Drug General Information (ID: DDID2U8M4O)
Drug Name			Dicoumarol		Drug Info		Ginseng		Drug Info
Drug Type		Small molecule				Natural product
Therapeutic Class		Anticoagulants				Herbal Products
Structure

Mechanism of Dicoumarol-Ginseng Interaction (Severity Level: Moderate)
Antagonize the effect of antithrombotic agents Click to Show/Hide Mechanism Graph
Drug Name		Dicoumarol				Ginseng
Mechanism		Vitamin K antagonist				Decrease the hypoprothrombinemic effect of vitamin K antagonist
Key Mechanism Factor 1
		Factor Name		Antithrombotic agents
		Factor Description		The beneficial effects of antithrombotic agents are reduced, leading to an increased risk of thromboembolism, stroke and/or myocardial infarction.
Mechanism Description		Antagonize the effect of Dicoumarol when combined with Ginseng

Recommended Action
Management		Patients should consult a healthcare provider before taking any herbal or alternative medicine. In general, consumption of ginseng supplements and large amounts of ginseng should preferably be avoided during use of warfarin. The same precaution may be applicable during therapy with other oral anticoagulants, although clinical data are lacking.

References
1	Heck AM, DeWitt BA, Lukes AL "Potential interactions between alternative therapies and warfarin." Am J Health Syst Pharm 57 (2000): 1221-7 quiz 1228-30. [PMID: 10902065]
2	Janetzky K, Morreale AP "Probable interaction between warfarin and ginseng." Am J Health Syst Pharm 54 (1997): 692-3. [PMID: 9075501]
3	Vaes LP, Chyka PA "Interactions of warfarin with garlic, ginger, or ginseng: nature of evidence." Ann Pharmacother 34 (2000): 1478-82. [PMID: 11144706]