A small crossover study used midazolam to examine CYP3A activity after red-ginseng supplementation. It did not find a clinically meaningful interaction under its tested conditions.
Kim and colleagues evaluated 14 healthy male volunteers with a cocktail of drugs used to assess several metabolic enzymes and a transporter. Participants were studied before and after two weeks of the selected red-ginseng product.
Midazolam and its hydroxylated metabolite contributed information about CYP3A activity. The authors described small changes in some enzyme measures but concluded that the observed effects were unlikely to be clinically significant with the studied product and exposure.
Ginseng preparations can differ in processing and constituent content. The researchers discussed differences between fresh and red ginseng and between laboratory experiments and human studies. A finding for this preparation cannot establish the behavior of every supplement marketed under the same plant name.
The sample was small, healthy, and male. The protocol did not establish interaction effects in frail patients, chronic high-dose users, or people with multiple interacting medicines. Metabolic probe results also do not directly measure driving ability or post-procedure recall.
Document supplements by preparation and timing rather than assuming a substantial interaction from a product category alone. Conversely, this limited negative result should not be converted into proof that supplements can never affect benzodiazepine exposure.
Original analysis of the supplied paper: Effect of Red Ginseng on cytochrome P450 and P glycoprotein activities in healthy volunteers. Paper identifier: PMC5052446.