Panax Ginseng - Technivie (Ombitasvir, Paritaprevir Ritonavir) Interaction

Interaction Details

Ombitasvir, Paritaprevir Ritonavir is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

• Malati CY, Robertson SM, Hunt JD, Chairez C, Alfaro RM, Kovacs JA, Penzak SR. Influence of Panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. J Clin Pharmacol 2012;52(6):932-9.
• Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother 2010;44(5):926-8.
• Kim Y, Jo JJ, Cho P, et al. Characterization of red ginseng-drug interaction by CYP3A activity increased in high dose administration in mice. Biopharm Drug Dispos. 2020;41(7):295-306.

Interaction Details

Ombitasvir, Paritaprevir Ritonavir is classified as belonging to the following category: Lopinavir/Ritonavir (Kaletra)

Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.

Interaction Rating

Likelihood of Occurrence

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

References

• Malati CY, Robertson SM, Hunt JD, Chairez C, Alfaro RM, Kovacs JA, Penzak SR. Influence of Panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. J Clin Pharmacol 2012;52(6):932-9.
• Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother 2010;44(5):926-8.
• Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15.

Ombitasvir, Paritaprevir Ritonavir Overview

• The combination of ombitasvir, paritaprevir, and ritonavir is usually used in combination with ribavirin (Copegus, Rebetol), but sometimes it is used alone to treat a certain type of chronic (long-term) hepatitis C infection (swelling of the liver caused by a virus). Ombitasvir is a hepatitis C virus (HCV) NS5A inhibitor. It works by stopping the virus that causes hepatitis C from spreading inside the body. Paritaprevir is a protease inhibitor. It works by decreasing the amount of HCV in the body. Ritonavir is a protease inhibitor. It helps to increase the amount of paritaprevir in the body so that the medication will have a greater effect. It is not known if ombitasvir, paritaprevir, or ritonavir prevent the spread of hepatitis C to other people.

Panax Ginseng - More Interactions

Panax Ginseng interacts with 1074 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.