Panax Notoginseng - Warfarin Interaction
Herbal: Panax Notoginseng
Also Known As: Panax notoginseng, Field Seven, Noto-Gin, Notoginseng, Samch'il, Sanchitongtshu, San Qi, San Qui, Sanchi, Sanchi Ginseng, Sanqi, Sanqi Powder, Sanshichi, Three Seven, Tian Qi, Tian San Qi, Tienchi, Tienchi Ginseng
Drug: Warfarin
Brand names:
Warfarin
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Warfarin is classified as belonging to the following category: Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction was attributed to the ability of Panax notoginseng to increase the activity of CYP1A2.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction 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
- Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.
Interaction Details
Warfarin is classified as belonging to the following category: Warfarin (Coumadin)
Theoretically, taking Panax notoginseng concomitantly with warfarin may increase the risk of bleeding.
Animal research shows that taking Panax notoginseng concomitantly with warfarin increases plasma warfarin levels, prothrombin time, and international normalized ratio when compared with control. In vitro research also suggests that Panax notoginseng may downregulate expression of cytochrome P450 3A4 enzymes, which may affect warfarin metabolism.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction 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
- Qian J, Chen W, Wu J, et al. Effects and Mechanism of Action of Panax notoginseng Saponins on the Pharmacokinetics of Warfarin. Eur J Drug Metab Pharmacokinet 2022;47(3):331-342.
Panax Notoginseng Overview
Panax notoginseng, also known as sanqi or tienchi ginseng, is a herb that is native to China, Vietnam, and Thailand. It is a member of the Panax genus, which also includes other well-known herbs such as ginseng and red ginseng.
Panax notoginseng has been used in traditional Chinese medicine to treat a variety of conditions and is believed to have anti-inflammatory as well as blood-stopping properties, It is most often used to treat internal and external bleeding, including nosebleeds, menstrual cramps, and blood in the urine. It is also used to treat hypertension, angina, and heart disease.
Although most parts of Panax notoginseng plant can be used commercially, the root is most commonly used in dietary supplements.
Warfarin Overview
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Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic (replacement or mechanical) heart valves, and people who have suffered a heart attack. Warfarin is also used to treat or prevent venous thrombosis (swelling and blood clot in a vein) and pulmonary embolism (a blood clot in the lung). Warfarin is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood.
Panax Notoginseng - More Interactions
Panax Notoginseng interacts with 205 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.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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