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Overview: Notoginseng is a plant called Panax notoginseng. It is also known as sanqi. Its root has a long history of use in traditional Chinese medicine, mostly to stop bleeding and to support the heart and blood vessels. People take notoginseng for heart and blood vessel problems, bleeding and bruising, blood sugar, and pain from injuries, but these benefits are not well defined. It seems to be well tolerated. The most common side effects include headache, nausea, upset stomach, dizziness, and skin rash. Before taking notoginseng, make sure to tell your health care provider about any health conditions you have or medicines you are taking, especially blood thinners.

Uses

What is notoginseng used for?

Notoginseng (Panax notoginseng) is a plant. Its root has a long history of traditional use in Chinese medicine, where it is used to stop bleeding, improve blood flow, and ease pain. It is used for the following, though evidence in humans is limited, and these benefits are not well defined.

Heart and Blood Vessel (Cardiovascular) Problems. Notoginseng is used to help with chest pain (angina), stroke recovery, poor blood flow, high blood pressure, and hardening of the arteries.

Bleeding, Bruising, and Wound Healing. In traditional use, notoginseng is taken to slow bleeding and help heal bruises and injuries.

Blood Sugar and Diabetes-Related Blood Vessel Problems. Notoginseng and its chemicals are studied for their possible effect on blood sugar levels and blood vessel damage linked to diabetes.

Pain and Swelling From Injuries. Notoginseng is used to help with pain, swelling, and bruising after an injury.

Notoginseng is also used for other purposes, such as supporting the immune system and general wellness. The benefits of notoginseng for these and other uses are not well defined.

Note: The FDA has not reviewed notoginseng for safety and effectiveness. Learn more about dietary supplements here.

How does notoginseng work (mechanism of action)?

Notoginseng comes from a plant called Panax notoginseng, also known as sanqi or tianqi. It is related to Asian ginseng (Panax ginseng) and American ginseng (Panax quinquefolius), but it is not the same plant. Even though the names are similar, these are different products with different effects, so do not confuse them.

The root is the main part used to make supplements, although the leaves and flowers are also sometimes used. The root can be used raw or after it has been steamed, and the two forms are used for different traditional purposes.

Notoginseng root naturally contains many chemicals. The ones studied most are a large group called saponins, which include notoginsenosides and ginsenosides. The root also contains a chemical called dencichine, along with flavonoids and large sugar molecules called polysaccharides.

Notoginseng seems to have two opposite effects on the blood. In laboratory and animal research, a chemical called dencichine and a saponin called 20(S)-panaxadiol appear to help the blood clot and slow bleeding. At the same time, in laboratory and animal research, some of the saponins appear to make the blood less likely to clot. This is one reason its effects on the body are hard to predict. In laboratory and animal research, the saponins also appear to relax and protect blood vessels and lower inflammation and oxidative stress (damage to cells).

In human studies, ginseng (the plant group that notoginseng belongs to) lowered fasting blood sugar by a small amount. When the saponins are swallowed, they are not absorbed well on their own. Bacteria in the gut change them into other substances that the body may absorb more easily, and this may affect how notoginseng works.

The benefits of notoginseng are not well defined. Most of what is known comes from traditional use and laboratory or animal research. Many of the human studies used injectable notoginseng products given in hospitals in China, which are not the same as the oral supplements sold in stores.

Herbal products, such as notoginseng, naturally contain many different chemicals. The amounts of each chemical in a specific notoginseng product may vary. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the product you are using.

How should I store notoginseng?

You should store notoginseng according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of notoginseng?

The most common side effects of notoginseng are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Nausea or vomiting
  • Upset stomach
  • Dizziness
  • Skin rash

There may be other side effects of notoginseng that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of notoginseng?

While less common, the most serious side effects of notoginseng are described below, along with what to do if they happen.

Severe Allergic Reactions. Notoginseng may cause allergic reactions, which can be serious. Serious allergic reactions, including a life-threatening reaction called anaphylaxis, have been reported mainly with injectable notoginseng products used in hospitals in China, not with the supplements sold in stores. Stop taking notoginseng and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Increased Bleeding or Bruising. Notoginseng can affect how your blood clots. This may raise the risk of bleeding, especially if you take a blood thinner or have a bleeding problem. Stop taking notoginseng and contact your health care provider right away if you have any of the following signs of a bleeding problem.

  • Bleeding that does not stop
  • Easy bruising or bruises with no clear cause
  • Nosebleeds or bleeding gums
  • Pink, red, or brown urine
  • Red, black, or tarry stools
  • Coughing up or vomiting blood or vomit that looks like coffee grounds
  • Unusual tiredness, weakness, or dizziness

Warnings & Precautions

Who should not use notoginseng?

Allergies to Ingredients. People who are allergic to any of the following should not take notoginseng.

  • Notoginseng
  • Panax notoginseng
  • Radix notoginseng
  • Sanchi
  • Sanqi
  • Tianqi
  • Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific notoginseng products they stock.

What should I know about notoginseng before using it?

Notoginseng is a dietary supplement. It cannot be marketed to treat or cure a disease.

Notoginseng is available in many forms. Common forms include dried root powder, capsules, tablets, teas, and liquid extracts (tinctures). In China, notoginseng is also made into injectable products that are given in hospitals, but those are not the same as the supplements sold in stores. Read and follow the directions on the specific product you are taking, or take it as recommended by your health care provider.

Do not confuse notoginseng with other plants that have similar names, such as Asian ginseng (Panax ginseng) and American ginseng (Panax quinquefolius). These are not the same plant as notoginseng, and they may have different effects. Check the label for the scientific name Panax notoginseng to be sure you have the right product.

If you use a powder, follow the label for how to measure a dose; it is usually by a scoop or by weight in grams. If you use a liquid extract or tincture, follow the label for how to measure a dose; it is usually with the dropper provided.

Keep notoginseng out of the reach of children.

Herbal products, such as notoginseng, naturally contain many different chemicals. The amount of each chemical in a specific notoginseng product can change for many reasons, including the area where the plant was grown, the weather during growth, the time of year when it was harvested, and the way that the plant was processed after it was harvested. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

The FDA has not tested notoginseng products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using notoginseng?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if notoginseng is right for you.

In particular, make sure that you discuss any of the following.

Bleeding Problems or Upcoming Surgery. Notoginseng can affect how your blood clots. If you have a bleeding problem or are going to have a surgery or dental procedure, talk to your health care provider before using notoginseng. You may need to stop taking it beforehand.

Diabetes and Blood Sugar. In human studies, ginseng (the plant group that notoginseng belongs to) lowered fasting blood sugar by a small amount. It is not known how much notoginseng itself changes blood sugar levels in people. If you have diabetes or take medicine to control your blood sugar, talk to your health care provider before using notoginseng and watch your blood sugar levels closely.

Other Medicines and Supplements. Before taking notoginseng, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how notoginseng could affect pregnancy or harm a fetus. There is not enough reliable information to know if notoginseng is safe to use during pregnancy. For this reason, pregnant women should not use notoginseng unless a health care provider says otherwise. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if notoginseng passes into breast milk. There is not enough reliable information to know if notoginseng is safe to use while breastfeeding. For this reason, women who are breastfeeding should not use notoginseng unless a health care provider says otherwise. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does notoginseng interact with foods or drinks?

There are no known interactions between notoginseng and foods or drinks.

It is unknown if drinking alcohol will affect notoginseng.

Does notoginseng interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using so they can watch for any potential interactions.

Research suggests that notoginseng may change how well some medicines work and may affect how well your blood clots.

If you take a blood thinner, such as warfarin, which is a medicine used to treat or prevent blood clots, or an antiplatelet medicine, such as aspirin or clopidogrel, which is a medicine used to prevent blood clots, talk to your health care provider before using notoginseng. Some research suggests notoginseng may make warfarin less effective, which could raise the risk of a blood clot. You may need closer monitoring, such as blood tests to check how fast your blood clots.

Notoginseng may also change the way the body breaks down some medicines, which could change how those medicines work.

In human studies, ginseng (the plant group that notoginseng belongs to) may have a small effect on blood sugar levels. If you take medicine to control your blood sugar, talk to your health care provider before using notoginseng, because it may affect your blood sugar levels.

The interactions between notoginseng and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with notoginseng is incomplete. Always check with your health care provider before taking notoginseng with any medicines.

Overdose/Missed Dose

What should I do if I accidentally use too much notoginseng?

If you or someone else has used too much notoginseng, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Notoginseng is available as dried root powder, capsules, tablets, teas, and liquid extracts (tinctures). Because notoginseng can affect how your blood clots, taking too much may raise the risk of bleeding or other problems. Read the product label closely, and speak with a health care provider about how to use notoginseng safely. Do not take double or extra doses, even if you miss a dose.