Drug & supplement interaction

Panax Ginseng + Roflumilast

Roflumilast brand names: Daliresp, Zoryve.

Moderate Interaction
The bottom line Moderate

Panax Ginseng has a moderate interaction with Roflumilast. Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.

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

Panax Ginseng and Roflumilast

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Roflumilast

Roflumilast 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 thing with Roflumilast (Daliresp): your liver uses an enzyme called CYP3A4 to help break it down. Panax ginseng has shown mixed effects on this same enzyme, so in theory it could nudge your Roflumilast levels up or down. If levels drift higher, you might notice more of the usual Roflumilast side effects, things like nausea, diarrhea, weight loss, headache, or trouble sleeping. If levels drop, the drug may not protect your lungs from flare-ups as well.

I want to be honest that this is mostly theoretical and the direction isn't predictable. Roflumilast is not a prodrug, so it doesn't flip the usual rules. Before adding ginseng, just run it by your pharmacist or doctor so they can keep an eye on how you feel.

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 Roflumilast one above is one of 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 Roflumilast

This page covers Panax Ginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Roflumilast page lists 141 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 96 moderate · 42 minor.

From our pharmacist’s overview on the Roflumilast page

“Roflumilast (Daliresp for severe COPD, Zoryve as a cream for skin conditions) is cleared almost entirely by one liver enzyme, CYP3A4, which is why 121 of the 141 supplements on this page can push its level up or down, and why real caution is warranted here. Start with the three rated major: grapefruit blocks that enzyme and can raise r…”

Reviewed by 2 · Jul 18, 2026

Open the Roflumilast 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 Roflumilast 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 Roflumilast 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 Roflumilast
Top half

#1,107 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 Roflumilast

What Is Roflumilast Used For?

Brand names: Daliresp, Zoryve

Daliresp and roflumilast tablets are used to reduce the risk of COPD (chronic obstructive pulmonary disease) flare-ups in adults with severe COPD linked to chronic bronchitis who have had flare-ups in the past. They are not rescue inhalers and will not relieve a sudden breathing attack.

Zoryve cream is used topically to treat plaque psoriasis (adults and children 2+) and mild to moderate atopic dermatitis (eczema) in adults and children as young as 2. Zoryve topical foam is used to treat seborrheic dermatitis (adults and children 9+) and plaque psoriasis of the scalp and body (adults and children 12+).

See full Roflumilast 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
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

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Pharmacist Counseling Corner

Taking Panax Ginseng and Roflumilast Together: Common Questions

Can you take Panax Ginseng with Roflumilast?
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.
How serious is the Panax Ginseng and Roflumilast 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 Roflumilast 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.