Ginseng and Jantoven

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using warfarin together with ginseng. Combining these medications may reduce the blood levels and effects of warfarin. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Ginseng may reduce the blood concentrations and hypoprothrombinemic effect of warfarin. The exact mechanism of interaction is unknown, but may involve the steroidal effects of the ginsenoside components, which can theoretically induce warfarin metabolism. In one case report, use of Asian ginseng was associated with decreased INR in a patient who had been stabilized on warfarin for nine months. In a study of 20 healthy volunteers, subjects given American ginseng (1 g orally twice daily for 2 weeks) and warfarin (5 mg daily for 3 days) had a small, but statistically significant reduction (-0.19) in peak INR compared to subjects given placebo and warfarin. The warfarin peak plasma concentration (Cmax) and systemic exposure (AUC) were also lower in the ginseng group, suggesting potential induction of warfarin metabolism via hepatic microsomal enzymes. All patients maintained a relatively consistent intake of dietary vitamin K and refrained from alcohol, tobacco products, and other medications throughout the study. In another investigative study, 25 patients with cardiac valve replacement stabilized on warfarin therapy had a nonsignificant mean decrease in INR of -0.14 after six weeks of treatment with Korean red ginseng extract 1 gram/day compared to placebo. The authors of the study suggest that the vitamin K present in Korean red ginseng may have been a contributing factor.

MANAGEMENT: Patients should consult a healthcare provider before taking any herbal or alternative medicine. In general, consumption of ginseng supplements and large amounts of ginseng should preferably be avoided during use of warfarin. The same precaution may be applicable during therapy with other oral anticoagulants, although clinical data are lacking.

Ginseng

Generic Name: ginseng

Brand name:

Synonyms: n.a.

What is Ginseng?

Jantoven

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Jantoven?