How to use Panax Ginseng: dosage,administration,precautions and combinations.
- Botanical Identification and Information of Panax Ginseng.
- Difference between Ginsengs.
- Botanical Description of Ginseng.
- Overview and tells of Panax ginseng.
- Panax ginseng Asian ginseng root.
- Constituents and Phytochemicals of Panax Ginseng.
- Various Uses of Panax Ginseng.
- Therapeutics and Pharmacology of Panax Ginseng.
- Substitutes of Panax Ginseng.
- How to use Panax Ginseng:Dosage,Administration Guide,Precautions and Combinations.
- The Ginseng Trade War.
- Panax Ginseng or Ren Shen:Notes from Ancient Herbal Classics and Herbalists.
- Research Update:Panax ginseng and Ginsenoside
How to use Panax Ginseng: dosage,administration,precautions and combinations.
Panax may be combined with Turnera and Serenoa in glandular weakness. In China, it is rarely used on its own, but is usually combined with liquorice or Chinese dates.
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1.To treat collapse due to qi deficiency with symptoms of paleness, cold sweating throughout the body and extremely faint pulse, tending to cease: ginseng can be used in its large dosage of concentrated decoction or in combinatioit with prepared aconite root for invigorating qi, recuperating depleted yang, rescue the patient from collapse, such as Shen Eu Decoction.
2.To treat deficiency of qi and yin, perspiration, lassitude, vexation, thirst and faint pulse tending to cease: ginseng is often used in combination with ophiopogon root and schisandra fruit for invigorating qi, nourishing yin, astringing perspiration and treating collapse, such as Shengmai Powder.
3.Invigorating qi and strengthening the spleen: Ginseng is often used in combination with white atractylodes rhizome, poria, liquorice and other herbs for invigorating qi and strengthening the spleen, such as Sijunzi Decoction, to treat deficiency of spleen-qi and stomach-qi, anorexia, emaciation, lassitude and loose stool; and with astragalus root, bupleurum root, cimicifuga rhizome and other herbs for invigorating qi and elevating yang, to treat sinking of qi in middle-jiao, lingering diarrhea, proctoptosis and splan chnoptosis.
4.For tonifying the lung, arresting cough and alleviating asthma, to treat deficiency of the lung-qi, lingering cough and asthma of deficiency type, perspiration on exertion, lassitude and faint pulse: Ginseng is often used in combination with schisandra fruit, astragalus root, tatarian aster root and other herbs for tonifying the lung, arresting cough and alleviating asthma, to treat deficiency of the lung-qi, lingering cough and asthma of deficiency type, perspiration on exertion, lassitude and faint pulse; and with genko, walnut kernel, psoralea fruit and other herbs for improving inspiration and relieving asthma, to treat lingering cough and asthma of deficiency type due to failure of the kidney in holding air.
5.For clearing heat and fire, invigorating qi and promoting yin (the production of the body fluid), to treat epidemic febrile disease caused by exopathogen, injury of qi and yin by heat, vexation, thirst, perspiration and lassitude: Ginseng is often used in combination with Baihu Decoction for clearing heat and fire, invigorating qi and promoting yin (the production of the body fluid), to treat epidemic febrile disease caused by exopathogen, injury of qi and yin by heat, vexation, thirst, perspiration and lassitude; and with dried rehmannia root , trichosanthes root, pueraria root and other herbs for promoting the production of the body fluid and quenching thirst, to treat interior heat and diabetes.
6.To treat vexation, insomnia and amnesia caused by deficiency of qi and blood and irritability: To treat vexation, insomnia and amnesia caused by deficiency of qi and blood and irritability, ginseng is often used in combination with longenaril, wild jujube seed, Chinese angelica root and other herbs for nourishing the heart and tranquilizing the mind.
One of Panax ginseng's most common side-effects is the inability to sleep.Other side-effects include nausea, diarrhea, euphoria, headaches, epistaxis, high blood pressure, low blood pressure, mastalgia, and vaginal bleeding.
The common adaptogen ginsengs (Panax ginseng and Panax quinquefolia) are generally considered to be relatively safe even in large amounts.
Panax ginseng is not recommended within Chinese Medicine to be administered along with anti-infective herbs unless a person is quite debilitated, because of the fear that the pathogen will be tonified. Herbalists in China believed this and according to Xu Dachun in his brief essay on ginseng (1757 A.D., during the Manchu Colonization Period): "if one administers Ginseng of a purely supplementing nature, then one will merely supplement the evil influences and help them settle down. In minor cases, the evil influences will, as a result of such mistaken therapy, never leave the body again. In serious cases, death is inevitable."
1. Reported adverse effects include erythema, fatal poisoning, persistent hiccups, severe edema, hypokalemia, diabetic relapse, diseases of the five sense organs, melanosis, hypertension, allergic reactions, high fever, etc.
2. An analysis of the reported cases involving adverse effects found: 1) 52.9% of the cases involved the nervous system, 11.8% the circulatory system, 8.8% the digestive system, 8.8% shock and death, 17.7% others; 2) the age of the patients involved ranged from 1 month to 74 years old; 3) the number of cases involving men was 1.7 times greater than that involving women; 4) all cases involved oral administration with one exception, wherein intramuscular injection was the mode of administration; 5) dosage ranged from 3 to 40 grams; and 6) the adverse effects occurred from several minutes to 30 days after treatment.
The PDR 4th edition noted the herb Panax Ginseng with some precautions and adverse reactions,as "Caution should be taken in patients with cardiovascular disease or diabetes.Panax ginseng has lowered blood glucose in diabetic and nondiabetic patients.(Sotaniemi et al,1995).General adverse effects include insomnia,epistaxis,headache,nervousness,and vomiting.Estrogenic effects have been observed with Ginseng products,though the exact type of Ginseng(i.e.,American,Panax,Siberian) was not reported.",togethor it noted further detailed precautions and adverse reactions in different categories including Cardiovascular "both hypertension and hypotension have been reported in patients taking Ginseng for 10 days...",Central Nervous System "...averaged a 3-gram daily dose,developed symptoms of Ginseng abuse(characterized by hypertension with nervousness,sleeplessness,skin eruptions,and diarrhea) in a 2 year study...",Dermatologic,"33% of 133 patients involved in a 2-year study developed various skin eruptions...",Endocrine/Metabolic related with the estrogenlike activity of Ginseng,and presented as symptoms including "a reduction in blood glucose","oral ginseng and ginseng face cream have been associated with postmenopausal vaginal bleeding.",Gastrointestinal,"47% of 133 patients enrolled in a 2 year study developed morning diarrhea.",and Teratogenicity.(6).
Antagonizing veratrum root, restraining trogopterus dung and inhibiting honey locust. Large doses are said to raise blood pressure.
No significant toxicity or drug interactions are known but excessive use can lead to sleeplessness, hypertension, headaches, oestrogenic effects, irritability or other side effects. It should not be used in pregnancy, menstrual irregularities, acute illness, hypertension, or in conjunction with other stimulants (including caffeine-containing drinks). It should not be taken continuously - occasional use or courses of 1 month followed by a 2 month interval are recommended.
Consuming large amounts of caffeine or other stimulants while taking ginseng can result in nervousness, sleeplessness, elevated blood pressure, and other complications. Avoid ginseng if you have an acute illness, uncontrolled high blood pressure, an irregular heart rhythm, or if you are pregnant.
Higher than commonly recommended doses may cause nervousness, insomnia, headache, skin eruptions, stomach upset, and increased menstrual bleeding and breast tenderness. If you experience any of these reactions, reduce your dose or stop taking the herb.
Panax ginseng is different from American ginseng and Eleuthero (formerly Siberian ginseng). They are not interchangeable.
Panax Ginseng or Ren Shen:Administration and Suggestions from Pharmacopoeias.
Indications and Dosage from CP for Panax Ginseng(Ren Shen):The CP defined the herb Panax Ginseng(Ren Shen) as the dry root of the Araliaceae family plant Panax ginseng C. A. Mey.,and noted the cultivated herb is named Yuan Shen(planted ginseng,Yuan means "garden"),the herb grow in wild field named Shan Shen(Wild Ginseng),normally dig out in autumn,wash clean,the sun dried or heat dried Yuan Shen is named "Sheng Shai Shen"(sun dried raw ginseng),the Shan Shen dried in sun is named "Sheng Shai Shan Shen"(sun dried mountain ginseng),with boiling water heat and soaking sugar then dried,is naed "Bai Tang Shen"(sugar prepared ginseng),once well steamed and dry in sun or by heat,named "Hong Shen"(Red Ginseng).It noted the herb Panax Ginseng(Ren Shen) taste sweet,light bitter,nature plain.Enter into spleen,lung,heart meridians.Main functions reinforce vital energy(invigorating primodial qi),restore the pulse and relieving depletion,replenish spleen and benefit lung,engender liquid(promote the secretion of saliva or body fluid),calm the nerves(relieve uneasiness of mind and body tranquilization).Indicated for weakness deficiency verging on desertion,cold limbs and weak pulse,spleen deficiency with low food intake,lung deficiency dyspnea with cough,body fluid impairment with thirst,internal heat and wasting thirst(drinking and urine,symptom-complex of excessive eating),prolonged illness weakness,palpitate with fear and insomnia,impotentia and uterine cold,heart-failure,cardiogenic shock.Suggested Dosage:3~9 grams,decoct separately and add into decoction to take,Ye Shan Shen grinded powder and swallow,2 grams once,twice daily.Cautions should be paid the herb should not combine with black false hellebore.Store at dry cool place,sealed,moth proof.
Indications and Dosage from CCHM for Panax Ginseng(Ren Shen):The CCHM defined the herb Panax Ginseng(Ren Shen) as the root of the Araliaceae family plant Panax ginseng C. A. Mey.[P. schin-seng Nees],its leaves also used medicinally,and named "Shen Ye"(Ginseng Leaves),normally the herb suitable for collect should have at least 5 years growing seasons,dig out in autumn,especially the wild mountain ginseng,once fruit mature and turn red may easy to be found,dig out with fibre root togethor,clean off sands and soil,dried and it named "Sheng Shai Shen"(sun dried raw ginseng),once heat with boiling water and soaking with sugar then dried,named "Bai Tang Shen"(sugar prepare ginseng),those steam cooked then dried in sun or dried by heat named "Hong Shen"(red ginseng).It noted the herb taste sweet,light bitter,light warm.Main functions tonify Qi(reinforce vital energy,invigorating primodial qi),relieving depletion,engender liquid(promote the secretion of saliva or body fluid),calm the nerves(relieve uneasiness of mind and body tranquilization),boost intelligence.Indicated for short of breath and hasty panting,palpitations and forgetful,thirsty with hyperhidrosis,eat less and powerless,shock and prostration due to all acute or chronic disease and hemorrhage.Suggested Dosage:0.5~3 qian(qian,weight unit,1 qian equals to 3.125 grams in traditional Chinese measurement system,or equal to 5.0 grams in metric system),big dose could be 1 liang(liang,weight unit,1 liang equals to 31.25 grams).Cautions should be paid the herb Ginseng could not be used togethor with black false hellebore,faeces togopteri.(2)
Indications and Dosage from DCTM for Panax Ginseng(Ren Shen):The DCTM(Dictionary of the Chinese Traditional Medicine) defined the herb Panax Ginseng(Ren Shen) as the root of the Araliaceae family plant Panax ginseng C. A. Mey..It noted the herb taste sweet slight bitter,nature warm.Enter into spleen,lung meridians.Main functions greatly tonify Qi(reinforce vital energy,invigorating primodial qi),relieving depletion,engender liquid(promote the secretion of saliva or body fluid),calm the nerves(relieve uneasiness of mind and body tranquilization).Indicated for internal lesion caused by overexertion and deficiency problems,low food intake,lassitude and fatigue,stomach reflux vomiting,efflux diarrhea,empty cough with hasty panting(dyspnea and tachypnea),spontaneous perspiration and fulminant desertion,palpitation due to alarm,amnesia(forgetful),dizziness headache,impotentia(asynodia,sexual impotence),frequent micturition(frequency of urinatior),wasting thirst(consumptive thirst,drinking and urine,symptom-complex of excessive eating),women uterine bleeding,chronic infantile convulsion,and other prolonged deficiency without recover,all deficiency syndrome with Qi blood and body liquid deficiency.Suggested Dosage:internal as decoction 0.5~3 qian,big dose 0.3~1 liang,also could be prepared as paste,or into pellets,powder.Cautions should be paid cases excess syndrome and heat syndrome should Not use the herb.(3)
Indications and Dosage from CHMM for Ginseng,Ginseng Root(Ren Shen):The CHMM(Chinese Herbal Materia Medica) defined the herb Ginseng,Ginseng Root(Ren Shen) as from the Araliaceae family plant Panaxginseng C. A. Mey.[P.schin-seng Nees].It noted the herb enter into lung,spleen,heart,kidney meridians.(4)
Indications and Dosage from APA Guide for Ginseng(Asian):The APA Guide book give some guide of indications and dosage for the herb Ginseng(Asian),it classified 1 species under the title "Ginseng(Asian)",which included "Panax ginseng C.A.Mey.,sometimes referred to as Panax schinseng Nees.Family:Araliaceae.Common Names:Chinese ginseng,...ren shen(man root)",it defined the medicinal parts are "The roots are typically dried and often cured before medicinal use.",it give some brief introduction about the uses of the herb traditional Chinese medicine,far east Asia,and ancient Western area,and noted that "What It Is Used For:Panax stems from the Greek word for 'all-healing',and in parts of Asia,ginseng has embodied this hope for millennia.Long ago,enthusiasts in China,Japan,Korea,Russia,and other parts of the world noted the curiously human-like shape of the root and started to take it as a 'bodywide' tonic and revitalizer to maintain health more than to treat any particular disease.They regard ginseng much the way Americans do vitamin pills.In traditional Chinese medicine,ginseng root is regarded as tonic,sedating,heart-strengthening,and secretion-promoting.The concept of 'hot' and 'cold' are properties believed to be inherent in both medicines and the diseases that these medicines are used to treat.American ginseng is believed to have 'cool' properties,while in contrast,Asian ginseng is said to possess 'hot' properties good for raising 'heat' in the blood or circulatory system.The many conditions Asian ginseng has been taken for,either alone or in combination with other herbs,include bleeding disorders,colitis,headache,fatigue,dizziness,impotence,rheumatism,amnesia,and appetite loss.Symptoms of senility,aging,and cancer have long been treated with ginseng.Interestingly,the leaf of Asian ginseng,which is not used,is said to have properties similar to those of American ginseng root.In recent times,Western sources have focused primarily on the adaptogenic properties of this treasured Asian root.Adaptogens are believed to strengthen the body,boosting its overall resisitance to the potentially damaging impact of physical,biological,or chemical stresses.Ginseng is billed as a key to vitality and longevity,the herb to take in cases of physical or mental exhaustion or lowered resistance to infection.Mild aphrodisiac qualities have been attributed to it."(5),the description for traditional Chinese medicine part are good wide enough and basically correct,but the "hot" property it mentioned is not very exact,actually in ancient Chinese herbal classics the nature of the herb are recorded as "light warm",or sometime as "light cold".With some introduction of the mechanism and properties findings and safety evaluations of the herb Asian Ginseng,it give some dosage suggestions too,as "Dosage Commonly Reported:A common dosage is 1 to 2 grams per day,although in Chinese medicine the standard is 1 to 9 grams a day.A decoction is made using 1/2 teaspoon dried,pulverized root per cup of water and is drunk once or twice per day.As a stimulant,a common dose of capsules standardized for 5 to 9 percent ginsenosides is 500 to 1,000 milligrams;as a tonic,250 to 500 milligrams is common."(5)
Indications and Dosage from PDR for Ginseng(Panax Ginseng):The PDR 4th edition defined the herb Ginseng as from botanical origin Panax Ginseng,and noted the "medicinal part is the dried root",its other section defined the herb as both main root and hair root,which is more exact,"Production:Ginseng root consists of the dried main and lateral root and root hairs of Panax ginseng.",it give a very detailed evaluation of the herb's pharmaceutical properties and effects in various aspects and clinical trials,a detailed precaution adverse reactions,drug interactions,overdose of the herb,and togethor it noted the herb's approved indication by their CE as for "Lack of stamina:Ginseng is used internally as a tonic and fortification in times of fatigue and debility;for declining performance,capacity for work,and concentration;and during convalescence.",togethor it noted the herb's uses in Folk medicine,Chinese medicine and Homeopathic,"Unproven Uses:In folk medicine,Ginseng is used for loss of appetite,cachexia,anxiety,impotence and sterility,neuralgia,and insomnia.Chinese Medicine:In Chinese medicine,Ginseng is used for hemoptysis,gastric disturbance,and vomiting.Homeopathic Uses:Ginseng is used for rheumatism and debility.",it sounds the herb Panax Ginseng used at Europe is still at a limited scope,their uses of the herb sounds still stay at a tonic level,not yet reach to a level for treatment of serious disease,its administration part suggested some dosage,"Mode of Administration:Comminuted drug infusion,powder and galenic preparations for internal use.Various standardized preparations containing Ginseng root are available...Preparation:to make an infusion,pour boiling water over 3 g comminuted drug and strain after 5 to 10 minutes.Daily Dosage:The average daily dosage is 1 to 2 g root.The infusion may be taken 3 to 4 times a day over 3 to 4 weeks.",togethor it give dosage suggestions for various purpose including cognitive functions,hypoglycemic effects,antiviral,erectile dysfunction,physical and psychological performance,and "Homeopathic Dosage:5 drops,1 tablet,5 to 10 globules or 1 mL injection solution sc twice weekly."(6)
Toxicity and Safety Data of Ginseng and Ginsenosides:
Safety Evaluation in General:
In traditional Chinese herbal medicine system,the herb Ginseng are noted has interactions with the herb black false hellebore,should not combine with herb Faeces Togopteri,Chinese honey locust.Cases including (1).hyperactivity of fire due to yin deficiency,(2).deficiency cold of spleen stomach,(3).all excess syndrome and heat syndrome without health-Qi deficiency should not take the herb.The toxicity of Ginseng is low,oral 3% Ginseng tincture 100mL only bring mild discomfort,if take 200mL or big dose of Ginseng root powder,may lead to toxicosis(poisoning),and appear symptoms including Gibert's disease(herpes tonsurans maculosus),pruritus(itching),headache(cephalea),dizziness(giddiness,vertigo),fervescence(increased body temperature),bleeding etc.Long period abuse of Ginseng(1 months to 2 years) may lead to ginseng-abuse-syndrome which presented as evelated blood pressure,throat itchy,euphoria,anxiety,elevated body temperature,erythra,bleeding,early morning diarrhea,edema,some patients also show depression or dysthymia.
The APA Guide book noted the safety conditions of the herb Ginseng(Asian,Panax Ginseng) as:"Will It Harm You?What the Studies Say:Millennia of use certainly testify to the relative safety of Asian ginseng,and serious adverse reactions are not generally reported.It has,however,caused nervousness,agitation,insomnia,diarrhea,and skin eruptions in some people.Neither a toxic dose nor a reliably effective dose has been described.Although long-term use appears to be safe,it is probably best to avoid taking ginseng continuously for long stretches of time(several months or more),given its documented side effects and pharmacologic activity.Several sources warn against taking ginseng if you have an acute illness,have high blood pressure,or are diabetic(blood-sugar-lowering properties have been reported,which could be dangerous for those taking medicines to lower blood sugar).A 1979 study describing a 'ginseng abuse syndrome,'characterized by an agreeable sensation of stimulation but disturbing nervousness,sleeplessness,high blood pressure,and other problems,has largely been discredited caffeine-containing substances,for example.For this reason,however,it would be wise to avoid ginseng if you regularly take another stimulant(including large amounts of caffeine-containing drinks such as coffee.)"(5)
The PDR 4th edition noted and listed some related syndromes with its section titled "Overdosage",as "OVERDOSAGE:Palpitations,insomnia,pruritus,heart pain,decreased sexual potency,vomiting,hemorrhagic diathesis,headache,and epistaxis have all been reported infrequently.Ingestion of large amounts is said to be fatal(Baranov,1982).Massive overdosage can bring about Ginseng Abuse Syndrome,which is characterized by hypertension,nervousness,insomnia,hypertonia,edema,morning diarrhea,inability to concentrate,and skin eruptions.It may occur after 1 to 3 weeks of ingestion of 3 g/d of Ginseng root(Ryu&Chien,1995)Weakness and tremor were seen in one patient upon withdrawwal.Large doses may cause insomnia,depression,and nervous disorders(Siegel,1979).about 10% of volunteers taking Ginseng developed this complex(Anon,1980a)."(6)
Acute Toxicity:Ginseng Extract.
LD50: 16.5mg/kg (mice/Ginseng extract/hypodermic injection).
Acute Toxicity:Ginsenoside Rb1
LD50,Lethal dose,50 percent kill.Intraperitoneal.Rodent-mouse.1110 mg/kg.Details of toxic effects not reported other lethal dose value.Reference:Chinese Herb.Shanghai Science and Technology Publishing.page/year:1280/1998
LD50,Lethal dose,50 percent kill.Intraperitoneal.Rodent-mouse.1110 mg/kg.Details of toxic effects not reported other lethal dose value.Reference:ARZNAD Arzneimittel-Forschung.Drug Research.(Editio Cantor Verlag,Postfach 1255,W-7960 Aulendorf,Fed.Rep.Ger.)V.1-1951-Volume(issue)/page/year:25,343,1975.
LD50,lethal dose,50 percent kill.Intravenous,Rodent-mouse.243 mg/kg.Details of toxic effects not reported other than lethal dose value.Reference:SYHJAM Saengyak Hakhoechi.Journal of Society of Pharmacognosy.(HangukSaengyak Hakhoe,c/o Natural Products Institute,Seoul National Univ.,28 Yunkeon-Dong,Chong-ro-ku,Seoul 110,Korea)1970-Volume(issue)/page/year:10,61,1979.
Mutagenic Data:Ginsenoside Rb1. Mutation test systems-not otherwise specified.Intraperitoneal.Rodent-rat.50 mg/kg.Reference:CPBTAL Chemical and Pharmaceutical Bulletin.V.6-1958-Volume(issue)/page/year:24,2400,1976.
Acute Toxicity:Ginsenoside Re.
LD50,Lethal dose,50 percent kill.Intraperitoneal.Rodent-mouse.465 mg/kg.Details of toxic effects not reported other lethal dose value.Reference:Chinese Herb.Shanghai Science and Technology Publishing.page/year:1280/1998
LD50,lethal dose,50 percent kill.Intraperitoneal.Rodent-mouse.405 mg/kg.Details of toxic effects not reported other than dose value.Reference:ARZNAD Arzneimittel-Forschung.Drug Research.(Editio Cantor Verlag,Postfach 1255,W-7960 Aulendorf,Fed.Rep.Ger.)V.1-1951-Volume(issue)/page/year:25,539,1975.
LD50,lethal dose,50 percent kill.Subcutaneous.Rodent-mouse.>1500 mg/kg.Details of toxic effects not reported other than dose value.Reference:SYHJAM Saengyak Hakhoechi.Journal of Society of Pharmacognosy.(HangukSaengyak Hakhoe,c/o Natural Products Institute,Seoul National Univ.,28 Yunkeon-Dong,Chong-ro-ku,Seoul 110,Korea)1970-Volume(issue)/page/year:10,61,1979.
LD50,lethal dose,50 percent kill.Intravenous.Rodent-mouse.130 mg/kg.Details of toxic effects not reported other than dose value.Reference:same as above
Acute Toxicity:Ginsenoside Rg1.
LD50,Lethal dose,50 percent kill.Oral.Rodent-mouse.5000 mg/kg.Details of toxic effects including reduce of activity,lower of body temperature and other inhibitive actions till death.Reference:Zhong Yao You Xiao Cheng Fen Yao Li Yu Ying Yong(Effective Constituents and Application of TCM).Ji Bin Yu.Hei Long Jiang Science and Technology Publishing.page/year:223/1995
LD50,Lethal dose,50 percent kill.Intraperitoneal.Rodent-mouse.1600 mg/kg.Details of toxic effects including reduce of activity,lower of body temperature and other inhibitive actions till death.Reference:Same as above.
LD50,Lethal dose,50 percent kill.intravenous.Rodent-mouse.396 mg/kg.Details of toxic effects including reduce of activity,lower of body temperature and other inhibitive actions till death.Reference:Same as above.
LD50,lethal dose,50 percent kill.Intraperitoneal.rodent-mouse.405 mg/kg.Details of toxic effects not reported other than lethal dose value.Reference:ARZNAD Arzneimittel-Forschung.Drug Research.(Editio Cantor Verlag,Postfach 1255,W-7960 Aulendorf,Fed.Rep.Ger.)V.1-1951-Volume(issue)/page/year:25,343,1975.
Acute Toxicity:Ginsenoside Rg3. LD50,lethal dose,50 percent kill.Intraperitoneal.rodent-mouse.1250 mg/kg.Details of toxic effects not reported other than lethal dose value.Reference:ARZNAD Arzneimittel-Forschung.Drug Research.(Editio Cantor Verlag,Postfach 1255,W-7960 Aulendorf,Fed.Rep.Ger.)V.1-1951-Volume(issue)/page/year:25,343,1975.
Preparation and Dosage:
Pediatric:This herb is not recommended for use in children because of its stimulant properties.
Regulatory Status: GSL Schedule 2
Single dose in morning:
Dried root: 0.6-2g or by decoction
Unless otherwise prescribed: 1 g of root per day for up to three months; a repeated course is feasible.
Decoction: 1 g in 150 ml of water.
Fluidextract 1:1 (g/ml): 1 ml.
Tincture 1:5 (g/ml): 5~10 ml.
Standardized extract (4% total ginsenosides): 100 mg twice daily.
5-10 g for being decocted alone and mixed with other herbal tea for oral medication. 2-3 times a day;
1-2 g each time for ginseng powder in form of infusion with hot boiled water.
15-30 g in concentrated decoction for emergency treatment of prostration syndrome.
In healthy individuals who wish to increase physical or mental performance, to prevent illness, or to improve resistance to stress, ginseng should be taken in one of the above dosages in cycles. For example, take every day for 2 to 3 weeks, then stop for 2 weeks.
For help recovering from an illness, the elderly should take 500 mg twice daily for three months. Alternatively, they may take the same dosage (500 mg twice daily) for a month, followed by a two-month break. This can then be repeated if needed.
Use During Pregnancy and Lactation :
The Commission E reports no known restrictions on the use of ginseng during pregnancy and lactation. Although the British Herbal Compendium contraindicates ginseng during pregnancy, this is not substantiated by use in Asia or by the Commission E (McGuffin et al., 1997). However, controlled, long-term safety studies have not been conducted. WHO has also reiterated that the safety of ginseng use during pregnancy has not been established, although it noted that ginseng is not teratogenic (WHO, 1999).
Interactions with Other Drugs:
The British Herbal Compendium contraindicates the use of ginseng with stimulants, including excessive use of caffeine (Bradley, 1992). The WHO monograph cites two cases of ginseng interaction with phenelzine, a monoamine oxidase inhibitor, although the clinical significance of this interaction was yet to be determined (WHO, 1999).
If you are currently being treated with any of the following medications, you should not use ginseng without first talking to your healthcare provider:
Blood Thinning Medications:
There have been reports that Asian ginseng may possibly decrease the effectiveness of the blood-thinning medication, warfarin. In addition, ginseng may inhibit platelet activity and, therefore, should probably not be used with aspirin either.
While taking ginseng, it is wise to avoid caffeine or other substances that stimulate the central nervous system because the ginseng may increase their effects, possibly causing nervousness, sweating, insomnia, or irregular heartbeat.
Ginseng may exaggerate the effects of this anti-psychotic medication, so these should not be taken together.
Ginseng may block the pain killing effects of morphine.
Phenelzine and other MAO inhibitors for Depression:
There have been reports of a possible interaction between ginseng and the antidepressant medication, phenelzine (which belongs to a class known as monoamine oxidase inhibitors [MAOIs]), resulting in symptoms ranging from manic-like episodes to headache and tremulousness.
Other Drug Interactions:
The PDR 4th edition noted the herb Panax Ginseng may has moderate risks drug interactions with below drugs:"Anticoagulants,Diabetic Agents/Insulin,Estrogen,Loop diuretics,Monoamine Oxidase Inhibitors(MOAIs),Nifedipine"(6);and may has potential interactions with below drugs:"Albendazole"(6).
1: What is the differenciation between Panax ginseng and Ginsengs,How to use Panax Ginseng,Chemistry and Pharmacology,Substitutes?
2: see CCHM(Quan Guo Zhong Cao Yao Hui Bian,or Compilation of Chinese Herbal Medicine)
3: see DCTM(Dictionary of the Chinese Traditional Medicine),ISBN:9787532382712,by Shanghai Science and Technology Press.
4: see CHMM(Zhong Hua Ben Cao,or Chinese Herbal Materia Medica)
5: see The American Pharmaceutical Association Practical Guide to Natural Medicines,1st Ed,under title "Ginseng,Asian",p298~301.
6: see PDR for Herbal Medicines 4th Ed.under title "Ginseng(Panax Ginseng)",p384~392.
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