Panax Notoginseng
OTHER NAME(S): Chai-Jen-Shen, Field Seven, Noto-Gin, Notoginseng, Panax Notoginseng Radix, Radix Notoginseng, Samch'il, Sanchitongtshu, San Qi, San Qui, San-Qi Ginseng, Sanchi, Sanchi Ginseng, Sanchitongtshu, Sanqi, Sanqi Powder, Sanshichi, Three Seven, Tian Qi, Tian San Qi, Tienchi, Tienchi Ginseng, Panax notoginseng, Aralia quinquefolia var. notoginseng, Panax pseudoginseng var. notoginseng, San-Qi Ginsing
Overview
Panax notoginseng is a plant that grows in the mountains in Southwest China. Its root is sometimes used as medicine once it has grown for 3-5 years.
Panax notoginseng might relax blood vessels, which might improve blood flow and reduce blood pressure. Some of the chemicals in Panax notoginseng might also reduce swelling and protect the heart.
People use Panax notoginseng for chest pain, stroke, heart attack, bleeding, high blood pressure, and many other conditions, but there is no good scientific evidence to support these uses.
Don't confuse Panax notoginseng with other plants with similar names, including Panax ginseng and American ginseng. These are not the same.
Uses
Possibly Effective for
- Chest pain (angina). Taking Panax notoginseng by mouth or by IV might reduce chest pain. But research evaluating this has been low quality, so it's not clear how well it works. IV products can only be given by a healthcare provider.
- Bleeding within the skull (intracranial hemorrhage). Taking Panax notoginseng by IV might improve recovery and reduce the risk of death in people that have had bleeding in the brain. But research evaluating this has been low quality, so it's not clear how well it works. IV products can only be given by a healthcare provider.
- Stroke. Taking Panax notoginseng by mouth or by IV might improve recovery after a stroke. But research evaluating this has been low quality, so it's not clear how well it works. IV products can only be given by a healthcare provider.
Possibly Ineffective for
- Heart attack. Taking Panax notoginseng by mouth doesn't seem to prevent heart attacks in people with heart disease who are using conventional medications for heart disease.
There is interest in using Panax notoginseng for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.
Side Effects
When taken by mouth: Panax notoginseng is possibly safe when used for up to 6 weeks. It's usually well-tolerated. Side effects might include dry mouth, flushed skin, insomnia, nausea, and rash.
When given in the rectum: There isn't enough reliable information to know if Panax notoginseng is safe or what the side effects might be.
Precautions
When taken by mouth: Panax notoginseng is possibly safe when used for up to 6 weeks. It's usually well-tolerated. Side effects might include dry mouth, flushed skin, insomnia, nausea, and rash.
When given in the rectum: There isn't enough reliable information to know if Panax notoginseng is safe or what the side effects might be.
Pregnancy and breast-feeding: Panax notoginseng is likely unsafe when taken by mouth while pregnant or breast-feeding. One of the chemicals in Panax notoginseng has caused birth defects in animals. Avoid use.
Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Panax notoginseng might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use Panax notoginseng.
Interactions
Moderate Interaction
Be cautious with this combination
- Aspirin interacts with Panax NotoginsengTaking Panax notoginseng with aspirin might increase how much aspirin and Panax notoginseng is in the blood. This might increase the side effects of both aspirin and Panax notoginseng.
- Caffeine interacts with Panax NotoginsengCaffeine is changed and broken down by the liver. Panax notoginseng might increase how quickly the liver breaks down caffeine. Taking Panax notoginseng along with caffeine might decrease the effects of caffeine.
- Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interacts with Panax NotoginsengSome medications are changed and broken down by the liver. Panax notoginseng might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
- Warfarin (Coumadin) interacts with Panax NotoginsengWarfarin is used to slow blood clotting. Panax notoginseng might increase the effects of warfarin. Taking Panax notoginseng along with warfarin might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin might need to be changed.
Dosing
Panax notoginseng has most often been used by adults in doses of 100-400 mg by mouth 1-3 times daily for up to 6 weeks. Speak with a healthcare provider to find out what dose might be best for a specific condition.
References
- White CM, Fan C, Chow M. An evaluation of the hemostatic effect of externally applied notoginseng and notoginseng total saponins. J Clin Pharmacol 2000; 40:1150-3.
- Hudault S, Lievin V, Bernet-Camard MF, Servin AL. Antagonistic activity exerted in vitro and in vivo by Lactobacillus casei (strain GG) against Salmonella typhimurium C5 infection. Appl Environ Microbiol 1997;63:513-8.
- Huang KC. The Pharmacology of Chinese Herbs. 2nd ed. New York, NY: CRC Press, LLC 1999:101-102.
- Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica. Seattle, WA: Eastland Press, 1996:359-60.
- Chan P, Tomlinson B. Antioxidant effects of Chinese traditional medicine: focus on trilinolein isolated from the Chinese herb sanchi. J Clin Pharmacol 2000;40:457-61.
- 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..
- Xu QF, Fang XL, Chen DF. Pharmacokinetics and bioavailability of ginsenoside Rb1 and Rg1 from Panax notoginseng in rats. J Ethnopharmacol 2003;84:187-92.
- Lam SK, Ng TB. Pananotin, a potent antifungal protein from roots of the traditional Chinese medicinal herb Panx notoginseng. Planta Med 2002;68:1024-8.
- Lam SK, Ng TB. A xylanase from roots of sanchi ginseng (Panax notoginseng) with inhibitory effects on human immunodeficiency virus-1 reverse transcriptase. Life Sci 2002;70:3049-58.
- Cicero AF, Vitale G, Savino G, Arletti R. Panax notoginseng (Burk.) effects on fibrinogen and lipid plasma level in rats fed on a high-fat diet. Phytother Res 2003;17:174-8.
- Chan RY, Chen WF, Dong A, et al. Estrogen-like activity of ginsenoside Rg1 derived from Panax notoginseng. J Clin Endocrinol Metab 2002;87:3691-5.
- Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr 2004;23:248-58.
- Sengupta S, Toh SA, Sellers LA, et al. Modulating angiogenesis: the yin and the yang in ginseng. Circulation 2004;110:1219-25.
- He L, Chen X, Zhou M, et al. Radix/rhizoma notoginseng extract (sanchitongtshu) for ischemic stroke: a randomized controlled study. Phytomedicine 2011;18:437-42.
- Park, S. H., Kim, S. K., Shin, I. H., Kim, H. G., and Choe, J. Y. Effects of AIF on Knee Osteoarthritis Patients: Double-blind, Randomized Placebo-controlled Study. Korean J Physiol Pharmacol. 2009;13(1):33-37.
- Du XF, Yin XP, Zhang GL, Shi HJ, Shao MH. Interstitial granulomatous drug reaction to a Chinese herb extract. Eur J Dermatol. 2012 May-Jun;22(3):419-20.
- Liang MT, Lau WY, Sokmen B, Spalding TW, Chuang WJ. Effects of Panax notoginseng (Chinese ginseng) and acute exercise on postprandial glycemia in non-diabetic adults. J Complement Integr Med. 2012 Jan 4;8. pii: /j/jcim.2011.8.issue-1/1553-3840.1402/1553-3840.1402.xml.
- 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.
- Pumpa KL, Fallon KE, Bensoussan A, Papalia S. The effects of Panax notoginseng on delayed onset muscle soreness and muscle damage in well-trained males: a double blind randomised controlled trial. Complement Ther Med. 2013 Jun;21(3):131-40.
- Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:940125.
- Tian Z, Pang H, Du S, Lu Y, Zhang L, Wu H, Guo S, Wang M, Zhang Q. Effect of Panax notoginseng saponins on the pharmacokinetics of aspirin in rats. J Chromatogr B Analyt Technol Biomed Life Sci. 2017 Jan 1;1040:136-143.
- Wang T, Guo R, Zhou G, Zhou X, Kou Z, Sui F, Li C, Tang L, Wang Z. Traditional uses, botany, phytochemistry, pharmacology and toxicology of Panax notoginseng (Burk.) F.H. Chen: A review. J Ethnopharmacol. 2016 Jul 21;188:234-58.
- Xu D, Huang P, Yu Z, Xing DH, Ouyang S, Xing G. Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action. Front Neurol. 2015 Jan 7;5:274.
- Yan Z, Zhu ZL, Wang HQ, Li W, Mi YX, Liu CX. Pharmacokinetics of panaxatrol disuccinate sodium, a novel anti-cancer drug from Panax notoginseng, in healthy volunteers and patients with advanced solid tumors. Acta Pharmacol Sin. 2010 Nov;31(11):1515-22.
- Yang X, Xiong X, Wang J. Sanqi panax notoginseng injection for angina pectoris. Evid Based Complement Alternat Med. 2014;2014:963208.
- Yin Z, Ma L, Xu J, Xia J, Luo D. Pustular drug eruption due to Panax notoginseng saponins. Drug Des Devel Ther. 2014 Jul 16;8:957-61.
- Zhang X, Wu J, Zhang B. Xuesaitong injection as one adjuvant treatment of acute cerebral infarction: a systematic review and meta-analysis. BMC Complement Altern Med. 2015 Feb 27;15:36.
- Song H, Wang P, Liu J, Wang C. Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytother Res. 2017 Jun 20.
- Liang MT, Podolka TD, Chuang WJ. Panax notoginseng supplementation enhances physical performance during endurance exercise. J Strength Cond Res. 2005 Feb;19(1):108-14.
- Tian Z, Pang H, Zhang Q, et al. Effect of aspirin on the pharmacokinetics and absorption of panax notoginsengsaponins. J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jan 2;1074-75.
- Shen Q, Li J, Zhang C, Wang P, Mohammed A, Ni S, Tang Z. Panax notoginseng saponins reduce high-risk factors for thrombosis through peroxisome proliferator-activated receptor -y pathway. Biomed Pharmacother. 2017 Dec;96:1163-69.
- Chen MY, Shao L, Zhang W, et al. Metabolic analysis of Panax notoginseng saponins with gut microbiota-mediated biotransformation by HPLC-DAD-Q-TOF-MS/MS. J Pharm Biomed Anal. 2018;150:199-207.
- Li C, Xu T, Zhou P, et al. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. BMC Complement Altern Med. 2018;18(1):277.
- Yan ST, Gao F, Dong TW, et al. Meta-analysis of randomized controlled trials of Xueshuantong injection in prevention of deep venous thrombosis of lower extremity after orthopedic surgery. Evid Based Complement Alternat Med. 2020 Nov 27;2020:8877791.
- Wang LD, Xu ZM, Liang X, et al. Systematic Review and Meta-Analysis on Randomized Controlled Trials on Efficacy and Safety of Panax Notoginseng Saponins in Treatment of Acute Ischemic Stroke. Evid Based Complement Alternat Med 2021;2021:4694076.
- Liu L, Shen XJ, Xue LJ, Yao SK, Zhu JY. Submucosal hematoma with a wide range of lesions, severe condition and atypical clinical symptoms: A case report. World J Clin Cases 2021;9(20):5683-5688.
- Ikeuchi S, Minamida M, Nakamura T, Konishi M, Kamioka H. Exploratory Systematic Review and Meta-Analysis of Panax Genus Plant Ingestion Evaluation in Exercise Endurance. Nutrients 2022;14(6):1185.
- Zeng L, Li X, Bai G, Liu Y, Lu Q. Rectal administration of Panax notoginseng and Colla Corii Asini suppositories in ulcerative colitis: clinical effect and influence on immune function. Am J Transl Res 2022;14(1):603-611.
- Wang CM, Guo XF, Liu LM, et al. Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients. Chin J Integr Med 2022.
- Wu Y, Wang W, Kou N, et al. Panax Notoginseng Saponins Combined with Dual Antiplatelet Drugs Potentiates Anti-Thrombotic Effect with Alleviated Gastric Injury in A Carotid Artery Thrombosis Rat Model. J Stroke Cerebrovasc Dis 2022;31(8):106597.
- Qian J, Chen W, Wu J, et al. Effects and Mechanism of Action of Panax notoginseng Saponins on the Pharmacokinetics of Warfarin. Eur J Drug Metab Pharmacokinet 2022;47(3):331-342.
- Dai L, Zhang Y, Jiang Y, Chen K. Panax notoginseng preparation plus aspirin versus aspirin alone on platelet aggregation and coagulation in patients with coronary heart disease or ischemic stroke: A meta-analysis of randomized controlled trials. Front Pharmacol 2022;13:1015048.
- Guan P, Gui D, Xu Y. Evaluation on the Efficacy and Safety of Panax Notoginseng Saponins in the Treatment of Stroke among Elderly People: A Systematic Review and Meta-Analysis of 206 Randomized Controlled Trials. Evid Based Complement Alternat Med 2023;2023:4312489.
- Wu L, Song H, Zhang C, et al. Efficacy and Safety of Panax notoginseng Saponins in the Treatment of Adults With Ischemic Stroke in China: A Randomized Clinical Trial. JAMA Netw Open 2023;6(6):e2317574.