Siberian ginseng: Reactions. Interactions.

Adverse Reactions

Clinical trials of 6 months’ duration have shown no side-effects from treatment. High doses may cause slight drowsiness, irritability, anxiety, mastalgia, palpitations or tachycardia although these side effects may be more relevant to Panax ginseng.

Clinical note — Case reports of Siberian ginseng need careful consideration

Some adverse reactions attributed to Siberian ginseng have subsequently been found to be due to poor product quality, herbal substitution and/or interference with test results. For example, initial reports linking maternal ginseng use to neonatal androgenisation are now suspected to be due to substitution with another herb, Periploca sepium (silkvine), as American herb companies importing Siberian ginseng from China have been known to be supplied with two or three species of Periploca. Additionally, rat studies have failed to detect significant androgenic action for Siberian ginseng.

Another example is the purported interaction between digoxin and Siberian ginseng, which was based on a single case report of a 74-year-old man found to have elevated digoxin levels for many years. It was subsequently purported that the herbal product may have been adulterated with digitalis. Additionally, Siberian ginseng contains glycosides with structural similarities to digoxin that may modestly interfere with digoxin. Considering that clinical symptoms of digoxin toxicity were not observed, it appears likely that an interference with the test methods used is responsible.

Significant Interactions

As controlled studies are not available, interactions are currently speculative and based on evidence of pharmacological activity and case reports. Studies have reported that normal doses of Siberian ginseng are unlikely to affect drugs metabolised by CYP2D6 or CYP3A4.


An in vivo study demonstrated that an isolated constituent in Siberian ginseng has anticoagulant activity and a clinical trial found a reduction in blood coagulation induced by intensive training in athletes. Whether these effects also occur in non-athletes is unknown. Observe.


An increased tolerance for chemotherapy and improved immune function has been demonstrated in women with breast cancer undergoing chemotherapy treatment. Caution, as co-administration may theoretically reduce drug effects. However, beneficial interaction may be possible under medical supervision.


Claims that Siberian ginseng has hypoglycaemic effects are based on intravenous use in animal studies and not observed in humans for whom oral intake may actually increase postprandial glycaemia. Observe diabetic patients taking ginseng.


Ginseng may reduce the risk of post-vaccine reactions, a possible beneficial interaction.