Eleuthero

Siberian ginseng/Drug Interactions:

  • ACE inhibitorsACE inhibitors: In vitro, Siberian ginseng fruit extracts inhibited angiotensin-converting (ACE) enzyme (81).
  • AlcoholAlcohol: According to secondary sources, the combined use of alcohol and Siberian ginseng may increase drowsiness. According to a review, Siberian ginseng may alter the serum concentrations of ethanol (80).
  • AlprazolamAlprazolam: According to a review and human research, Siberian ginseng does not appear to alter the pharmacokinetics of alprazolam, particularly through cytochrome P450 2D6 activity (77; 112). However, theoretically, Siberian ginseng may increase the risk of drowsiness due to its sedative effects (22).
  • Antiallergic agentsAntiallergic agents: In animal research, Siberian ginseng inhibited allergic reactions and histamine release (82; 83), as well as mast cell-mediated anaphylaxis (84).
  • AnticoagulantsAnticoagulants: In human research, exercise-induced increase of blood coagulation was reversed using Siberian ginseng (113). In animal research, Siberian ginseng has shown anticoagulant effects (46; 114). In animal research, concomitant use of Kan Jang?, a combination product containing Siberian ginseng, and warfarin did not produce significant effects on the pharmacokinetics or pharmacodynamics of warfarin (115).
  • AntibioticsAntibiotics: Dietary Siberian ginseng extract exhibited antibacterial effects in fish (72).
  • AntidepressantsAntidepressants: According to a review, Siberian ginseng may alter the serum concentrations of antidepressants (80).
  • Antidiabetic agentsAntidiabetic agents: In human and animal research, Siberian ginseng or its constituents reduced plasma levels of glucose (48; 49; 50; 51; 52; 53; 54; 35; 55). However, increased postprandial plasma glucose has also been observed in other human research (14). The effects with antidiabetic agents are not well understood.
  • AntihypertensivesAntihypertensives: In vitro, Siberian ginseng has shown vasorelaxant effects (28). In human research, injection with Siberian ginseng resulted in decreased levels of plasma and urinary endothelin (116). In other human research, increased blood pressure and total peripheral resistance were seen with use of Siberian ginseng (43).
  • Anti-inflammatory agentsAnti-inflammatory agents: In vitro, Siberian ginseng and its constituents suppressed proinflammatory mediators (117; 32; 118; 105).
  • AntilipemicsAntilipemics: In human research, Siberian ginseng has shown hypolipidemic effects, resulting in reduced triglycerides and LDL cholesterol (48; 119). Serum beta-lipoprotein and HDL cholesterol levels have also improved with Siberian ginseng use in combination with Elsholtzia splendens, in human research (120). In vitro, triterpenoid saponins from Siberian ginseng fruit inhibited pancreatic lipase, a key enzyme in lipid digestion (121).
  • AntineoplasticsAntineoplastics: In animal and in vitro research, Siberian ginseng or its constituents have shown antitumor and antiproliferative effects (122; 123; 60; 124; 125; 6; 126; 81; 127). In human research, Siberian ginseng as part of a multi-ingredient herbal product increased some T cells, as well as IgG and IgM, in patients on chemotherapy (128). The breast cancer resistance protein (BCRP) is a member of the ATP-binding cassette family of drug transporters and confers resistance to various anticancer drugs. In vitro, Siberian ginseng weakly inhibited BCRP-mediated transport of methotrexate (129).
  • AntiviralsAntivirals: In vitro, a liquid extract of Siberian ginseng inhibited the productive replication of RNA viruses, human rhinovirus (HRV), respiratory syncytial virus (RSV), and influenza A virus, with no effect on various DNA viruses, adenovirus, or herpes simplex type 1 virus (7). The effects of Siberian ginseng with antiviral agents are not well understood.
  • Cardiac glycosidesCardiac glycosides: In human research, Siberian ginseng use increased plasma digoxin levels (44). In animal research, Siberian ginseng use was found to falsely elevate plasma digoxin levels (45; 130; 131).
  • Cytochrome P450-metabolized agentsCytochrome P450-metabolized agents: In human research, Siberian ginseng lacked an effect on agents metabolized primarily by CYP 2D6 or CYP 3A4 (77).
  • DextromethorphanDextromethorphan: According to review data, Siberian ginseng may have no effect on the pharmacokinetics of dextromethorphan (112).
  • EstrogensEstrogens: In in vitro research, Siberian ginseng had a slight, but significant, inhibitory effect on estrone-3-sulfate uptake (76).
  • Gastrointestinal agents, miscellaneousGastrointestinal agents, miscellaneous: According to preliminary research, Siberian ginseng may have effects on digestive organ function (92).
  • Growth hormonesGrowth hormones: In animal research, Siberian ginseng normalized growth and weight gain in hypokinetic animals (132).
  • HexobarbitalHexobarbital: In vitro, Siberian ginseng injection inhibited hexobarbital metabolism (22).
  • Hormonal agentsHormonal agents: Anecdotal evidence suggests that hormonal changes occur with use of Siberian ginseng; however, preliminary research suggests a lack of androgenicity (133). In vitro, Siberian ginseng bound to classical steroid receptors (91). In vitro, Siberian ginseng had a slight, but significant, inhibitory effect on estrone-3-sulfate uptake (76). In mice, a Siberian ginseng extract improved hair growth by restoring the number and activity of hair follicles by increasing testosterone levels (134).
  • ImmunosuppressantsImmunosuppressants: Siberian ginseng extract, particularly the eleutherosides (active constituents), has shown immunostimulant effects in human, animal, and in vitro research (56; 57; 58; 59; 60; 61; 62; 63; 64; 65; 66; 67; 68; 69; 135; 136; 70; 71; 72; 73; 74; 75).
  • MorphineMorphine: In human research, morphine-induced enzyme activation was offset by Siberian ginseng (85).
  • Neurologic agentsNeurologic agents: Traditional use of Siberian ginseng has demonstrated improved mental performance (106). According to a review, Siberian ginseng protects neurons and inhibits brain cell apoptosis (20). In animal research, a water extract of Siberian ginseng inhibited inflammation and microglial activation in brain ischemia (9; 137). In vitro, extracts of Siberian ginseng were shown to have neuroprotective effects (138; 139).
  • P-glycoprotein-transported agentsP-glycoprotein-transported agents: In cultured Caco-2 cells, Siberian ginseng extract suppressed intestinal drug transporter p-glycoprotein and peptide transporter activities in a noncompetitive manner (79).
  • Photosensitizing agentsPhotosensitizing agents: In vitro, Siberian ginseng acted as a photosensitizer (86).
  • RadiotherapyRadiotherapy: In vitro, Siberian ginseng extract was slightly radioprotective to gamma irradiation (21). In mice, a combination therapy composed of Cistanche, Siberian ginseng, and Ziziphus jujuba protected against gamma irradiation (89).
  • SedativesSedatives: In animal research, Siberian ginseng injection decreased sleep latency and increased sleep duration (22). In mice, eleutheroside E from Siberian ginseng prevented sleep deprivation-induced behavioral impairment (140). In animals, dietary supplementation with Siberian ginseng extract inhibited stress (141; 142; 143; 144; 145).
  • SteroidsSteroids: In vitro, Siberian ginseng was shown to bind to classical steroid receptors (91).
  • StimulantsStimulants: In mice, eleutherosides from Siberian ginseng alleviated both physical and mental fatigue (30). In animals, Siberian ginseng increased the time to exhaustion during exercise (87; 88; 89).
  • SULT1A3-metabolized agentsSULT1A3-metabolized agents: In vitro, Siberian ginseng extract enhanced sulfotransferase 1A3 (SULT1A3) activity (a phase II detoxifying enzyme of xenobiotics found in the intestinal epithelium) (78).
  • VasodilatorsVasodilators: In vitro, Siberian ginseng has shown vasorelaxant effects (28).

    • Siberian ginseng/Herb/Supplement Interactions:

  • Antiallergic herbs and supplementsAntiallergic herbs and supplements: In animal research, Siberian ginseng inhibited allergic reactions and histamine release (82; 83), as well as mast cell-mediated anaphylaxis (84).
  • AntibacterialsAntibacterials: Dietary Siberian ginseng extract exhibited antibacterial effects in fish (72).
  • Anticoagulant and antiplateletsAnticoagulant and antiplatelets: In human research, exercise-induced increase of blood coagulation was reversed using Siberian ginseng (113). In animal research, Siberian ginseng has shown anticoagulant effects (46). In animal research, concomitant use of Kan Jang?, containing Siberian ginseng, and warfarin did not produce significant effects on the pharmacokinetics or pharmacodynamics of warfarin (115).
  • AntidepressantsAntidepressants: According to a review, Siberian ginseng may alter the serum concentrations of antidepressants (80).
  • Anti-inflammatory herbs and supplementsAnti-inflammatory herbs and supplements: In vitro, Siberian ginseng and its constituents suppressed proinflammatory mediators (117; 32; 118; 105).
  • AntilipemicsAntilipemics: In human research, Siberian ginseng has shown hypolipidemic effects, resulting in reduced triglycerides and LDL cholesterol (48). Serum beta-lipoprotein and HDL cholesterol levels have also improved with Siberian ginseng use in combination with Elsholtzia splendens, in human research (120). In vitro, triterpenoid saponins from Siberian ginseng fruit inhibited pancreatic lipase, a key enzyme in lipid digestion (121).
  • AntineoplasticsAntineoplastics: In animal and in vitro research, Siberian ginseng or its constituents have shown antitumor and antiproliferative effects (122; 123; 60; 124; 125; 6; 126). In human research, Siberian ginseng as part of a multi-ingredient plant product increased some T cells, as well as IgG and IgM, in patients on chemotherapy (128).
  • AntioxidantsAntioxidants: In vitro, a Siberian ginseng extract exhibited antiradical and antioxidant effects (5; 6; 127; 81; 146; 147; 75; 118). In animal studies, dietary Siberian ginseng enhanced antioxidative function (148; 149; 150).
  • AntiviralsAntivirals: In vitro, a liquid extract of Siberian ginseng inhibited the productive replication of the RNA viruses, human rhinovirus (HRV), respiratory syncytial virus (RSV), and influenza A virus, with no effect on various DNA viruses, adenovirus, or herpes simplex type 1 virus (7). The effects with antiviral agents are not well understood.
  • Cardiac glycosidesCardiac glycosides: In human research, Siberian ginseng use increased plasma digoxin levels (44). In animal research, Siberian ginseng use was found to falsely elevate plasma digoxin levels (45).
  • Cytochrome P450-metabolized herbs and supplementsCytochrome P450-metabolized herbs and supplements: In human research, Siberian ginseng had no effect on agents metabolized primarily by CYP 2D6 or CYP 3A4 (77).
  • Gastrointestinal agentsGastrointestinal agents: According to preliminary research, Siberian ginseng may have effects on digestive organ function (92).
  • Growth agentsGrowth agents: In animal research, Siberian ginseng normalized growth and weight gain in hypokinetic animals (132).
  • Hormonal herbs and supplementsHormonal herbs and supplements: Anecdotal evidence suggests that hormonal changes occur with use of Siberian ginseng; however, preliminary research suggests a lack of androgenicity (133). In vitro, Siberian ginseng bound to classical steroid receptors (91). In vitro, Siberian ginseng had a slight, but significant, inhibitory effect on estrone-3-sulfate uptake (76). In mice, a Siberian ginseng extract improved hair growth by restoring the number and activity of hair follicles by increasing testosterone levels (134).
  • HypoglycemicsHypoglycemics: In human and animal research, Siberian ginseng or its constituents reduced plasma levels of glucose (48; 49; 50; 51; 52; 53). However, increased postprandial plasma glucose has also been observed in other human research (14). The effects with blood glucose-lowering agents are not well understood.
  • HypotensivesHypotensives: In vitro, Siberian ginseng has shown vasorelaxant effects (28). In human research, injection with Siberian ginseng resulted in decreased levels of plasma and urinary endothelin (116). In other human research, increased blood pressure and total peripheral resistance were seen with use of Siberian ginseng (43).
  • ImmunostimulantsImmunostimulants: Siberian ginseng extract, particularly the eleutherosides (active constituents), has shown immunostimulant effects in human, animal, and in vitro research (56; 57; 58; 59; 60; 61; 62; 63; 64; 65; 66; 67; 68; 69).
  • Neurologic agentsNeurologic agents: Traditional use of Siberian ginseng includes improved mental performance (106). In animal research, a water extract of Siberian ginseng inhibited inflammation and microglial activation in brain ischemia (9). In vitro, extracts of Siberian ginseng were shown to have neuroprotective effects (138; 139).
  • P-glycoprotein-transported agentsP-glycoprotein-transported agents: In cultured Caco-2 cells, Siberian ginseng extract suppressed intestinal drug transporter p-glycoprotein and peptide transporter activities in a noncompetitive manner (79).
  • PhotosensitizersPhotosensitizers: In vitro, Siberian ginseng acted as a photosensitizer (86).
  • PhytoestrogensPhytoestrogens: In in vitro research, Siberian ginseng had a slight, but significant, inhibitory effect on estrone-3-sulfate uptake (76).
  • Radioprotective agentsRadioprotective agents: In vitro, Siberian ginseng extract was slightly radioprotective to gamma irradiation (21).
  • SedativesSedatives: In animal research, Siberian ginseng injection decreased sleep latency and increased sleep duration (22).
  • SteroidsSteroids: In animal research, Siberian ginseng extract protected against steroid-induced osteoporosis (151). In vitro, Siberian ginseng was shown to bind to classical steroid receptors (91).
  • StimulantsStimulants: In mice, eleutherosides from Siberian ginseng alleviated both in physical and mental fatigue (30). In animals, Siberian ginseng increased the time to exhaustion during exercise (87; 88; 89).
  • SULT1A3-metabolized agentsSULT1A3-metabolized agents: In vitro, Siberian ginseng extract enhanced sulfotransferase 1A3 (SULT1A3) activity (SULT1A3 is a phase II detoxifying enzyme of xenobiotics found in the intestinal epithelium) (78).
  • VasodilatorsVasodilators: In vitro, Siberian ginseng has shown vasorelaxant effects (28).

    • Siberian ginseng/Food Interactions:

  • Insufficient available evidence.

    • Siberian ginseng/Lab Interactions:

  • AlbuminAlbumin: In human research, injection with Siberian ginseng resulted in decreased levels of urinary albumin (116).
  • Blood glucoseBlood glucose: In human and animal research, Siberian ginseng or its constituents reduced plasma levels of glucose (48; 49; 50; 51; 52; 53). However, increased postprandial plasma glucose has also been observed in other human research (14).
  • Blood pressureBlood pressure: In vitro, Siberian ginseng has shown vasorelaxant effects (28). In human research, injection with Siberian ginseng resulted in decreased levels of plasma and urinary endothelin (116). In other human research, increased blood pressure and total peripheral resistance were seen with use of Siberian ginseng (43).
  • Bone mineral densityBone mineral density: In humans, a combination therapy containing low-dose calcium and vitamin D3, Rehmannia glutinosa, and Siberian ginseng reduced decreasing bone mineral density (BMD) in postmenopausal women (152). In animal research, Siberian ginseng extract protected against steroid-induced osteoporosis (151).
  • Calcium levelsCalcium levels: In animal research, Siberian ginseng extract protected against steroid-induced osteoporosis, as evidenced by an increase in calcium and phosphorus levels (151).
  • Coagulation panelCoagulation panel: In human research, an exercise-induced increase of blood coagulation was reversed using Siberian ginseng (113). In animal research, Siberian ginseng has shown anticoagulant effects (46). In animal research, concomitant use of Kan Jang?, containing Siberian ginseng, and warfarin did not produce significant effects on the pharmacokinetics or pharmacodynamics of warfarin (115).
  • Digoxin serum levelsDigoxin serum levels: The active components of Siberian ginseng interfered with serum digoxin measurements by immunoassays, especially polyclonal antibody-based immunoassays (130; 131).
  • Electrocardiogram (ECG, EKG)Electrocardiogram (ECG, EKG): In human research, ventricular potential was improved in heart disease patients with use of eleutherosides (153).
  • EstrogensEstrogens: In in vitro research, Siberian ginseng had a slight, but significant, inhibitory effect on estrone-3-sulfate uptake (76).
  • HistamineHistamine: In animal research, Siberian ginseng inhibited mast cell histamine release (82).
  • Hormone panelHormone panel: Anecdotal evidence suggests that hormonal changes occur with use of Siberian ginseng; however, preliminary research suggests a lack of androgenicity (133). In animal research, Siberian ginseng extract protected against steroid-induced osteoporosis (151). In vitro, Siberian ginseng bound to classical steroid receptors (91). In animal research, Siberian ginseng increased plasma corticosterone (154). In vitro, Siberian ginseng had a slight, but significant, inhibitory effect on estrone-3-sulfate uptake (76).
  • Immune panelImmune panel: Siberian ginseng extract has shown immunological effects in human, animal, and in vitro research (56; 57; 58; 59; 60; 61; 62; 63; 64; 65; 66; 67; 68; 69). In human research, Siberian ginseng as part of a multi-ingredient herbal product increased IgG and IgM and some types of T cells, CD3, CD4, CD5, and CD8 (128). In animal research, Siberian ginseng resulted in spontaneous leukosis (155). In human and animal research, Siberian ginseng inhibited release of interleukins (67; 82). In vitro, Siberian ginseng had no effect on levels of interleukin-12, interleukin-1beta, interleukin-15, or TNF-alpha RNA levels (156). In animal research, injection of water-soluble polysaccharides from Siberian ginseng lowered serum levels of tumor necrosis factor-alpha (157).
  • Lipid profileLipid profile: In human research, Siberian ginseng has shown hypolipidemic effects, resulting in reduced triglycerides and LDL cholesterol (48). Serum beta-lipoprotein and HDL cholesterol levels have also improved with Siberian ginseng use in combination with Elsholtzia splendens in human research (120).
  • Liver function testsLiver function tests: In animal research, injection of water-soluble polysaccharides from Siberian ginseng lowered serum levels of aspartate transaminase and alanine transaminase (157). In mice, a combination treatment of Cistanche, Siberian ginseng, and Ziziphus jujuba prolonged the weight-loading swimming time of the mice; BUN and LDH levels decreased (89).
  • Phosphorus levelsPhosphorus levels: In animal research, Siberian ginseng extract protected against steroid-induced osteoporosis, as evidenced by an increase in calcium and phosphorus levels (151).
  • Viral loadViral load: In vitro, a liquid extract of Siberian ginseng inhibited the productive replication of the RNA viruses, human rhinovirus (HRV), respiratory syncytial virus (RSV), and influenza A virus, with no effect on various DNA viruses, adenovirus, or herpes simplex type 1 virus (7).