Drug & supplement interaction

Panax Ginseng + Cabotegravir, Rilpivirine

Cabotegravir, Rilpivirine brand name: Cabenuva.

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

Cabotegravir, Rilpivirine falls into 2 drug categories that Panax Ginseng can interact with; the most serious is rated moderate. Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias.

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

Panax Ginseng and Cabotegravir, Rilpivirine

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. Cabotegravir, Rilpivirine 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

QT INTERVAL-PROLONGING DRUGS

1 of 2

Why this applies to Cabotegravir, Rilpivirine

Cabotegravir, Rilpivirine falls under QT INTERVAL-PROLONGING DRUGS — the group Panax Ginseng interacts with.

Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
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 short version on combining Panax ginseng with your Cabenuva (cabotegravir and rilpivirine) injections. The concern isn't about ginseng changing your HIV medicine levels. Instead, it's about the heart's electrical timing, called the QT interval. Rilpivirine can slightly stretch that interval, and some short-term studies suggest ginseng may do the same. Stacking two things that pull in the same direction could, in theory, raise the risk of an irregular heartbeat.

That said, the evidence here is mixed and mostly theoretical, and longer-term ginseng use hasn't shown QT changes. So I wouldn't panic. Still, since this is your HIV treatment, please run the ginseng past your pharmacist or doctor first, especially if you have heart rhythm issues or take other QT-affecting drugs.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002;36:758-63..
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cabotegravir, Rilpivirine 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

Here's the thing with Cabenuva (the cabotegravir and rilpivirine injection): the rilpivirine part is partly cleared by a liver enzyme called CYP3A4. Panax ginseng may nudge that enzyme, but honestly the direction isn't settled. In studies it sped up the breakdown of one drug (midazolam) while seeming to slow down another. So we can't say for sure which way it would push rilpivirine levels.

That uncertainty matters more here than usual, because keeping HIV medicines at steady levels is what keeps the virus suppressed. If ginseng lowered rilpivirine even a little, it could in theory make the treatment less reliable. This is mostly theoretical, but please don't add ginseng without first checking with your HIV provider or pharmacist.

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

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 Cabotegravir, Rilpivirine 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. Cabotegravir, Rilpivirine)
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 Cabotegravir, Rilpivirine

This page covers Panax Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cabotegravir, Rilpivirine page lists 134 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 7 major · 98 moderate · 29 minor.

From our pharmacist’s overview on the Cabotegravir, Rilpivirine page

“Cabenuva, the long-acting injection of cabotegravir and rilpivirine given every month or two, keeps HIV suppressed only while its blood levels hold steady, so the 134 supplement interactions on file here deserve real vigilance. St.”

Reviewed by 2 · Jul 18, 2026

Open the Cabotegravir, Rilpivirine 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 Cabotegravir, Rilpivirine 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 Cabotegravir, Rilpivirine 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%

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

29 days ago today
Medication Cabotegravir, Rilpivirine
Top 10%

#164 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 Cabotegravir and Rilpivirine Injections

What Is Cabotegravir and Rilpivirine Injections Used For?

Brand name: Cabenuva

CABENUVA (cabotegravir + rilpivirine) is used to treat HIV-1 infection in adults and adolescents 12 years and older who weigh at least 35 kg (about 77 lbs). It is not a starter treatment — it's designed for people who are already virologically suppressed, meaning their HIV is currently undetectable on a stable daily pill regimen and who have no history of treatment failure.

The goal is to keep the virus fully suppressed while freeing the person from taking a pill every day. Because it stays active in the body for weeks after each injection, strict adherence to the injection schedule is essential.

See full Cabotegravir and Rilpivirine Injections 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 Cabotegravir, Rilpivirine, 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 Cabotegravir, Rilpivirine supplement interactions › Every supplement checked against Cabotegravir, Rilpivirine, ranked by severity Cabotegravir and Rilpivirine Injections 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 Cabotegravir, Rilpivirine Together: Common Questions

Can you take Panax Ginseng with Cabotegravir, Rilpivirine?
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 Cabotegravir, Rilpivirine?
Cabotegravir, Rilpivirine 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 Cabotegravir, Rilpivirine 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 Cabotegravir, Rilpivirine 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.