Drug & supplement interaction

American Ginseng + Azathioprine

Azathioprine brand names: Imuran, Azamune.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

American Ginseng has a moderate interaction with Azathioprine. Theoretically, American ginseng use might interfere with immunosuppressive therapy.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

American Ginseng and Azathioprine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Azathioprine

Azathioprine falls under IMMUNOSUPPRESSANTS — the group American Ginseng interacts with.

Theoretically, American ginseng use might interfere with immunosuppressive therapy.
American ginseng seems to stimulate immune function. Theoretically, American ginseng might decrease the effectiveness of immunosuppressant drugs.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thinking behind this one. Azathioprine works by calming down your immune system, which is exactly what you want if you've had a kidney transplant or you're treating tough rheumatoid arthritis. American ginseng, on the other hand, is believed to do the opposite and gently rev the immune system up. So in theory, the two could work against each other, and your azathioprine might not hold your immune system back as well as it should.

I want to be honest though: this is a theoretical concern based on how ginseng seems to behave, not on solid studies in people. Still, with a medication this important, I wouldn't take chances. Before adding American ginseng, please check with your transplant team or your prescriber so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McElhaney JE, Gravenstein S, Cole SK, et al. A Placebo-Controlled Trial of a Proprietary Extract of North American Ginseng (CVT-E002) to Prevent Acute Respiratory Illness in Institutionalized Older Adults. J Am Geriatr Soc 2004;52:13-9. PubMed
  2. Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173:1043-8.. PubMed
  3. McElhaney JE, Goel V, Toane B, et al. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006;12:153-7. PubMed
  4. Predy GN, Goel V, Lovlin RE, et al. Immune modulating effects of daily supplementation of COLD-fX (a proprietary extract of North American ginseng) in healthy adults. J Clin Biochem Nutr 2006;39:162-167. DOI

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

American Ginseng Also Interacts With Other Medications

American Ginseng has 2 major, 214 moderate known drug interactions in our database — the Azathioprine one above is one of them. If you take anything else, check it against the full list below.

Major 2 Moderate 214 No known interaction 2,614 (incl. Azathioprine)
Taking anything else?

Check Another of Your Medications Against American Ginseng

Covers the 2,830 medications we’ve checked against American Ginseng. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Azathioprine

This page covers American Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Azathioprine page lists 106 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 4 major · 92 moderate · 10 minor.

From our pharmacist’s overview on the Azathioprine page

“Azathioprine (Imuran) quiets an overactive immune system, which is why people take it after a transplant or for autoimmune disease, and it is also why I read this interaction list with real caution. Fully half of the 106 supplements on file, 53 of them, appear because they stimulate immunity and could blunt the very effect you depend on.”

Reviewed by 2 · Jul 18, 2026

Open the Azathioprine interaction page

One more smart check

Taking American Ginseng as Part of a Dietary Supplement Product? Check It for Interactions

We hold 992 real supplement products containing American Ginseng, each one broken down to its full ingredient list — and combination products often carry several ingredients besides American Ginseng. Your product may carry other ingredients that interact with Azathioprine too, on top of American Ginseng — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where American Ginseng and Azathioprine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement American Ginseng
Top 25%

#219 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Azathioprine
Top 25%

#633 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About American Ginseng

What is American Ginseng?

American Ginseng
  • Stress and energy support
  • Immune support and colds
  • Blood sugar management
  • Mental focus and clarity
  • General wellness (adaptogen)

American ginseng is an herbal root used as an 'adaptogen' to support energy, stress, immune function, and blood sugar. Some uses—such as reducing the chance or length of colds and modestly lowering after-meal blood sugar—have early supportive evidence, but most claims are not well proven. Talk to your pharmacist or doctor before use, especially if you have a health condition or take medications.

Read the full American Ginseng monograph & all interactions
Medication

About Azathioprine

What Is Azathioprine Used For?

Brand names: Imuran, Azamune

Azathioprine is used alongside other medications to help prevent the body from rejecting a kidney transplant (renal homotransplantation). It is also used to treat active rheumatoid arthritis — reducing signs and symptoms in adults who have not responded well enough to other treatments.

Other pain relievers such as aspirin, NSAIDs, or low-dose steroids may be continued alongside azathioprine for rheumatoid arthritis. Combining azathioprine with disease-modifying antirheumatic drugs (DMARDs) has not been well studied and is not recommended.

See full Azathioprine drug information
Keep checking

Other Drugs & American Ginseng

Browse every other medication we’ve checked against American Ginseng — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
214Moderate
0Minor
2,613No known interaction
2 Major 214 Moderate 2,613 No interaction
Major

2 interactions

Moderate

214 interactions

Showing 60 of 214 moderate interactions — see all 214 on the American Ginseng page.

No interaction 2,613 drugs checked — show the list

We also checked American Ginseng against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,613 medications checked with no known interaction — see the full American Ginseng list.

See the full American Ginseng interactions page
See every supplement checked against Azathioprine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

Keep exploring
American Ginseng monograph › Uses, safety, and every drug interaction in one place Azathioprine supplement interactions › Every supplement checked against Azathioprine, ranked by severity Azathioprine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking American Ginseng and Azathioprine Together: Common Questions

Can you take American Ginseng with Azathioprine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the American Ginseng and Azathioprine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Azathioprine and American Ginseng?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.