The Polypharmacy Network

Polypharmacy Prevention
Click the name of a supplement above for more information.
What You Should Know About Ginseng?
By: Joanne Jansen PharmD and Anjanette Dymerski PharmD
Many people consider herbal supplements safe since they are natural. However, even natural things can be bad for you; for example, a bite from a black widow spider is natural and not good. Always discuss any new supplements with your doctor or pharmacist before taking them to make sure they do not interact with your medications or cause worsening of a disease you have.

It is important to remember that natural supplements and vitamins are not regulated by the Food and Drug Administration (FDA). This means that there may be ingredients in the products that are not listed. There is also no guarantee that the ingredients listed on the bottle are accurate.

Ginseng is often used as a stimulant, as in many energy drinks, a water pill, to help with diabetes, and to help fight upper respiratory infections. Part of the ginseng has been shown to lower blood glucose after a meal. This may be due to increased insulin sensitization or due to ginseng helping the body to make more insulin, or a combination or both of these actions. There has been evidence that shows that American ginseng works better in lowering blood glucose levels than Panax ginseng. Ginseng may provide benefit in preventing and reducing upper respiratory symptoms by helping to boost the immune system.

Although some people may feel that they do get some benefit from ginseng, there are many reasons you may not want to take it. Ginseng may interact with some drugs and change or increase their effects. For instance, ginseng interacts with all of these drugs and more:
• warfarin (Coumadin®)
     o Ginseng makes warfarin work less effectively and will decrease the International Normalized Ratio (INR).

Ginkgo can cause problems in people with certain diseases. If you have one of the following, discuss with your doctor or pharmacist whether you should take ginkgo:
• Diabetes
• Hormone sensitive cancers or conditions
• Insomnia
• Schizophrenia

Other things you should know about ginkgo:
• Tell your doctor you are taking this drug before you have surgery. You may need to stop it two weeks before surgery to so blood sugars can be controlled during the procedure.
• Tell your doctor or pharmacist you are taking this drug before you start any new medications.
• Ginseng is generally well tolerated, but it has been known to cause insomnia, vaginal bleeding, increased heart rate, decreased appetite, rash, headache, and palpitations.

More information available at the Natural Products Database of The Pharmacist’s Letter.