- What other names is Ginkgo known by?
- What is Ginkgo?
- Is Ginkgo effective?
- How does Ginkgo work?
- Are there safety concerns?
- Are there any interactions with medications?
- Dosing considerations for Ginkgo.
Abricot Argenté Japonais, Adiantifolia, Arbre aux Écus, Arbre aux Quarante Écus, Arbre du Ciel, Arbre Fossile, Bai Guo Ye, Baiguo, Extrait de Feuille de Ginkgo, Extrait de Ginkgo, Fossil Tree, Ginkgo biloba, Ginkgo Biloba Leaf, Ginkgo Extract, Ginkgo Folium, Ginkgo Leaf Extact, Ginkgo Seed, Graine de Ginkgo, Herba Ginkgo Biloba, Japanese Silver Apricot, Kew Tree, Maidenhair Tree, Noyer du Japon, Pei Go Su Ye, Salisburia Adiantifolia, Yen Xing, Yinhsing.
Ginkgo is a large tree with fan-shaped leaves. Although Ginkgo is native parts of Asia, including China, Japan, and Korea, it has been grown in Europe since around 1730 and in the United States since around 1784.
Ginkgo leaf is often taken by mouth for memory disorders including Alzheimer's disease. It is also used for conditions that seem to be due to reduced blood flow in the brain, especially in older people. These conditions include memory loss, headache, ringing in the ears, vertigo, dizziness, difficulty concentrating, mood disturbances, and hearing disorders. Some people use it for other problems related to poor blood flow in the body, including leg pain when walking (claudication), and Raynaud's syndrome (a painful response to cold, especially in the fingers and toes).
Ginkgo been used for eye problems including glaucoma, diabetic eye disease, and age-related macular degeneration (AMD), as well as attention deficit-hyperactivity disorder (ADHD), autism, heart disease and heart complications, high cholesterol, premenstrual syndrome (PMS), and bloody diarrhea. Ginkgo leaf is also taken by mouth for chronic fatigue syndrome (CFS), schizophrenia, and to prevent winter depression, preventing mountain sickness and aging, controlling stomach acid, improving liver and gallbladder function, and controlling blood pressure. It is also taken by mouth to treat asthma, allergies, bronchitis, and for disorders of the central nervous system.
The list of other uses of ginkgo is very long. This may be because this herb has been around for so long. Ginkgo biloba is one of the longest living tree species in the world. Ginkgo trees can live as long as a thousand years. Using ginkgo for asthma and bronchitis was described in 2600 BC.
In manufacturing, ginkgo leaf extract is used in cosmetics. In foods, roasted ginkgo seed, which has the pulp removed, is an edible delicacy in Japan and China.
There is some scientific evidence that ginkgo can slow the loss of memory and social skills in people with Alzheimer's disease. Ginkgo might also help normal memory loss in older people and can possibly sharpen the thinking skills of younger people.
Ginkgo might also help people who experience leg pain when they walk due to poor bloodflow. Ginkgo seems to be able to help people with this condition walk farther before the pain starts. It might also help people with balance problems, ease some of the symptoms of premenstrual syndrome (PMS) (especially breast tenderness), improve distance vision in people with macular degeneration, improve color vision in people with diabetes, and reverse the sexual side effects of certain medications for depression (such as Prozac, Paxil, Zoloft, etc.).
There isn't enough information to know if ginkgo leaf is effective for the other conditions people use it for, including: attention deficit-hyperactivity disorder (ADHD), blood clots, heart disease, high cholesterol, “hardening” of the arteries, depression, mountain sickness, and others.
Possibly Effective for...
- Anxiety. Research shows that taking a specific ginkgo extract (EGb 761, Dr. Willmar Schwabe Pharmaceuticals) for 4 weeks can reduce symptoms of anxiety.
- Mental function. Although some conflicting evidence exists, most research suggests that ginkgo can slightly improve memory, speed of thinking, and attention in healthy adults. Doses of 120-240 mg per day seem to be as effective as or more effective than higher doses up to 600 mg per day. Some research has investigated the effects of ginkgo when used with other supplements. Some evidence suggests that taking ginkgo in combination with Panax ginseng or codonopsis can improve memory better than the individual ingredients alone. However, a specific combination of ginkgo and Panax ginseng (Gincosan, Pharmaton Natural Health Products) does not seem to improve mood or thinking in postmenopausal women. Also, taking a specific product containing ginkgo and brahmi (Blackmores Ginkgo Brahmi) does not seem to improve memory or problem solving in healthy adults.
- Dementia. Some evidence shows that taking ginkgo leaf extract by mouth modestly improves symptoms of Alzheimer's, vascular, or mixed dementias. However, there are concerns that findings from many of the early ginkgo studies may not be reliable. Although most clinical trials show ginkgo helps for symptoms of Alzheimer's disease and other dementias, there are some conflicting findings, suggesting it may be hard to determine which people might benefit.
Early research shows that taking a specific ginkgo leaf extract called EGb 761 (Dr. Willmar Schwabe Pharmaceuticals) daily for 22-24 weeks seems to be as effective as the drug donepezil (Aricept) for treating mild to moderate Alzheimer's disease. But, other research suggests that ginkgo leaf extract might be less effective than the conventional drugs donepezil (Aricept) and tacrine (Cognex).
While ginkgo may help treat various types of dementia, ginkgo does not appear to help prevent dementia from developing.
- Vision problems in people with diabetes. There is some evidence that taking ginkgo leaf extract by mouth can improve color vision in people with retinal damage caused by diabetes.
- Vision loss (glaucoma). Taking ginkgo leaf extract by mouth for up to 12.3 years seems to improve pre-existing damage to the visual field in some people with normal tension glaucoma. However, conflicting research shows that ginkgo does not prevent glaucoma progression when taken for only 4 weeks.
- Leg pain when walking due to poor blood flow (peripheral vascular disease). Some evidence shows that taking ginkgo leaf extract increases the distance people with poor blood circulation in their legs can walk without pain. Taking ginkgo might also reduce the chance of requiring surgery. However, people with this condition may need to take ginkgo for at least 24 weeks before they see improvement.
- Premenstrual syndrome (PMS). Taking ginkgo leaf extract by mouth seems to relieve breast tenderness and other symptoms associated with PMS when started during the 16th day of the menstrual cycle and continued until the 5th day of the following cycle.
- Schizophrenia. Research shows that taking ginkgo daily in addition to conventional antipsychotic medications can reduce symptoms of schizophrenia. It may also reduce adverse effects associated with the antipsychotic medication, haloperidol.
- A movement disorder called tardive dyskinesia. Tardive dyskinesia is a movement disorder that is caused by certain antipsychotic drugs. Research shows that taking a specific ginkgo extract (EGb 761, Yi Kang Ning, Yang Zi Jiang Pharmaceuticals Ltd., Jiangsu, China) can reduce the severity of tardive dyskinesia symptoms in people with schizophrenia who are taking antipsychotic drugs.
- Vertigo and dizziness. Taking ginkgo leaf extract by mouth seems to improve symptoms of dizziness and balance disorders.
Possibly Ineffective for...
- Age-related memory loss. Some research suggests that ginkgo leaf extract might slightly improve memory and mental function in people with age-related memory problems. But most evidence shows that taking ginkgo leaf extract by mouth does not improve memory or attention in older people with normal mental function, in those with mild mental problems, or in those with dementia and age-related memory loss. Ginkgo also does not seem to prevent age-related memory loss from developing.
- Sexual dysfunction caused by antidepressant drugs. Although some early research suggests that taking ginkgo leaf extract by mouth might improve sexual problems caused by antidepressant drugs, more recent research suggests it is probably not effective.
- Mental problems caused by chemotherapy. Research shows that taking a specific ginkgo leaf extract called EGb 761 (Dr. Willmar Schwabe Pharmaceuticals) twice daily starting before the second cycle of chemotherapy and continuing until one month after chemotherapy treatment ends does not prevent mental problems caused by the chemotherapy in people being treated for breast cancer.
- High blood pressure. Research shows that taking a specific ginkgo leaf extract (EGb 761) by mouth for up to 6 years does not reduce blood pressure in older people with high blood pressure.
- Multiple sclerosis. Taking ginkgo leaf extract or ginkgolide B, a specific chemical found in ginkgo extract, does not improve mental function or disability in people with multiple sclerosis.
- Seasonal depression (seasonal affective disorder). Taking ginkgo leaf extract by mouth does not seem to prevent winter depression symptoms in people with seasonal depression.
- Ringing in the ears (tinnitus). Taking ginkgo leaf extract by mouth does not seem to improve ringing in the ears.
Likely Ineffective for...
- Heart disease. Taking a specific ginkgo extract (EGb 761, Dr. Willmar Schwabe Pharmaceuticals) does not reduce the chance of having a heart attack, chest pain, or stroke in elderly people.
Insufficient Evidence to Rate Effectiveness for...
- Age-related vison loss (age-related macular degeneration). There is some early evidence that ginkgo leaf extract might improve symptoms and distance vision in people with age-related vision loss.
- Hayfever (allergic rhinitis). Early research shows that applying specific eye drops (Trium, SOOFT) that contain ginkgo extract and hylauronic acid three times daily for one month can reduce eye redness, swelling and discharge in people with swollen eyes due to seasonal allergies.
- Altitude sickness. Research on the effects of ginkgo leaf extract on altitude sickness is inconsistent. Some research suggests that taking ginkgo leaf extract can reduce altitude sickness symptoms when taken 4 days before climbing. However, other research shows that using a specific ginkgo extract (GK501, Pharmaton Natural Health Products) for 1-2 days before climbing does not prevent altitude sickness.
- Asthma. Research shows that taking two capsules of a specific product containing ginkgo extract, ginger, and Picrorhiza kurroa (AKL1, AKL International Ltd) twice daily for 12 weeks does not improve lung function or asthma symptoms in adults with asthma.
- Attention deficit-hyperactivity disorder (ADHD). There is early evidence that a specific combination product (AD-fX, CV Technologies, Canada) containing ginkgo leaf extract, in combination with American ginseng (Panax quinquefolius), might help improve ADHD symptoms such as anxiety, hyperactivity, and impulsiveness in 3 to 17 year-old children. However, other research shows that taking ginkgo extract (Ginko T.D., Tolidaru Pharmaceuticals) does not improve ADHD symptoms compared to methylphenidate, a drug used to treat ADHD, in children 6-14 years-old.
- Autism. Research shows that taking a specific ginkgo extract (Ginko T.D. Tolidaru Pharmaceuticals) daily for 10 weeks along with conventional medication does not improve autism symptoms in children.
- A lung disease called chronic obstructive pulmonary disease (COPD). Research shows that taking a specific product that contains ginkgo extract, ginger, and Picrorhiza kurroa (AKL1, AKL International Ltd) twice daily for 8 weeks does not improve lung function in people with COPD.
- Cocaine addiction. Research suggests that taking a ginkgo leaf extract called EGb 761 twice daily for 10 weeks does not help people with a cocaine addiction.
- Colorectal cancer. Early research suggests that using a specific ginkgo leaf extract (EGb 761, ONC) intravenously (by IV) together with anticancer drugs might benefit people with colorectal cancer.
- Dyslexia. Early research suggests that taking a specific ginkgo leaf extract (EGb 761) can help reduce dyslexia in children aged 5-16 years.
- Fibromyalgia. Early research suggests that taking specific ginkgo leaf extract tablets (Bio- Biloba, Pharma Nord) together with coenzyme Q-10 capsules (Bio Quinone Q10, Pharma Nord) by mouth might increase feelings of wellness and perception of overall health and reduce pain in people with fibromyalgia.
- Stomach cancer. Early research suggests that taking carbohydrates from the outer layer of the ginkgo fruit by mouth twice daily for 30 days might reduce tumor size in people with stomach cancer.
- Hearing loss. There is some early evidence that taking ginkgo might help short-term hearing loss due to unknown causes. However, many of these people recover hearing on their own. It is hard to know if ginkgo has any effect.
- Hemorrhoids. Early research suggests that taking a combination of ginkgo and certain conventional medications might decrease some symptoms of hemorrhoids, including bleeding and pain.
- Migraine. Early research shows that taking ginkgolide B, a chemical found in ginkgo leaf extract, might help prevent migraines in children and women.
- Ovarian cancer. Evidence suggests that using ginkgo leaf extract is associated with a decreased risk of developing ovarian cancer.
- Pancreatic cancer. Early research suggests that taking a specific ginkgo leaf extract (EGb 761) intravenously (by IV) together with anticancer drugs might slow the progression of pancreatic cancer in some people.
- Quality of life. Early evidence suggests that taking ginkgo extract (LI 1370, Lichtwer Pharma) might improve quality of life measures such as activities in daily living, mood, sleep, and alertness in older people.
- Radiation exposure. Early research suggests that taking a specific ginkgo leaf extract (EGb 761, Tanakan Ipsen) might reduce some of the negative effects of radiation on the body.
- Skin toxicity caused by radiation. Early research suggests that applying a specific cream product (Radioskin 2, Herbalab di Perazza Massimiliano Company) that contains ginkgo extract, Aloe vera, and metal esculetina along with another product (Radioskin 1, Herbalab di Perazza Massimiliano Company) might improve skin moisture and reduce toxicity in breast cancer patients receiving radiation treatments.
- Blood vessel disorder (Raynaud's syndrome). Some research suggests that taking ginkgo leaf extract by mouth can decrease the number of painful attacks per week in people with a blood vessel disorder called Raynaud's syndrome. However, other research suggests that ginkgo is not beneficial or is less effective than drugs such as nifedipine.
- Sexual dysfunction. Some research shows that taking ginkgo leaf extract daily for 8 weeks does not improve sexual function in women with sexual arousal disorder. However, taking a specific combination product containing ginkgo, ginseng, damiana, L-arginine, multivitamins, and minerals (ArginMax for Women) appears to improve sexual satisfaction in women with sexual dysfunction.
- Stroke. There is contradictory evidence about the effectiveness of ginkgo for improving recovery in people with strokes caused by a clot. Some evidence suggests that people may improve more after a stroke when treated with ginkgo. However, other research shows no benefit.
- Skin discolorations (Vitiligo). There is some early research that taking a specific ginkgo leaf extract (Ginkgo Plus, Seroyal) might decrease the size and spread of skin lesions.
- High cholesterol.
- "Hardening of the arteries" (atherosclerosis).
- Blood clots.
- Thinking problems related to Lyme disease.
- Chronic fatigue syndrome (CFS).
- Bloody diarrhea.
- Urinary problems.
- Digestion disorders.
- Skin sores.
- Other conditions.
Ginkgo seems to improve blood circulation, which might help the brain, eyes, ears, and legs function better. It may slow down Alzheimer's disease by interfering with changes in the brain that interfere with thinking.
Ginkgo seeds contain substances that might kill the bacteria and fungi that cause infections in the body. The seeds also contain a toxin that can cause side effects like seizure and loss of consciousness.
Ginkgo LEAF EXTRACT is LIKELY SAFE for most people when taken by mouth in appropriate doses. It can cause some minor side effects such as stomach upset, headache, dizziness, constipation, forceful heartbeat, and allergic skin reactions.
There is some concern that ginkgo leaf extract might increase the risk of liver and thyroid cancers. However, this has only occurred in animals given extremely high doses of ginkgo. There is not enough information to know if it could happen in humans.
Ginkgo fruit and pulp can cause severe allergic skin reactions and irritation of mucous membranes. Ginkgo might cause an allergic reaction in people who are allergic to poison ivy, poison oak, poison sumac, mango rind, or cashew shell oil.
There is some concern that ginkgo leaf extract might increase the risk of bruising and bleeding. Ginkgo thins the blood and decreases its ability to form clots. A few people taking ginkgo have had bleeding into the eye and into the brain, and excessive bleeding following surgery. Ginkgo leaf extract can cause allergic skin reactions in some people.
Ginkgo LEAF EXTRACT is POSSIBLY UNSAFE when used intravenously (by IV), short-term. It has been used safely for up to 10 days.
The ROASTED SEED or CRUDE GINKGO PLANT is POSSIBLY UNSAFE when taken by mouth. Eating more than 10 roasted seeds per day can cause difficulty breathing, weak pulse, seizures, loss of consciousness, and shock. The FRESH SEED is even more dangerous. Fresh seeds are poisonous and are LIKELY UNSAFE. Eating fresh ginkgo seeds could cause seizures and death.
There isn't enough reliable information available to know if ginkgo is safe when applied to the skin.
Not enough is known about the safety of ginkgo when applied to the skin to determine if it is safe.
Special Precautions & Warnings:Pregnancy and breast-feeding: Ginkgo is POSSIBLY UNSAFE when taken by mouth during pregnancy. It might cause early labor or extra bleeding during delivery if used near that time. Not enough is known about the safety of using ginkgo during breast-feeding. Do not use ginkgo if you are pregnant or breast-feeding.
Infants and children: Ginkgo leaf extract is POSSIBLY SAFE when taken by mouth for a short time. Some research suggests that a specific combination of ginkgo leaf extract plus American ginseng might be safe in children when used short-term. Do not let children eat the ginkgo seed. It is LIKELY UNSAFE.
Bleeding disorders: Ginkgo might make bleeding disorders worse. If you have a bleeding disorder, don't use ginkgo.
Diabetes: Ginkgo might interfere with the management of diabetes. If you have diabetes, monitor your blood sugar closely.
Seizures: There is a concern that ginkgo might cause seizures. If you have ever had a seizure, don't use ginkgo.
Deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD): Ginkgo might cause severe anemia in people have G6PD enzyme deficiency. Until more is known, use cautiously or avoid using ginkgo if you have G6PD deficiency.
Surgery: Ginkgo might slow blood clotting. It might cause extra bleeding during and after surgery. Stop using ginkgo at least 2 weeks before a scheduled surgery.
TalinololInteraction Rating: Major Do not take this combination.
Taking ginkgo leaf extract multiple times per day might increase levels of talinolol. In theory, this might increase the effects and side effects of talinolol. However, taking a single dose of ginkgo does not seem to affect talinolol levels.
Alprazolam (Xanax)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking ginkgo along with alprazolam might decrease the effects of alprazolam in some people.
AtorvastatinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
The body breaks down atorvastatin to get rid of it. Ginkgo might increase how quickly the body gets rid of atorvastatin. However, it's not clear if this is a big concern. Ginkgo does not appear to influence the effects of atorvastatin on cholesterol levels. Until more is known, use cautiously.
Buspirone (BuSpar)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Ginkgo seems to affect the brain. Buspirone (BuSpar) also affects the brain. One person felt hyper and overexcited when taking ginkgo, buspirone (BuSpar), and other medications. It is unclear if this interaction was caused by ginkgo or the other medications.
Efavirenz (Sustiva)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Efavirenz (Sustiva) is used to treat HIV infection. Taking efavirenz (Sustiva) along with ginkgo extract might decrease the effects of efavirenz (Sustiva). Before taking ginkgo, talk to your healthcare provider if you take efavirenz (Sustiva).
Fluoxetine (Prozac)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking ginkgo along with buspirone (BuSpar), St. John's wort, melatonin, and fluoxetine (Prozac) might cause you to feel irritated, nervous, jittery, and excited. This is called hypomania. It's not known if this is a concern when just ginkgo is taken with fluoxetine (Prozac).
IbuprofenInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Ginkgo might slow blood clotting. Ibuprofen can also slow blood clotting. Taking ginkgo with ibuprofen might slow blood clotting too much and increase the chance of bruising and bleeding.
Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Ginkgo might decrease how quickly the liver breaks down some medications. Taking ginkgo along with some medications that are changed by the liver might increase the effects and side effects of some medications. Before taking ginkgo, talk to your healthcare provider if you take any medications that are changed by the liver.
Some of these medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Ginkgo might increase how quickly the liver breaks down some medications. Taking ginkgo with these medications might decrease how well the medication works. Before taking ginkgo, talk to your healthcare provider if you take any medications that are changed by the liver.
Some of these medications that are changed by the liver include amitriptyline (Elavil), carisoprodol (Soma), citalopram (Celexa), diazepam (Valium), lansoprazole (Prevacid), omeprazole (Prilosec), phenytoin (Dilantin), warfarin (Coumadin), and many others.
Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Ginkgo might decrease how quickly the liver breaks down some medications. Taking ginkgo along with these medications that are changed by the liver might increase the effects and side effects of your medication. Before taking ginkgo, talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), diazepam (Valium), zileuton (Zyflo), celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), warfarin (Coumadin), and others.
Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Ginkgo might decrease how quickly the liver breaks down some medications. Taking ginkgo along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking ginkgo, talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Ginkgo might increase or decrease how quickly the liver breaks down some medications. This might decrease the effectiveness of the medication or increase its side effects. Before taking ginkgo, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some medications changed by the liver include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and others.
Medications for depression (Antidepressant drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Ginkgo might decrease a brain chemical called serotonin. Some medications for depression increase serotonin. Taking ginkgo along with these medications for depression might decrease their effectiveness.
Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and others; and tricyclic and atypical antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.
Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Diabetes medications are used to lower blood sugar. Ginkgo might increase or decrease insulin and blood sugar in people with type 2 diabetes. Taking ginkgo along with diabetes medications might decrease how well your medication works. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications for HIV/AIDS (Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs))Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications used to treat HIV/AIDS are changed and broken down by the liver. Ginkgo might increase how quickly the liver breaks down these medications. This might decrease levels and the effects of these medications. Before taking ginkgo, talk to your healthcare provider if you are taking certain medications for HIV/AIDS that are changed by the liver.
Some medications used for HIV/AIDS that are changed by the liver include delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), and rilpivirine (Edurant).
Medications that increase the chance of having a seizure (Seizure threshold lowering drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications increase the chance of having a seizure. Taking ginkgo might cause seizures in some people. If this combination is taken, it might greatly increase the chance of having a seizure. Do not take ginkgo with medications that increase the chance of having a seizure.
Some medications that increase the chance of having a seizure include anesthesia (propofol, others), antiarrhythmics (mexiletine), antibiotics (amphotericin, penicillin, cephalosporins, imipenem), antidepressants (bupropion, others), antihistamines (cyproheptadine, others), immunosuppressants (cyclosporine), narcotics (fentanyl, others), stimulants (methylphenidate), theophylline, and others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Ginkgo might slow blood clotting. Taking ginkgo along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), and others.
Medications used to prevent seizures (Anticonvulsants)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Medications used to prevent seizures affect chemicals in the brain. Ginkgo can also affect chemicals in the brain in a way that might possibly decrease the effectiveness of medications used to prevent seizures.
Risperidone (Risperdal)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Ginkgo might decrease how quickly the liver breaks down some medications, including risperidone, which might increase the risk of side effects. Before taking ginkgo, talk to your healthcare provider if you are taking risperidone.
Simvastatin (Zocor)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
The body breaks down simvastatin (Zocor) to get rid of it. Ginkgo might increase how quickly the body gets rid of simvastatin (Zocor). However, it's not clear if this is a big concern as it does not appear to reduce the drug's effect on cholesterol levels. Until more is known, use cautiously.
Trazodone (Desyrel)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Trazodone (Desyrel) affects chemicals in the brain. Ginkgo can also affect chemicals in the brain. Taking trazodone (Desyrel) along with ginkgo might cause serious side effects in the brain. One person taking trazodone and ginkgo went into a coma. Do not take ginkgo if you are taking trazodone (Desyrel).
Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Warfarin (Coumadin) is used to slow blood clotting. Ginkgo might also slow blood clotting. Taking ginkgo along with warfarin (Coumadin) might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
HydrochlorothiazideInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.
Hydrochlorothiazide is used to help decrease swelling and control blood pressure. Taking hydrochlorothiazide along with ginkgo might increase blood pressure. Before taking ginkgo, talk to your healthcare provider if you take medications for high blood pressure.
NifedipineInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.
Taking both ginkgo and nifedipine by mouth might increase nifedipine levels in the body. This might cause increased side effects, including headaches, dizziness, and hot flushes. However, taking nifedipine intravenously (by IV) while taking ginkgo by mouth does not seem to have the same effect.
Omeprazole (Prilosec)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Omeprazole (Prilosec) is changed and broken down by the liver. Ginkgo might increase how fast the liver breaks down omeprazole (Prilosec). Taking ginkgo with omeprazole (Prilosec) might decrease how well omeprazole (Prilosec) works.
The following doses have been studied in scientific research:
- For anxiety: 80 mg or 160 mg of a ginkgo leaf extract called EGb 761 has been taken three times per day for 4 weeks.
- For dementia: a dosage of 120-240 mg per day of ginkgo leaf extract (EGb 761), divided in two or three doses.
- For retinal damage caused by diabetes: 120 mg of a ginkgo leaf extract called EGb 761 has been taken daily for 6 months.
- For improving mental function: single doses of 240-600 mg of ginkgo extract have been used. A ginkgo extract called EGb 761 has been taken in a dosage of 120-240 mg per day for 4 weeks to 4 months. A ginkgo leaf extract called LI 1370 has been taken in a dosage of 120-300 mg for two days. Also, a combination product containing ginkgo extract and Panax ginseng (Ginkoba M/E) has been taken in a dosage of 60-360 mg for 12 weeks.
- For walking pain due to poor circulation (claudication, peripheral vascular disease): a dosage of 120-240 mg per day of ginkgo leaf extract (EGb 761), divided into two or three doses, has been used for up to 6.1 years. The higher dose may be more effective.
- For vertigo: 160 mg of a ginkgo leaf extract called EGb 761 has been taken once daily or in two divided doses daily for 3 months.
- For premenstrual syndrome (PMS): 80 mg of a ginkgo leaf extract called EGb 761 has been taken twice daily, starting on the sixteenth day of the menstrual cycle until the fifth day of the next cycle. Also 40 mg of a ginkgo leaf extract called Ginko T.D. has been taken three times daily starting on the sixteenth day of the menstrual cycle until the fifth day of the next cycle.
- For the treatment of glaucoma: 120 to 160 mg of ginkgo leaf extract has been taken in two or three divided doses per day for up to 12.3 years.
- For schizophrenia: 120-360 mg of a ginkgo leaf extract called EGb 761 (Yi Kang Ning, Yang Zi Jiang Pharmaceuticals Ltd., Jiangsu, China) has been used daily for 8-16 weeks.
- For tardive dyskinesia: 80 mg of a ginkgo leaf extract called EGb 761, three times daily for 12 weeks, has been used.
You should avoid crude ginkgo plant parts. These can contain dangerous levels of the toxic chemicals found in the seed of the plant and elsewhere. These chemicals can cause severe allergic reactions.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
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