Ginseng and Linezolid Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Linezolid Injection
Ginseng
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Insomnia, tremor, headache, agitation, and worsening of depression
Interaction Deep Dive
Two case reports suggest that ginseng when taken with phenelzine may result in insomnia, tremor, headache, agitation, and worsening of depression suggestive of manic-type symptoms34. The exact type of ginseng (i.e. Panax, Siberian, American, etc) was not reported. Similar effects may be seen when taken with other monoamine oxidase inhibitors. The exact mechanism of action is unknown but ginseng may cause mania independently 5. Ginseng increased GABA metabolism in the brain and dopamine levels in the adrenals. Its impact also may be correlated with its effect on corticosteroid secretion 6. Saponins and prosapogenins containing 20 (2)-protopanaxadiol from the roots of Panax ginseng inhibited cyclic AMP phosphodiesterase which parallels corticosteroid production. This may partly account for the manic episodes 3.
Why it happens (mechanism)
Ginseng may increase GABA metabolism; inhibition of cAMP phosphodiesterase increasing corticosteroid production
Literature reports
3 reports — tap to read
a) A 64-year-old woman experienced headache and tremulousness when she added ginseng (Natrol High(R)) to her phenelzine regimen (the dosage of neither entity was specified). She had used phenelzine without effect but when she initiated a rechallenge with this combination, headache and tremulousness resumed. A time frame for either occurrence was not provided 1.
b) An ethanolic extract of ginseng was administered orally to female mice for 52 days in doses of 30 or 150 milligrams/kilogram/day (mg/kg/day) to determine the effect on neurotransmitters in the brain and adrenals. The higher dose significantly increased the activities of glutamate decarboxylase and GABA-transaminase in the brain and increased dopamine (p less than 0.001), but not norepinephrine or epinephrine, levels in the adrenals compared to controls. Dopamine and norepinephrine levels in the hypothalamus were not significantly changed at either dose 2.
c) A 42-year old woman had experienced refractory depression with no history of any manic or hypomanic episodes. She was started on phenelzine, escalating doses gradually to 45 milligrams per day (mg/day). The patient was taking ginseng during this time in an unspecified amount. The patient experienced relief from symptoms of depression, becoming very active and optimistic unlike her formerly introverted self. She invited strangers to her house for dinner, slept less, became irritable, and experienced tension headaches as well as vague visual hallucinations. She discontinued phenelzine with full return of depression. She resumed phenelzine to 45 mg/day without the desired therapeutic effect but did experience headaches. The authors report the patient was no longer taking ginseng "at this point" but did not specify the time of discontinuation 3.
Common questions
Can I take Ginseng and Linezolid Injection together?
Insomnia, tremor, headache, agitation, and worsening of depression Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ginseng and Linezolid Injection interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Ginseng or Linezolid Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (6)
- Shader R & Greenblatt D: Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985; 5(2):65. PubMed
- Kim YH, Wie MB, Choi SY, et al: Effects of long-term administration of Panax ginseng ethanol extracts on GABA metabolism and catecholamine levels in mouse brain. Planta Med 1992; 58 (Suppl 1):A 645-646.
- Jones BD & Runikis AM: Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987; 7:201-202. DOI
- Shader RI & Greenblatt DJ: Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985; 5(2):65. PubMed
- Bahrke MS: Comments on "Manic episode and ginseng: report of a possible case". J Clin Psychopharmacol 1997; 17(2):140-1. DOI
- Nikaido T: Inhibitors of cyclic AMP phosphodiesterase in Panax ginseng CA Meyer and Panax japonicus CA Meyer. Chem. Pharm Bull 1984; 32:1477-1483.
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