Drug & supplement interaction

Panax Ginseng + Pazopanib

Pazopanib brand name: Votrient.

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

Pazopanib falls into 4 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
Interactions4
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Panax Ginseng and Pazopanib

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Panax Ginseng interacts with whole categories of medication. Pazopanib falls into 4 of those categories, so it can interact with Panax Ginseng in 4 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 4

Why this applies to Pazopanib

Pazopanib 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 connection worth knowing about. Pazopanib (Votrient) can stretch out something called the QT interval, which is part of your heart's electrical rhythm. Panax ginseng has also been shown, at least with short-term use, to lengthen the QT interval a bit. Stacking two things that both nudge the same direction could, in theory, raise the odds of an irregular heartbeat.

I want to be honest about the evidence though. This is mostly theoretical, and the research is genuinely mixed. Longer-term ginseng use didn't show QT changes at all. Still, because pazopanib is a cancer drug where heart rhythm is already monitored, it's smart to loop in your oncology team or pharmacist before adding ginseng rather than starting it on your own.

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 4

Pazopanib 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 situation with pazopanib (Votrient) and Panax ginseng. Your body relies on an enzyme called CYP3A4 to break down pazopanib. Ginseng can nudge this enzyme in either direction, which makes the outcome hard to predict. If it slows the enzyme, pazopanib could build up and you might see more side effects like high blood pressure, diarrhea, fatigue, or liver irritation. If it speeds the enzyme up, your pazopanib levels could drop and the cancer treatment may not work as well.

Honestly, this is mostly theoretical for ginseng, and pazopanib already needs careful dosing and regular monitoring. Because of that, I wouldn't pair them on your own. Please run it by your oncologist or pharmacist first so they can keep you safe.

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

ANTICOAGULANT/ANTIPLATELET DRUGS

3 of 4

Pazopanib 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

Here's the honest picture for Votrient (pazopanib) and Panax ginseng. In a test tube, the ginsenosides in ginseng can make platelets a little less sticky, which in theory could add to bleeding risk. Pazopanib itself can already raise the chance of bleeding and can affect blood pressure, so the worry is whether ginseng nudges that further.

The reassuring part is that studies in actual people have not shown ginseng meaningfully changing platelet function, likely because the body absorbs and clears these compounds quickly. So a real-world problem is considered unlikely. Still, since you're on a cancer therapy, it's smart to run any ginseng product past your oncology team or pharmacist before adding it, and watch for unusual bruising or bleeding.

Contact Dr. Brian directly if you have additional questions on this interaction
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

IMMUNOSUPPRESSANTS

4 of 4

Pazopanib also falls under IMMUNOSUPPRESSANTS.

Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
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 idea behind this one with pazopanib (Votrient). Panax ginseng may gently stir up the immune system, and since pazopanib is a cancer medicine that works by quieting certain growth signals, there's a theoretical worry that ginseng could work against the kind of control you're trying to achieve. I want to be honest, though: this concern is grouped with immune-suppressing drugs and is mostly theoretical, not proven specifically for pazopanib.

Pazopanib isn't a prodrug, so this isn't about ginseng activating or blocking it. The bigger practical reasons to be cautious are that ginseng can raise blood pressure and disturb sleep, and pazopanib already does both. Since this is a serious cancer therapy, please don't add ginseng without first checking with your oncologist or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Shin HR, Kim JY, Yun TK, et al. The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence. Cancer Causes Control 2000;11:565-76. 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 Pazopanib 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. Pazopanib)
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 Pazopanib

This page covers Panax Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pazopanib page lists 349 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Asarabacca (major) and Beer (major).

By severity: 14 major · 297 moderate · 38 minor.

From our pharmacist’s overview on the Pazopanib page

“Take a careful look before mixing supplements with pazopanib (Votrient), an oral pill for advanced kidney cancer and certain sarcomas. Fourteen of the 349 ingredients on file are rated major, grapefruit among them, since it can raise pazopanib levels enough to intensify side effects.”

Reviewed by 2 · Jul 18, 2026

Open the Pazopanib 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 Pazopanib 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 Pazopanib 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%

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

29 days ago today
Medication Pazopanib
Steady interest

#2,516 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 Pazopanib

What Is Pazopanib Used For?

Brand name: Votrient

Pazopanib tablets — sold as the brand Votrient and as generic pazopanib — are used to treat two types of advanced cancer in adults: advanced renal cell carcinoma (RCC), the most common form of kidney cancer, and advanced soft tissue sarcoma (STS) in patients who have already received prior chemotherapy.

Important limitation: Pazopanib has not been shown to work in adipocytic soft tissue sarcoma (a subtype involving fat cells) or in gastrointestinal stromal tumors (GISTs), so it is not used for those cancers.

See full Pazopanib 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 Pazopanib, 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 Pazopanib supplement interactions › Every supplement checked against Pazopanib, ranked by severity Pazopanib 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 Pazopanib Together: Common Questions

Can you take Panax Ginseng with Pazopanib?
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 4 interactions listed for Panax Ginseng and Pazopanib?
Pazopanib 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 Pazopanib 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 Pazopanib 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.