Drug & supplement interaction

Panax Ginseng + Aspirin, Caffeine, Hydrocodone

Aspirin, Caffeine, Hydrocodone brand name: Damason-P.

Moderate Interaction
The bottom line Moderate

Aspirin, Caffeine, Hydrocodone falls into 5 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 report
SeverityModerate
LikelihoodPossible
Interactions5
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Panax Ginseng and Aspirin, Caffeine, Hydrocodone

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

Panax Ginseng interacts with whole categories of medication. Aspirin, Caffeine, Hydrocodone falls into 5 of those categories, so it can interact with Panax Ginseng in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 5

Why this applies to Aspirin, Caffeine, Hydrocodone

Aspirin, Caffeine, Hydrocodone falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Panax Ginseng interacts with.

Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
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.
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 wrinkle with your Damason-P combo. The hydrocodone in it leans on a liver enzyme called CYP2D6 to be turned into its more active pain-relieving form. So hydrocodone acts a bit like a prodrug. If Panax ginseng slows that enzyme down, you could theoretically get slightly less pain relief from the hydrocodone piece, not more.

Honestly though, the evidence here is thin and contradictory. One study showed ginseng blocking CYP2D6 by only about 6%, which is small, and other research found no real effect. The aspirin and caffeine parts aren't the concern. I wouldn't lose sleep over this, but if you take ginseng regularly and notice your pain isn't as well controlled, mention it to your pharmacist or doctor.

References
  1. 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.
  2. 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
  3. 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
  4. 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

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 5

Aspirin, Caffeine, Hydrocodone also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

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

This combo pill pairs aspirin and caffeine with hydrocodone, an opioid for pain. The piece that connects to ginseng is hydrocodone, which the liver enzyme CYP3A4 helps process. Panax ginseng's effect on this enzyme has gone both ways in studies, so honestly the direction here is hard to pin down. If ginseng nudges the enzyme to work faster, you might get less pain relief from the hydrocodone. If it slows the enzyme, hydrocodone could build up and bring more drowsiness, dizziness, constipation, or slowed breathing.

Keep in mind this is mostly theoretical for hydrocodone, and one occasional dose of ginseng is unlikely to cause trouble. Still, since opioids carry real risks, please run this by your pharmacist or doctor before combining them.

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

ANTICOAGULANT/ANTIPLATELET DRUGS

3 of 5

Aspirin, Caffeine, Hydrocodone also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Severity Moderate Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

The piece of your Damason-P combo that matters here is the aspirin, since aspirin thins the blood by keeping platelets from clumping together. In a test tube, ginseng's active compounds (ginsenosides) seem to do something similar, so the worry is they could stack on top of aspirin and make bleeding or bruising more likely.

The good news is that this is mostly a lab finding. When researchers actually studied ginseng in people, it did not really change how platelets behave, probably because the body absorbs little of it and clears it fast. So a real bleeding problem here is considered unlikely. Still, if you notice easy bruising, nosebleeds, or bleeding gums, or you take blood thinners, check in with your pharmacist or doctor before combining the two.

References
  1. Park HJ, Lee JH, Song YB, Park KH. Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. Biol Pharm Bull 1996;19:1434-9. PubMed
  2. Xu QF, Fang XL, Chen DF. Pharmacokinetics and bioavailability of ginsenoside Rb1 and Rg1 from Panax notoginseng in rats. J Ethnopharmacol 2003;84:187-92. PubMed
  3. Jiang X, Williams KM, Liauw WS, et al. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57:592-9. PubMed
  4. Yun YP, Do JH, Ko SR, et al. Effects of Korean red ginseng and its mixed prescription on the high molecular weight dextran-induced blood stasis in rats and human platelet aggregation. J Ethnopharmacol 2001;77:259-64. PubMed
Moderate

STIMULANT DRUGS

4 of 5

Aspirin, Caffeine, Hydrocodone also falls under STIMULANT DRUGS.

Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
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 piece to focus on with Damason-P: this combo pill contains caffeine, which is itself a mild stimulant. Panax ginseng can have its own gentle stimulant-like effects, so pairing the two might stack up. The concern here is mostly theoretical and based on how these things work in the body, not strong human studies, so I don't want to alarm you.

In real life, you might notice a bit more jitteriness, a racing or pounding heart, trouble sleeping, or feeling wired. The aspirin and hydrocodone parts of this medicine aren't really the issue. If you take ginseng and notice these effects, or you're sensitive to caffeine, just check in with your pharmacist or doctor before combining them.

References
  1. 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.
  2. Gonzalez-Seijo JC, Ramos YM, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995;15:447-8.
Moderate

CAFFEINE

5 of 5

Aspirin, Caffeine, Hydrocodone also falls under CAFFEINE.

Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
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 piece worth knowing about your Damason-P combo (aspirin, caffeine, and hydrocodone): the interaction is really about the caffeine part. Panax ginseng can act as a mild stimulant on its own, and caffeine is a stimulant too. Put them together and the effects can stack up. You might notice things like feeling jittery, a racing or pounding heartbeat, trouble falling asleep, or feeling more anxious or wired than usual.

This is largely a theoretical concern backed by limited evidence, so it's not a reason to panic, and a single cup of coffee with ginseng probably won't be dramatic. But if you take concentrated ginseng supplements regularly, it's worth a quick chat with your pharmacist or doctor first.

References
  1. 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.
  2. 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.

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 Aspirin, Caffeine, Hydrocodone one above is among them. If you take anything else, check it against the full list below.

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 Aspirin, Caffeine, Hydrocodone

This page covers Panax Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Hydrocodone page lists 398 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Danshen (major).

By severity: 17 major · 334 moderate · 47 minor.

From our pharmacist’s overview on the Aspirin, Caffeine, Hydrocodone page

“Damason-P packs three drugs into one tablet, the opioid hydrocodone, aspirin, and caffeine, so a supplement can collide with any one of them, and its list of 398 interacting ingredients earns real respect. More than 200 of those can add to aspirin's bleeding risk, while 78 can deepen the opioid's sedation.”

Reviewed by 2 · Jul 18, 2026

Open the Aspirin, Caffeine, Hydrocodone 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 Aspirin, Caffeine, Hydrocodone 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 Aspirin, Caffeine, Hydrocodone 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%

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

29 days ago today
Medication Aspirin, Caffeine, Hydrocodone
Steady interest

#1,762 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
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
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
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
Pharmacist Counseling Corner

Taking Panax Ginseng and Aspirin, Caffeine, Hydrocodone Together: Common Questions

Can you take Panax Ginseng with Aspirin, Caffeine, Hydrocodone?
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 5 interactions listed for Panax Ginseng and Aspirin, Caffeine, Hydrocodone?
Aspirin, Caffeine, Hydrocodone 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 Aspirin, Caffeine, Hydrocodone 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

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