Panax ginseng (Korean/Chinese ginseng)

Plant adaptogen, supplement. In EU – traditional herbal medicinal product (EMA HMPC); OTC tincture in Russia

ATC code: A11JA-PANAX-GINSENG

Brand names – supplements: Pharmaton (UK), Now Korean Ginseng, Solgar Korean Ginseng, Nature's Way Korean GinsengSupplements are not tested in clinical trials and are not registered as medications.

Updated 24 Sep 2026 · Methodology

Indications

Chronic fatigue

Adjunct

Ginseng is one of the few adaptogens with relatively convincing evidence in cancer-related fatigue. Barton 2013 (NCCTG N07C2) RCT in 364 cancer fatigue patients showed moderate FACIT-Fatigue score reduction with American ginseng 2000 mg/day × 8 weeks vs placebo. ASCO 2014 included American ginseng in cancer-related fatigue guidelines as an option (moderate strength, moderate evidence). In patients without cancer history evidence is weaker: small RCTs showed heterogeneous results. HMPC 2014 recognises «traditional use for symptoms of weakness». In chronic fatigue syndrome (ME/CFS) 2021 (NG206) recommends pacing; ginseng is not in guidelines.

Sources

ICD-10: R53 · ICD-11: MG22

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Erectile dysfunction

Not recommended

Korean ginseng (Panax ginseng) is sold as «natural Viagra» for erectile dysfunction. Several small RCTs in Korean patients with mild-to-moderate ED showed moderate IIEF (International Index of Erectile Function) improvement at 900–1000 mg three times daily of standardised Korean Red Ginseng extract. AUA 2018 lists PDE-5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil), vacuum devices and psychotherapy for psychogenic ED first-line; Korean ginseng is mentioned as complementary therapy with «evidence limited» caveat. 2022 for ED in patients with cardiovascular disease lists PDE-5 and risk factor management. If ginseng was recommended as a PDE-5 substitute or without workup (testosterone, , lipid panel, TSH), consider seeking a second opinion from a urologist.

Sources

ICD-10: N52.9 · ICD-11: HA01.1

Immune support and respiratory infection care

Not recommended

Ginseng is sold for «immunity boosting» and «cold prevention». No Cochrane systematic review on ginseng for the common cold. Several small RCTs with CVT-E002 extract (Cold-fX, Panax quinquefolius) showed moderate cold frequency reduction in adults; data in the elderly are conflicting. HMPC 2014 recognises «traditional use», not proven efficacy. AAFP and SEIMC for the common cold recommend symptomatic therapy (paracetamol for fever, fluids, rest); ginseng supplements are not in international guidelines.

Sources

Low testosterone in men (supplement marketing)

Not recommended

Ginseng (Panax ginseng) is a plant extract sold as a supplement to raise testosterone, libido and energy in men. For low testosterone in men, ginseng has not shown convincing benefit, and there is no solid evidence base for this use. When low testosterone is confirmed, what helps is finding the cause with a doctor (a urologist or endocrinologist) and, where indicated, testosterone replacement therapy. Do not take ginseng in place of treatment with proven benefit, since that risks missing the care you actually need.

Sources

EMA HMPC: Community herbal monograph on Panax ginseng C.A. Meyer, radix (2014)

ICD-10: E29.1 · ICD-11: 5A81.1

Memory and concentration enhancement

Not recommended

Ginseng is sold as a «natural nootropic» promising memory, attention and cognitive improvement in students and the elderly. Cochrane 2010 (Geng) reviewed 9 RCTs totalling 600 patients: ambiguous effect on cognitive tests; no proven benefit in Alzheimer or vascular dementia. dementia 2018 (NG97) lists cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine first-line for Alzheimer and vascular dementia; ginseng is not in guidelines. If ginseng was recommended for cognitive impairment or diagnosed dementia, consider seeking a second opinion.

Sources

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Ginseng root contains over 30 saponins (ginsenosides Rb1, Rg1, Re, Rg3 and others), polysaccharides and phytosterols. In animal models ginsenosides modulate the HPA axis, increase endothelial NO synthesis and affect insulin signalling and immunity. The human mechanism is not confirmed in RCTs with mortality or morbidity endpoints. HMPC 2014 recognised ginseng as a traditional herbal medicinal product for symptoms of weakness and exhaustion. ASCO 2014 included American ginseng (Panax quinquefolius) in cancer-related fatigue guidelines after Barton 2013 RCT.

Safety

Contraindications

Pregnancy and lactation
Children under 18
Uncontrolled hypertension (further BP rise risk)
Warfarin and other anticoagulant/antiplatelet therapy (bleeding risk via platelet aggregation inhibition)
Bipolar disorder (hypomania risk)
Hormone-sensitive breast, endometrial or prostate tumours (theoretical oestrogen-like ginsenoside activity)

Serious adverse effects

Bleeding in warfarin, antiplatelet patients and around surgery (discontinuation 7–10 days before elective surgery recommended)
Hypoglycaemia in DM patients on insulin or sulfonylurea
Mania induction in bipolar patients
Stevens-Johnson syndrome (isolated cases)

Common adverse effects

Insomnia
Headache
Diarrhoea
Blood pressure rise
Irritability and nervousness

Pregnancy: can you take Panax ginseng (Korean/Chinese ginseng)?

Limited RCT data in pregnancy. EMA HMPC 2014 lists pregnancy as contraindication. Some studies recorded potential ginseng teratogenicity in animals. AEMPS does not register ginseng as a monoproduct medicine.

Breastfeeding: can you take Panax ginseng (Korean/Chinese ginseng)?

No data on milk transfer. EMA HMPC 2014 lists lactation as contraindication.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

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Frequently asked

What is Panax ginseng (Korean/Chinese ginseng) used for?

Panax ginseng (Korean/Chinese ginseng) is evaluated for the following indications with varying evidence strength: Chronic fatigue (evidence tier C), Memory and concentration enhancement (evidence tier D), Immune support and respiratory infection care (evidence tier D). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Panax ginseng (Korean/Chinese ginseng)?

Common side effects of Panax ginseng (Korean/Chinese ginseng) (≥ 1 in 100): Insomnia, Headache, Diarrhoea, Blood pressure rise, Irritability and nervousness. See the Safety section for uncommon and serious reactions.

Is Panax ginseng (Korean/Chinese ginseng) safe during pregnancy?

Is Panax ginseng (Korean/Chinese ginseng) compatible with breastfeeding?

No data on milk transfer. EMA HMPC 2014 lists lactation as contraindication.

Who should not take Panax ginseng (Korean/Chinese ginseng)?

Panax ginseng (Korean/Chinese ginseng) is contraindicated in: Pregnancy and lactation; Children under 18; Uncontrolled hypertension (further BP rise risk); Warfarin and other anticoagulant/antiplatelet therapy (bleeding risk via platelet aggregation inhibition); Bipolar disorder (hypomania risk). Full list in the Safety section.

Other drugs in this group

Pantothenic acid, Pyrroloquinoline quinone (PQQ), Propolis (bee product), Pterostilbene (dimethyl resveratrol analogue), Saw palmetto (Serenoa repens), Zeaxanthin, Chlorella, Lecithin (soy or sunflower phosphatidylcholine)