Drug & supplement interaction

Panax Notoginseng + Acetaminophen, Caffeine, Codeine

Acetaminophen, Caffeine, Codeine brand names: Gesic C8, Gesic C15, Lenoltec 2, Gesic C30, Lenoltec 3, and others.

Moderate Interaction
The bottom line Moderate

Acetaminophen, Caffeine, Codeine falls into 2 drug categories that Panax Notoginseng can interact with; the most serious is rated moderate. Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.

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

Panax Notoginseng and Acetaminophen, Caffeine, Codeine

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

Why Are There 2 Interactions?

Panax Notoginseng interacts with whole categories of medication. Acetaminophen, Caffeine, Codeine falls into 2 of those categories, so it can interact with Panax Notoginseng 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 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Acetaminophen, Caffeine, Codeine

Acetaminophen, Caffeine, Codeine falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Panax Notoginseng interacts with.

Theoretically, taking Panax notoginseng might reduce the levels and clinical effects of CYP1A2 substrates.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction was attributed to the ability of Panax notoginseng to increase the activity of CYP1A2.
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

This combination pill has three ingredients, but the interaction we're talking about mainly touches the caffeine part. Caffeine is cleared by a liver enzyme called CYP1A2, and Panax notoginseng may speed that enzyme up. If it does, your body could clear caffeine a bit faster, so you might notice less of caffeine's usual lift, meaning a touch more drowsiness or a little less of that alert feeling.

I want to be honest about the evidence here: this comes only from animal research, not from people, so it's mostly theoretical. The acetaminophen and codeine portions aren't really affected through this pathway. Everyday tea or food amounts of ginseng are unlikely to matter, but if you're using a concentrated supplement, just check with your pharmacist or doctor first.

References
  1. Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.
Moderate

CAFFEINE

2 of 2

Acetaminophen, Caffeine, Codeine also falls under CAFFEINE.

Theoretically, taking Panax notoginseng may decrease the levels and clinical effects of caffeine.
Animal research shows that administering Panax notoginseng intravenously for 7 days before intraperitoneal injection of caffeine can decrease maximal blood levels of caffeine by 37%. This interaction is attributed to the ability of Panax notoginseng to increase the activity of cytochrome P450 1A2 (CYP1A2) enzymes.
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

This combo pill has three parts, but the interaction on file only touches the caffeine piece. The idea is that Panax notoginseng may speed up an enzyme called CYP1A2, which is the same one that clears caffeine from your body. If that happens, caffeine could be broken down faster, so you might notice less of its usual perk-up effect (less of that alertness or wake-up boost). It would not make the caffeine dangerous, just potentially weaker.

Keep in mind this comes only from animal research, not people, so it is theoretical and likely minor in real life. It does not change the acetaminophen (pain and fever relief) or the codeine (pain relief) parts. If you regularly use this herb, just mention it to your pharmacist or doctor so they can keep an eye on things.

References
  1. Liu R, Qin M, Hang P, Liu Y, Zhang Z, Liu G. Effects of Panax notoginseng saponins on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats in vivo. Phytother Res. 2012 Aug;26(8):1113-8.

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 Notoginseng Also Interacts With Other Medications

Panax Notoginseng has 206 moderate known drug interactions in our database — the Acetaminophen, Caffeine, Codeine 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 Notoginseng

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

Everything else you take

See Every Supplement That Interacts With Acetaminophen, Caffeine, Codeine

This page covers Panax Notoginseng only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Caffeine, Codeine page lists 303 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 Ephedra (major).

By severity: 15 major · 244 moderate · 44 minor.

Open the Acetaminophen, Caffeine, Codeine interaction page

One more smart check

Taking Panax Notoginseng as Part of a Dietary Supplement Product? Check It for Interactions

We hold 55 real supplement products containing Panax Notoginseng, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Panax Notoginseng. Your product may carry other ingredients that interact with Acetaminophen, Caffeine, Codeine too, on top of Panax Notoginseng — 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 Notoginseng and Acetaminophen, Caffeine, Codeine 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 Notoginseng
Top half

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

29 days ago today
Medication Acetaminophen, Caffeine, Codeine
Top 5%

#80 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 Notoginseng

What is Panax Notoginseng?

Panax Notoginseng
  • Bleeding and bruising
  • Heart and circulation health
  • High blood pressure
  • Chest pain (angina)
  • Inflammation and swelling

Panax notoginseng (sanqi or tienchi ginseng) is a traditional Chinese herb most often used to help with bleeding, bruising, and circulation. Human evidence for these uses is limited and mostly early, so it should not replace proven treatments. Talk to a pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Panax Notoginseng monograph & all interactions
Keep checking

Other Drugs & Panax Notoginseng

Browse every other medication we’ve checked against Panax Notoginseng — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
206Moderate
0Minor
2,623No known interaction
Moderate

206 interactions

Showing 60 of 206 moderate interactions — see all 206 on the Panax Notoginseng page.

No interaction 2,623 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 Notoginseng and Acetaminophen, Caffeine, Codeine Together: Common Questions

Can you take Panax Notoginseng with Acetaminophen, Caffeine, Codeine?
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 Notoginseng and Acetaminophen, Caffeine, Codeine?
Acetaminophen, Caffeine, Codeine belongs to more than one drug category, and Panax Notoginseng 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 Notoginseng and Acetaminophen, Caffeine, Codeine 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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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.