Panax Ginseng + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine brand name: Multi Symptom Cold Relief.
Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine falls into 3 drug categories that Panax Ginseng can interact with; the most serious is rated moderate. Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full interaction reportPanax Ginseng and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Panax Ginseng interacts with whole categories of medication. Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine falls into 3 of those categories, so it can interact with Panax Ginseng in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 3Why this applies to Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine
Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Panax Ginseng interacts with.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
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.
Here's the short version: one ingredient in this cold combo, the cough suppressant dextromethorphan, is cleared by a liver enzyme called CYP2D6. There's some weak evidence that Panax ginseng might slow that enzyme down a little (we're talking roughly 6 percent in lab work, and a small effect in animal studies). If that happened, dextromethorphan could hang around a bit longer, which might mean more drowsiness, dizziness, or a foggy feeling.
Honestly, though, the research is conflicting and the effect looks tiny, so for most people this is unlikely to cause real problems. I wouldn't lose sleep over it. Still, if you take ginseng regularly and use this medicine often, it's worth a quick chat with your pharmacist or doctor before combining them.
- Gurley BJ, Gardner SF, Hubbard MA. Clinical assessment of potential cytochrome P450-mediated herb-drug interactions. AAPS Ann Mtg & Expo Indianapolis, IN: 2000; Oct 29 - Nov 2:presentation #3460.
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
- Gurley, B. J., Gardner, S. F., Hubbard, M. A., Williams, D. K., Gentry, W. B., Cui, Y., and Ang, C. Y. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and DOI
- 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. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
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 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.
This combo cold product has four ingredients, and the one most affected here is dextromethorphan, the cough suppressant, which is partly handled by the CYP3A4 enzyme. Ginseng's effect on this enzyme is unpredictable. It might speed up or slow down clearance, so in theory your dextromethorphan levels could shift a little in either direction. If they rose, you might feel more dizzy, drowsy, or foggy; if they dropped, the cough relief could be weaker.
Honestly, this is mostly theoretical and based on limited evidence, so for occasional cold-medicine use it's unlikely to cause real trouble. Still, since this medicine already causes drowsiness from the chlorpheniramine, it's worth a quick chat with your pharmacist before pairing it with ginseng supplements.
- 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. PubMed
STIMULANT DRUGS
3 of 3Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine also falls under STIMULANT DRUGS.
Panax ginseng has been shown to have stimulant effects.
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.
This combination cold product contains phenylpropanolamine, a decongestant that acts like a mild stimulant on your body. Panax ginseng is also thought to have its own gentle stimulant-type effects. So when you put the two together, the worry is that those effects could stack up a bit. You might notice things like a faster or pounding heartbeat, jitteriness, higher blood pressure, or trouble falling asleep (and the chlorpheniramine part can leave you drowsy at the same time, which is an odd mix).
To be honest with you, this is a theoretical concern based on how these substances work, not on strong studies, so it may not amount to much for most people. Still, if you have high blood pressure, heart issues, or already feel wired, it is worth a quick chat with your pharmacist before pairing them.
- Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold. Drugs Exp Clin Res 1996;22:65-72.
- Gonzalez-Seijo JC, Ramos YM, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995;15:447-8.
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Panax Ginseng Also Interacts With Other Medications
Panax Ginseng has 1,129 moderate known drug interactions in our database — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Panax Ginseng
We haven’t checked that one against Panax Ginseng yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Panax Ginseng. Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine
This page covers Panax Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine page lists 300 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Ephedra (major) and Grapefruit (major).
By severity: 14 major · 241 moderate · 45 minor.
Open the Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction page
Taking Panax Ginseng as Part of a Dietary Supplement Product? Check It for Interactions
We hold 517 real supplement products containing Panax Ginseng, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Panax Ginseng. Your product may carry other ingredients that interact with Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine too, on top of Panax Ginseng — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Panax Ginseng and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine 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.
#236 of 1,452 supplements looked up here in the last 7 days
#42 of 2,830 medications looked up here in the last 7 days
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.
About Panax Ginseng
What is Panax Ginseng?
- Boosting energy and fighting fatigue
- Improving mental focus and memory
- Coping with stress (adaptogen)
- Erectile dysfunction
- Supporting immune health
- Blood sugar support
Panax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well tolerated for short-term use in healthy adults, but it can cause side effects like trouble sleeping and may not be safe during pregnancy or breastfeeding. Always check with your pharmacist or doctor before starting it, especially if you have a medical condition or take other medicines.
Other Drugs & Panax Ginseng
Browse every other medication we’ve checked against Panax Ginseng — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,129 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Phentermine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Methylphenidate ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Phenylpropanolamine ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Nicotine ›
- Oxybutynin ›
- Oxycodone ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Phenylephrine ›
- Procainamide ›
- Pseudoephedrine ›
- Trimipramine ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Diethylpropion ›
- Everolimus ›
Showing 60 of 1,129 moderate interactions — see all 1,129 on the Panax Ginseng page.
No interaction 1,700 drugs checked — show the list
We also checked Panax Ginseng against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Acetaminophen ›
- Rosuvastatin ›
- Escitalopram ›
- Isotretinoin ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Levothyroxine, Liothyronine ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Doxycycline ›
- Pregabalin ›
- Bendamustine ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Ezetimibe ›
- Cephalexin ›
- Atenolol, Chlorthalidone ›
- Cyclopentolate ›
- Avatrombopag Maleate ›
- Levetiracetam ›
- Levodopa ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Sacubitril, Valsartan ›
- Enalapril Maleate ›
- Thyroid Hormone ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Carbidopa, Levodopa ›
- Mannitol ›
- Daunorubicin, Cytarabine ›
- Valsartan ›
- Bupivacaine, Meloxicam ›
- Alginic Acid, Aluminum Hydroxide ›
- Spironolactone ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Roxithromycin ›
- Charcoal (otc Drug) ›
- Atenolol ›
- Peginterferon Alfa-2a, Ribavirin ›
- Aminolevulinic Acid Hydrochloride ›
- Magnesium Hydroxide (otc Drug) ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Levothyroxine Sodium ›
- Sodium Bicarbonate (otc Drug) ›
- Cytomegalovirus Immune Globulin ›
- Alpha-1 Proteinase Inhibitor ›
- Articaine, Epinephrine ›
Showing the 60 most looked-up of 1,700 medications checked with no known interaction — see the full Panax Ginseng list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine as a medicine that can lower these. This is not an interaction with Panax Ginseng — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Panax Ginseng and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine Together: Common Questions
Can you take Panax Ginseng with Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine?
Why are there 3 interactions listed for Panax Ginseng and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine?
How serious is the Panax Ginseng and Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.