Merck Manual

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Laura Shane-McWhorter

, PharmD, University of Utah College of Pharmacy

Reviewed/Revised Jan 2022 | Modified Sep 2022

What is ginseng?

Ginseng is usually derived from 2 different species of plant: American ginseng and Asian ginseng. American ginseng is milder than Asian ginseng. Ginseng is available in many forms, such as fresh and dried roots, extracts, solutions, capsules, tablets, cosmetics, sodas, and teas. The active components are panaxosides in American ginseng and ginsenosides in Asian ginseng.

Siberian ginseng is not really ginseng and contains different active components.

Ginseng products vary considerably in quality because many contain little or no detectable active ingredient. In very few cases, some ginseng products from Asia have been purposefully mixed with mandrake root or with phenylbutazone or aminopyrine—drugs that have been removed from the market in the United States because of unacceptable side effects.

What claims are made about ginseng?

People take ginseng mostly to enhance physical and mental performance and to increase energy and resistance to the harmful effects of stress and aging. Many take it to enhance sexual performance, including treating erectile dysfunction Erectile Dysfunction (ED) Erectile dysfunction (ED) is the inability to attain or sustain an erection satisfactory for sexual intercourse. (See also Overview of Sexual Dysfunction in Men.) Every man occasionally has... read more . Ginseng may reduce blood sugar levels and increase levels of high-density lipoprotein (HDL)—the good—cholesterol. Ginseng may also improve immune function.

Does ginseng work?

There is no convincing evidence that ginseng enhances mental performance in either healthy people or those diagnosed with dementia.

One study found that ginseng did not prevent colds but did shorten their duration.

In one large but short study, ginseng improved quality of life, according to a subjective report. However, evaluating quality of life (and some other possible effects of ginseng, such as energy) is difficult because it is so subjective. In one study of people with diabetes, ginseng reduced blood sugar levels and improved mood and energy. Some preliminary evidence suggests that American ginseng may help relieve respiratory tract infections.

What are the possible side effects of ginseng?

Ginseng has a reasonably good safety record. However, some authorities recommend limiting the use of ginseng to 3 months because of the possible development of side effects. The most common side effects are nervousness and excitability, which usually decrease after the first few days. The ability to concentrate may decrease and blood sugar may decrease to abnormally low levels (hypoglycemia). Other side effects may include headaches, allergic reactions, and sleep and digestive problems, breast tenderness, and menstrual irregularities. Because ginseng has an estrogen-like effect, women who are pregnant or breastfeeding should not take it, nor should children.

Occasionally, there have been reports of more serious side effects, such as asthma attacks, increased blood pressure, palpitations or risk of abnormal heart rhythms, and, in postmenopausal women, uterine bleeding. To many people, ginseng tastes unpleasant.

What drug interactions occur with ginseng?

Ginseng can interact with drugs that prevent blood clots, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, digoxin, estrogen therapy, monoamine oxidase inhibitors (MAOIs, used to treat depression), and drugs that decrease blood sugar levels (antihyperglycemic drugs, used to treat diabetes).

Ginseng may also increase serum concentrations of certain drugs. For instance, ginseng can increase levels of imatinib (used to treat leukemia) and raltegravir (used to treat HIV), causing liver toxicity.

If ginseng is combined with certain drugs that affect heart rhythm, such as amiodarone or thioridazine, arrhythmias may occur.


Ginseng is not recommended because it does not provide any proven health benefit and has some risk of significant side effects and drug interactions. Pregnant or breastfeeding women should not take ginseng.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
Digitek , Lanoxicaps, Lanoxin, Lanoxin Pediatric
Isentress, Isentress HD
Cordarone, Nexterone, Pacerone
Mellaril, Mellaril Concentrate , Mellaril-S
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