Panax ginseng is a herbal drug that consists of ginsenosides, polysaccharides, and peptides. Ginsenosides have been found to have CYP3A4 inhibitory activity. Here, CYP3A4 is Cytochrome P450 3A4 enzyme that is used to oxidize small organic molecules (xenobiotics). Nevertheless, Panax ginseng also protects the body from myocardial infarction and cerebral ischemia. This drug also possesses antioxidant activity and anti-free-radical activity. In terms of interaction of Panax ginseng, this drug can alter the pharmacokinetics of midazolam by inducing cyp3a enzyme functions in the gastrointestinal tract and liver. It can also interact with warfarin.
Shaikh, A. S., Thomas, A. B., & Chitlange, S. S. (2020, May). Herb-drug interaction studies of herbs used in treatment of cardiovascular disorders-A narrative review of preclinical and clinical studies. Phytother Res, 34(5), 1008-1026. https://doi.org/10.1002/ptr.6585
Panax Ginseng Capsules (Affiliate link)