Drug Safety

, Volume 25, Issue 5, pp 323–344 | Cite as

Panax ginseng

A Systematic Review of Adverse Effects and Drug Interactions
  • Joanna Thompson CoonEmail author
  • Edzard Ernst
Review Article


Panax ginseng C.A. Meyer is a perennial herb native to Korea and China and has been used as an herbal remedy in eastern Asia for thousands of years. Modern therapeutic claims refer to vitality, immune function, cancer, cardiovascular diseases, improvement of cognitive and physical performance and sexual function. A recent systematic review of randomised controlled trials found that the efficacy of ginseng root extract could not be established beyond doubt for any of these indications. In order to obtain a balanced assessment of the therapeutic value of P. ginseng it is also necessary to consider the safety profile. In view of the extremely widespread use of P. ginseng it seems important to ask whether this herbal medicine involves health risks for the consumer. This review was conducted as a systematic attempt to document and evaluate all the available safety data on P. ginseng root extracts.

Systematic searches were performed in five electronic databases and the reference lists of all papers located were checked for further relevant publications. All articles containing original data on adverse events and drug interactions with P. ginseng were included. Information was also requested from 12 manufacturers of ginseng preparations, the spontaneous reporting schemes of the WHO and national drug safety bodies. No language restrictions were imposed.

Data from clinical trials suggest that the incidence of adverse events with ginseng monopreparations is similar to that with placebo. The most commonly experienced adverse events are headache, sleep and gastrointestinal disorders. The possibility of more serious adverse events is indicated in isolated case reports and data from spontaneous reporting schemes; however, causality is often difficult to determine from the evidence provided. Combination products containing ginseng as one of several constituents have been associated with serious adverse events and even fatalities. Interpretation of these cases is difficult as ingredients other than P. ginseng may have caused the problems. Possible drug interactions have been reported between P. ginseng and warfarin, phenelzine and alcohol. Collectively, these data suggest that P. ginseng monopreparations are rarely associated with adverse events or drug interactions. The ones that are documented are usually mild and transient. Combined preparations are more often associated with such events but causal attribution is usually not possible.


Ginsenosides Panax Ginseng Premature Ejaculation Phenelzine Royal Jelly 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Joanna Thompson Coon was supported by a research fellowship provided by Pharmaton SA, Lugano, Switzerland.

The authors wish to thank Jongbej Park KMD, Barbara Wider and Katja Schmidt, Department of Complementary Medicine, University of Exeter for the translation of studies from Chinese, Korean, Japanese, Danish, Swedish, French, Spanish, Italian, German and Russian and Esther Prati, Pharmaton SA, Lugano, Switzerland for assistance with locating relevant articles.


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Copyright information

© Adis International Limited 2002

Authors and Affiliations

  1. 1.Department of Complementary MedicineSchool of Postgraduate Medicine and Health Sciences, University of ExeterExeterUnited Kingdom

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