Major interaction on record — check this product against your medications before combining. Based on 4 of 5 ingredients. Check your meds →
Dietary supplement

Ginseng Xtra Ingredients & Drug Interactions

by Sundown Naturals

Ginseng Xtra label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Ginseng Xtra against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Ginseng Xtra is a dietary supplement by Sundown Naturals with 5 active ingredients. Its ingredients are commonly taken for treating or preventing b12 deficiency, pernicious anemia, low energy and fatigue.Based on those ingredients, 1,250 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Panax Ginseng Extract, American Ginseng Extract, Royal Jelly concentrate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Ginseng Xtra by Sundown Naturals

Ask about any prescription or over-the-counter medication and we check it for interactions with Ginseng Xtra by Sundown Naturals — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Ginseng Xtra by Sundown Naturals

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 5 of its 5 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Ginseng Xtra contains 5 active ingredients. Vitamin B12 is an essential nutrient involved in nerve and blood cell function.

Royal jelly concentrate is a nutrient-dense secretion from honeybees, sometimes used for menopausal symptoms. The product includes two forms of ginseng — Panax ginseng extract and American ginseng extract — both adaptogens traditionally used for energy and stress.

It also contains Chinese Red Ginseng Extract. The rest of the capsule is made up of inactive ingredients like rice flour and gelatin.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: promotes physical performance.
  • We looked for evidence on: Athletic performance, Exercise-induced muscle damage, Fatigue, Cancer-related fatigue, Chemotherapy-related fatigue, Chronic fatigue syndrome (CFS) — and 4 related terms.
  • The strongest evidence on file: Panax Ginseng is rated "Possibly Effective" for Multiple sclerosis-related fatigue (Natural Medicines).
  • Also on file: Panax Ginseng is rated "Possibly Ineffective" for Athletic performance.
  • Also on file: Royal Jelly is rated "Insufficient Reliable Evidence To Rate" for Athletic performance, Cancer-related fatigue, Chemotherapy-related fatigue.

The evidence for this product's ingredients varies. Vitamin B12 is effective for B12 deficiency and certain conditions like Imerslund-Grasbeck disease.

Royal jelly is possibly effective for menopausal symptoms but appears possibly ineffective for hay fever and diabetes. Panax ginseng shows possibly effective evidence for erectile dysfunction, sexual arousal, influenza, cognitive function, and multiple sclerosis-related fatigue.

American ginseng is possibly effective for upper respiratory tract infections but has insufficient evidence for anemia of chronic disease and breast cancer. We hold no effectiveness data for Chinese Red Ginseng Extract.

The evidence, ingredient by ingredient Vitamin B12 Royal Jelly Panax Ginseng American Ginseng

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin B12 is generally very safe — excess is removed in your urine and there's no established upper limit. It's safe during pregnancy and breastfeeding at recommended amounts.

Royal jelly is generally well tolerated but can trigger serious allergic reactions in people with a history of asthma or allergies; safety data during pregnancy and breastfeeding is not sufficient, so it's best avoided. Panax ginseng is generally well tolerated short-term in healthy adults, though the most common side effect is insomnia.

Safety data for pregnancy and breastfeeding is inadequate, so it should be avoided during both. American ginseng is similarly well tolerated short-term but quality and long-term safety vary; it should also be avoided in pregnancy and breastfeeding due to insufficient safety data.

We have no safety data on file for Chinese Red Ginseng Extract.

Side effects, ingredient by ingredient Vitamin B12 Royal Jelly Panax Ginseng American Ginseng

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — Royal Jelly, Vitamin B12, American Ginseng, Panax Ginseng.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,251 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Double-check before you start if you take warfarin or other blood thinners, insulin or diabetes medications, blood pressure medications, midazolam or other sedatives, furosemide, MAOIs or selegiline, raltegravir, metformin, or any drug metabolized by the CYP2D6 enzyme. These are the main medication types our data shows can interact with ingredients in this product.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product may help with upper respiratory infections, cognitive function, or menopausal symptoms depending on which ingredient is doing the work — but the ginseng components carry real medication interactions, especially with blood thinners and blood pressure drugs. If you take warfarin, insulin, any MAOI or related medication, or a water pill, talk to your pharmacist before starting.

Anyone with a history of asthma or severe allergies should be cautious because of the royal jelly.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 5 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 26, 2014.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Ginseng Xtra, straight from the product label.

Brand Sundown Naturals
Barcode (UPC) 030768014988
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Feb 26, 2014
DSLD ID 30230
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Ginseng Xtra by Sundown Naturals, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
UPC/BARCODE
030768014988
IngredientAmount% DV
Vitamin B1215 mcg250%
Royal Jelly concentrate1 mg--
Panax Ginseng Extract150 mg--
American Ginseng Extract25 mg--
Chinese Red Ginseng Extract25 mg--

Other ingredients: Rice Flour, Gelatin, Contains <2% of

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

As a reminder, discuss the supplements and medications you take with your health care providers.

Standardized Herb Promotes Physical Performance*

Seals/Symbols

{Bottle} PLEASE RECYCLE

GUARANTEED LABORATORY TESTED QUALITY

{Wheat} FREE OF Gluten & Wheat

Precautions

KEEP OUT OF REACH OF CHILDREN.

TAMPER RESISTANT: DO NOT USE IF SEAL UNDER CAP IS BROKEN OR MISSING.

WARNING: Not intended for use by pregnant or nursing women. If you are taking any medications or have any medical condition, consult your doctor before use.

Avoid this product if you are allergic to bees or bee products.

Discontinue use and consult your doctor if any adverse reactions occur.

Not intended for use by persons under the age of 18.

Storage

STORE AT ROOM TEMPERATURE AND AVOID EXCESSIVE HEAT.

FDA Statement of Identity

HERBAL SUPPLEMENT

General

Prod. No. 44642 10F B52595 BAC

Brand IP Statement(s)

(C)2013

Smart Facts Many active people find that Sundown Naturals’ Ginseng XTRA(R) helps them make the most of their natural energy.* Ginseng XTRA(R) has the ability to revitalize and rejuvenate the body.*

Formula

with B-12, Panax, American and Chinese Red Ginseng

Suggested/Recommended/Usage/Directions

DIRECTIONS: FOR ADULTS, TAKE ONE (1) CAPSULE FOUR TIMES DAILY, PREFERABLY WITH MEALS.

FDA Disclaimer Statement

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Formulation

No Artificial Color or Flavor, No Preservatives, No Sugar, No Milk, No Lactose, No Soy, No Gluten, No Wheat, No Yeast, No Fish, Sodium Free.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Ginseng Xtra by Sundown Naturals label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Ginseng Xtra label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Ginseng Xtra by Sundown Naturals

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Vitamin B12

Interacts with
20 drugs
15 mcg per serving Form: Cyanocobalamin

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...

Vitamin B12 monograph & interactions

Royal Jelly concentrate

Interacts with
174 drugs
1 mg per serving

Royal jelly is a nutrient-rich substance made by worker bees to feed the queen bee. People take it for menopause symptoms, energy, skin, and immune su...

Royal Jelly concentrate monograph & interactions

Panax Ginseng Extract

Interacts with
1,130 drugs
150 mg per serving Form: Ginsenosides

Panax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and m...

Panax Ginseng Extract monograph & interactions

American Ginseng Extract

Interacts with
217 drugs
25 mg per serving Form: ginsenosides

American ginseng is an herbal root used as an 'adaptogen' to support energy, stress, immune function, and blood sugar. Some uses—such as reducing the...

American Ginseng Extract monograph & interactions

Chinese Red Ginseng Extract

Interacts with
1,130 drugs
25 mg per serving Form: ginsenosides

Panax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and m...

Chinese Red Ginseng Extract monograph & interactions

Other (inactive) ingredients: Rice Flour, Gelatin, Contains <2% of. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ginseng Xtra by Sundown Naturals Drug Interactions

Want to check YOUR meds against Ginseng Xtra?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,250Drugs
2 Major 1,248 Moderate

Ingredients driving the most interactions

Panax Ginseng Extract 1,130
American Ginseng Extract 217
Royal Jelly concentrate 174
Vitamin B12 20

Individual Drug Interactions

The ingredients in Ginseng Xtra interact with 1,250 drugs. Click any drug to see the details.

4 of the 5 ingredients in Ginseng Xtra interact with drugs. Each result below shows which ingredient is responsible. Panax Ginseng Extract American Ginseng Extract Royal Jelly concentrate Vitamin B12

Each ingredient & the kinds of drugs it affects

For each ingredient in Ginseng Xtra with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Panax Ginseng Extract20 drug types · 1,130 drugs

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.

Likelihood Unlikely Evidence B
Antidiabetes Drugs

Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.

Likelihood Probable Evidence B
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.

Likelihood Probable Evidence B
Cytochrome P450 2D6 (Cyp2D6) Substrates

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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence B
Estrogens

Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.

Likelihood Possible Evidence D
Furosemide (Lasix)

Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.

Likelihood Possible Evidence D
Imatinib (Gleevec)

Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.

Likelihood Possible Evidence B
Insulin

Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.

Likelihood Probable Evidence B
Midazolam (Versed)

Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests 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.

Likelihood Probable Evidence B
Monoamine Oxidase Inhibitors (Maois)

Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.

Likelihood Probable Evidence D
Nifedipine (Procardia)

Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.

Likelihood Possible Evidence B
Qt Interval-Prolonging Drugs

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.

Likelihood Possible Evidence B
Raltegravir (Isentress)

Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.

Likelihood Possible Evidence D
Selegiline (Eldepryl)

Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.

Likelihood Unlikely Evidence B
Fexofenadine (Allegra)

Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.

Likelihood Possible Evidence D
Lopinavir/Ritonavir (Kaletra)

Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.

Likelihood Unlikely Evidence B
Panax Ginseng Extract full monograph & interactions

American Ginseng Extract4 drug types · 217 drugs

Warfarin (Coumadin)

American ginseng seems to decrease the effectiveness of warfarin therapy.
Healthy patients receiving warfarin 5 mg daily, who also take American ginseng 1 gram twice daily, seem to have a significantly reduced international normalized ratio (INR).

Likelihood Likely Evidence B
Antidiabetes Drugs

Theoretically, taking American ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
American ginseng seems to lower postprandial blood glucose. Theoretically, concomitant use with antidiabetes drugs might enhance blood glucose lowering effects and possibly cause hypoglycemia.

Likelihood Probable Evidence B
Immunosuppressants

Theoretically, American ginseng use might interfere with immunosuppressive therapy.
American ginseng seems to stimulate immune function. Theoretically, American ginseng might decrease the effectiveness of immunosuppressant drugs.

Likelihood Possible Evidence D
Monoamine Oxidase Inhibitors (Maois)

Theoretically, American ginseng can interfere with MAOI therapy.
There is one case report of insomnia, headache, and tremors when an unspecified ginseng product was used with phenelzine (Nardil), an MAOI. There is also one case report of hypomania when an unspecified ginseng product was used with phenelzine. Theoretically, American ginseng may interfere with MAOI therapy.

Likelihood Possible Evidence D
American Ginseng Extract full monograph & interactions

Royal Jelly concentrate2 drug types · 174 drugs

Antihypertensive Drugs

Theoretically, royal jelly might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that royal jelly might lower blood pressure.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Royal jelly might increase the risk of bleeding when taken with warfarin.
In one case, an 87-year-old male who was previously stabilized on warfarin developed hematuria and was found to have an INR of 7.29 after taking a royal jelly supplement for one week.

Likelihood Possible Evidence D
Royal Jelly concentrate full monograph & interactions

Vitamin B121 drug type · 20 drugs

Metformin (Glucophage)

Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.

Likelihood Possible Evidence A
Vitamin B12 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Ginseng Xtra, from the product label.

Sundown Naturals

See all Sundown Naturals products
Web Address
www.sundownnaturals.com
Pharmacist Counseling Corner

Ginseng Xtra by Sundown Naturals: Common Questions

Does Ginseng Xtra by Sundown Naturals interact with any medications?
Yes. Based on its ingredients, Ginseng Xtra has a known interaction with 1,250 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ginseng Xtra contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this safe to take if I'm pregnant?
The safety data isn't there for Panax ginseng, American ginseng, or royal jelly during pregnancy — the data advises against them. Vitamin B12 is actually needed and considered safe in pregnancy at normal recommended amounts. Talk with your doctor or pharmacist about whether this product is right for you.
What's royal jelly supposed to do?
Royal jelly is possibly effective for menopausal symptoms. It's less likely to help with hay fever or diabetes based on the evidence we hold. People with asthma or a history of allergies should be aware it can cause serious allergic reactions in rare cases.
Can I take this if I have diabetes?
American ginseng and Panax ginseng may lower blood sugar, which could increase hypoglycemia risk if you're on insulin or other diabetes medications. You'd need to talk with your doctor before taking this — your dose might need adjusting.
What's the most common side effect?
Insomnia is the most common side effect reported with Panax ginseng. Headache has been reported with American ginseng. Royal jelly tends to cause allergic symptoms like itching, hives, or skin irritation in people with a history of allergies or asthma.
Does this product have a lot of fillers?
The inactive ingredients are rice flour, gelatin, and a small amount of other ingredients (less than 2%). That's a pretty minimal list.
Is vitamin B12 in here enough to treat a deficiency?
B12 is effective for treating B12 deficiency, but we don't have the dose from the label — you'd want to check the nutrition facts panel to see if the amount is therapeutic for your situation. Your doctor or pharmacist can advise whether this dose is right for you.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Ginseng Xtra label
Go deeper

The Full Monographs Behind Ginseng Xtra’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Vitamin B12

Interacts with 20 drugs

Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — su...

Read the full Vitamin B12 monograph → Herb & supplement monograph

Royal Jelly

Interacts with 174 drugs

Royal jelly is a nutrient-rich substance made by worker bees to feed the queen bee. People take it for menopause symptoms, energy, skin, and immune support, but solid human evidence is limit...

Read the full Royal Jelly monograph → Herb & supplement monograph

Panax Ginseng

Interacts with 1,130 drugs

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...

Read the full Panax Ginseng monograph → Herb & supplement monograph

American Ginseng

Interacts with 217 drugs

American ginseng is an herbal root used as an 'adaptogen' to support energy, stress, immune function, and blood sugar. Some uses—such as reducing the chance or length of colds and modestly l...

Read the full American Ginseng monograph →
Sources

Sources & How We Checked

Ginseng Xtra's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 122 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Vitamin B12 30 references
  1. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
  2. Hartman TJ, Woodson K, Stolzenberg-Solomon R, et al. Association of the B-vitamins pyridoxal 5'-phosphate (B6), B12, and folate with lung cancer risk in older men. Am J Epidemiol 2001;153:688-94.. DOI
  3. Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
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Royal Jelly 14 references
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Panax Ginseng 66 references
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  58. Bessell E, Fuller NR, Markovic TP, et al. Effects of a-cyclodextrin on cholesterol control and hydrolyzed ginseng extract on glycemic control in people with prediabetes: a randomized clinical trial. JAMA Netw Open 2020 Nov 2;3(11):e2023491.
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American Ginseng 12 references
  1. Shader RI, Greenblatt DJ. Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985;5:65. PubMed
  2. Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-2. PubMed
  3. Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692-3. PubMed
  4. Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009-13. PubMed
  5. Vuksan V, Stavro MP, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 2000;23:1221-6. PubMed
  6. Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8..
  7. McElhaney JE, Gravenstein S, Cole SK, et al. A Placebo-Controlled Trial of a Proprietary Extract of North American Ginseng (CVT-E002) to Prevent Acute Respiratory Illness in Institutionalized Older Adults. J Am Geriatr Soc 2004;52:13-9. PubMed
  8. Yuan CS, Wei G, Dey L, et al. American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled trial. Ann Intern Med 2004;141:23-7.
  9. Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173:1043-8.. PubMed
  10. McElhaney JE, Goel V, Toane B, et al. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006;12:153-7. PubMed
  11. Predy GN, Goel V, Lovlin RE, et al. Immune modulating effects of daily supplementation of COLD-fX (a proprietary extract of North American ginseng) in healthy adults. J Clin Biochem Nutr 2006;39:162-167. DOI
  12. Stavro PM, Woo M, Leiter LA, et al. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47(4):791-6. PubMed

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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.

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