Interactions with pharmaceuticals: None known for P.quinquefolius ³    

Practitioners should use caution when advising diabetics to take American ginseng as it may significantly reduce their blood sugars thereby reducing their need for hypoglycemic drugs.

Theoretically, American ginseng could interfere with antipsychotic drugs and monoamine oxidase inhibiters (MAOIs). ¹⁵

There have been some reports that ginseng can cause falsely elevated levels of digoxin in patients being monitored for this cardiac glycoside, depending on the immunoassay used.  Clinicians should be aware of this possibility before reducing digoxin dosage.

There is one preliminary report that Panax ginseng extracts can inhibit CYP3A4 activity in cultured human hepatocytes.  Clinicians should be aware of the potential for elevated plasma levels of CYP3A4 substrates in patients taking ginseng until this report is substantiated or refuted.

There are also sporadic reports of estrogenic effects of ginsenosides that would make ginseng use unwise in breast cancer patients with ER-positive disease.

 Interactions with other herbs: American ginseng can potentiate the effects of caffeine (coffee, tea, guarana, mate). ¹⁵