Drug & supplement interaction

Panax Ginseng + Alogliptin

Alogliptin brand name: Nesina.

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

Alogliptin falls into 2 drug categories that Panax Ginseng can interact with; the most serious is rated moderate. Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Panax Ginseng and Alogliptin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Panax Ginseng interacts with whole categories of medication. Alogliptin falls into 2 of those categories, so it can interact with Panax Ginseng in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Alogliptin

Alogliptin falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Panax Ginseng interacts with.

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.
Severity Moderate Likelihood Possible Evidence B

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 good news first: this concern is mostly theoretical for alogliptin (Nesina). The interaction is flagged because ginseng can nudge an enzyme called CYP3A4, which handles some medications. But alogliptin barely relies on that pathway. Most of it leaves your body unchanged through the kidneys, so ginseng isn't likely to make much of a difference either way.

Alogliptin is not a prodrug, and it doesn't lean heavily on liver enzymes to work, which is reassuring here. Still, since ginseng itself can sometimes shift blood sugar, it's smart to keep an eye on your readings if you start it. Watch for lows like shakiness, sweating, or dizziness. Before adding ginseng, just run it by your pharmacist or doctor so they can confirm it fits your situation.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.
  2. 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.
  3. 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
Moderate

ANTIDIABETES DRUGS

2 of 2

Alogliptin also falls under ANTIDIABETES DRUGS.

Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

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

Here's the gist: Panax ginseng may have a mild blood sugar lowering effect of its own. Since alogliptin (Nesina) is already working to bring your numbers down, stacking the two could push your blood sugar lower than intended. That raises the chance of hypoglycemia, which can show up as shakiness, sweating, a fast heartbeat, dizziness, or feeling confused or unusually hungry.

The good news is this is considered a moderate, mostly theoretical concern, and the human research behind it is limited. Alogliptin on its own rarely causes lows, so the risk is modest. If you'd like to try ginseng, it's worth a quick chat with your pharmacist or doctor first, and keep an eye on your home glucose readings during the first couple of weeks.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Oh MR, Park SH, Kim SY, Back HI, Kim MG, Jeon JY, Ha KC, Na WT, Cha YS, Park BH, Park TS, Chae SW. Postprandial glucose-lowering effects of fermented red ginseng in subjects with impaired fasting glucose or type 2 diabetes: a randomized, double-blind, pla

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

Panax Ginseng Also Interacts With Other Medications

Panax Ginseng has 1,129 moderate known drug interactions in our database — the Alogliptin one above is among them. If you take anything else, check it against the full list below.

Moderate 1,129 No known interaction 1,701 (incl. Alogliptin)
Taking anything else?

Check Another of Your Medications Against Panax Ginseng

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

Everything else you take

See Every Supplement That Interacts With Alogliptin

This page covers Panax Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alogliptin page lists 356 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 299 moderate · 51 minor.

Open the Alogliptin interaction page

One more smart check

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 Alogliptin 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:

How much people look this up

Where Panax Ginseng and Alogliptin 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 Panax Ginseng
Top 25%

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

29 days ago today
Medication Alogliptin
Top half

#897 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 Panax Ginseng

What is Panax Ginseng?

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.

Read the full Panax Ginseng monograph & all interactions
Medication

About Alogliptin

What Is Alogliptin Used For?

Brand name: Nesina

Alogliptin tablets — sold under the brand names Alogliptin and Nesina — are used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Alogliptin is not used for type 1 diabetes or diabetic ketoacidosis, as it would not be effective in those situations.

See full Alogliptin drug information
Keep checking

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.

0Major
1,129Moderate
0Minor
1,700No known interaction
1,129 Moderate 1,700 No interaction
Moderate

1,129 interactions

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.

Showing the 60 most looked-up of 1,700 medications checked with no known interaction — see the full Panax Ginseng list.

See the full Panax Ginseng interactions page
See every supplement checked against Alogliptin, 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
Panax Ginseng monograph › Uses, safety, and every drug interaction in one place Alogliptin supplement interactions › Every supplement checked against Alogliptin, ranked by severity Alogliptin 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 Panax Ginseng and Alogliptin Together: Common Questions

Can you take Panax Ginseng with Alogliptin?
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.
Why are there 2 interactions listed for Panax Ginseng and Alogliptin?
Alogliptin belongs to more than one drug category, and Panax Ginseng interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Panax Ginseng and Alogliptin 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 Alogliptin and Panax 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.