported that ginseng blocks the analgesic
effects of opioids and may offer a clinically useful option for the treatment of
opioid dependence and abuse (Takahashi and Tokuyama
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
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.
Cheng TO. Ginseng-warfarin interaction. ACC Curr J Rev. 2000;9(1):84.
Ding DZ, Shen TK, Cui YZ, et al. The effects of red ginseng on the congestive
heart failure and its mechanism [in Chinese]. Chung Kuo Chung His I Chieh Ho
Tsa Chih. 1995;15(6):325-327.
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
Kim YR, Lee SY, Shin BA, Kim KM. Panax ginseng blocks morphine-induced
thymic apoptosis by lowering plasma corticosterone level. Gen Pharmacol.
Takahashi M, Tokuyama S. Pharmacological and physiological effects of ginseng
on actions induced by opioids and psychostimulants. Meth Find Exp Clin
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