The Who, What, Where, When and Sometimes, Why.

Ginkgo

Ginkgo

What is it?

Ginkgo is a large tree with fan-shaped leaves. Although Ginkgo is a native plant to China, Japan, and Korea, it has been grown in Europe since around 1730 and in the United States since around 1784. The ginkgo tree is thought to be one of the oldest living trees, dating back to more than 200 million years.

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, dizziness, difficulty concentrating, and mood disturbances. Some people use it for leg pain when walking related to poor blood flow (claudication).

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 BCE.

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.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for Ginkgo are as follows:

Possibly Effective for…

  • Anxiety. Research shows that taking a ginkgo extract for 4 weeks can reduce symptoms of anxiety.
  • Dementia related to Alzheimer’s disease, vascular disease or other diseases. Some research shows that taking ginkgo for up to one year slightly improves some symptoms of Alzheimer’s, vascular, or other dementias. Doses of 240 mg per day might work better than doses of 120 mg per day. However, there are concerns that findings from many of these studies may not be reliable. While most research shows that ginkgo helps for symptoms of Alzheimer’s disease and other dementias, there are some conflicting findings. This makes it hard to determine which people might benefit. While ginkgo may help treat the symptoms of various types of dementia, ginkgo does not appear to help prevent dementia from developing. Also, it does not appear to prevent Alzheimer’s related dementia from getting worse.
  • 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). Taking ginkgo together with prescription medications like donepezil or rivastigmine does not appear to be better than taking the medication alone for the symptoms of Alzheimer’s disease.
  • Vision problems in people with diabetes. There is some evidence that taking ginkgo leaf extract by mouth for 6 months can improve color vision in people with retinal damage caused by diabetes.
  • Vision loss related to 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 glaucoma. However, since conflicting research shows that ginkgo does not prevent glaucoma progression when taken for only 4 weeks, it may need to be taken for a longer time in order to see any improvement.
  • Leg pain when walking related 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 for 8-16 weeks can reduce symptoms of schizophrenia. It may also reduce some side effects like thirst and constipation and 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 .) for 12 weeks can reduce the severity of tardive dyskinesia symptoms in people with schizophrenia who are taking antipsychotic drugs.
  • Dizziness (vertigo). Taking ginkgo leaf extract by mouth seems to improve symptoms of dizziness and balance disorders.

Possibly Ineffective for…

  • 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 hyaluronic 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 (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). The effect of ginkgo on symptoms related to ADHD is unclear. There is early evidence that a product containing ginkgo leaf extract and American ginseng might help improve ADHD symptoms such as anxiety, hyperactivity, and impulsiveness in children 3-17 years-old. But other research shows that taking ginkgo extract does not improve ADHD symptoms compared to methylphenidate, a drug used to treat ADHD, in children 6-14 years-old. Also, taking gingko extract along with methylphenidate does not seem to greatly improve parent or teacher reported ADHD symptoms compared to methylphenidate alone in children 6-12 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 (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.
  • Mental function. The effect of gingko leaf extract on mental function and memory in healthy adults is not clear. Some research shows that ginkgo might improve memory, speed of thinking, and attention in healthy adults. But other research shows no benefit. More studies are needed to determine the effect of gingko on mental function in healthy adults.
  • 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 advanced colorectal cancer.
  • Depression. Early research shows that taking a specific ginkgo extract (Harbin HaoBo Pharmaceutical Co., Ltd.) with the antidepressant citalopram might improve depression in the elderly better than taking citalopram alone.
  • Dyslexia. Early research suggests that taking a specific ginkgo leaf extract (EGb 761) for about 30 days might 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 for 84 days 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.
  • Headaches related to migraines. 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 for 6 months is associated with a decreased risk of developing ovarian cancer.
  • Pancreatic cancer. Early research suggests that taking a specific injectable form of 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) for 6 months 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 shows that applying a specific cream product (Radioskin 2, Herbalab di Perazza Massimiliano Company) that contains ginkgo extract and other ingredients along with another product (Radioskin 1, Herbalab di Perazza Massimiliano Company) might improve skin moisture and reduce skin adverse events in breast cancer patients receiving radiation treatments.
  • Blood vessel disorder (Raynaud’s syndrome). Some research suggests that taking ginkgo leaf extract for 10 weeks by mouth might 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) for 4 weeks appears to improve sexual satisfaction in women with sexual dysfunction.
  • Stroke. The effect of ginkgo on recovery in people who have had a stroke caused by blocked blood vessels is not clear. Some evidence suggests that people might improve more after a stroke when treated with ginkgo. However, higher quality 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.
  • Blood clots.
  • Bloody diarrhea.
  • Bronchitis.
  • Chronic fatigue syndrome (CFS).
  • Digestion disorders.
  • “Hardening of the arteries” (atherosclerosis).
  • High cholesterol.
  • Thinking problems related to Lyme disease.
  • Urinary problems.
  • Scabies.
  • Skin sores.
  • Other conditions.

More evidence is needed to rate ginkgo for these uses.

Ginkgo seems to improve blood circulation, which might help the brain, eyes, ears, and legs function better. It may act as an antioxidant to slow down Alzheimer’s disease and interfere with changes in the brain that might cause problems 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 serious side effects like seizures 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, brain, and lungs and excessive bleeding following surgery. Ginkgo leaf extract can cause allergic skin reactions in some people.

Ginkgo LEAF EXTRACT is POSSIBLY SAFE 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 LIKELY UNSAFE when taken by mouth. Fresh seeds are poisonous and are considered dangerous. 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.

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. The fresh seeds have caused seizures and death in children

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.

Infertility: Ginkgo use might interfere with getting pregnant. Discuss your use of ginkgo with your healthcare provider if you are trying to get pregnant.

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.

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.

Atorvastatin (Lipitor)

Interaction 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 (Lipitor). 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 together. 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.

Fluoxetine is used to treat depression and nervousness. 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).

Hydrochlorothiazide

Interaction Rating = Minor Be watchful with this combination.
Talk with your health provider.

Hydrochlorothiazide is used to help decrease swelling and control blood pressure. One person had increased blood pressure when taking hydrochlorothiazide along with ginkgo. Before taking ginkgo, talk to your healthcare provider if you take medications for high blood pressure.

Ibuprofen

Interaction 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. Before taking ginkgo, talk to your healthcare provider if you are taking ibuprofen.

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), 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 of these medications that are changed by the liver include amitriptyline (Elavil), citalopram (Celexa), diazepam (Valium), lansoprazole (Prevacid), omeprazole (Prilosec), phenytoin (Dilantin), warfarin (Coumadin), and many 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 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 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 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), enoxaparin (Lovenox), heparin, indomethacin (Indocin), naproxen (Aleve), apixaban (Eliquis), 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.

Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), levetiracetam (Keppra), and others.

Nifedipine

Interaction Rating = Minor Be watchful with this combination.
Talk with your health provider.

Taking both ginkgo and nifedipine (Procardia, Adalat) by mouth might increase nifedipine levels in the body. This might cause increased side effects of nifedipine, 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 watchful 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.

Risperidone (Risperdal)

Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.

Risperidone is changed and broken down by the liver. Ginkgo might decrease how quickly the liver breaks down risperidone, which might increase the risk of side effects of risperidone such as drowsiness, dizziness, or dry mouth. One case of a prolonged erection has been reported. 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). It’s not clear if this is a big concern since ginkgo does not appear to reduce the effect of simvastatin (Zocor) on cholesterol levels. Until more is known, use cautiously.

Talinolol

Interaction Rating = Major Do not take this combination.

Talinolol is used to lower blood pressure. Taking ginkgo leaf extract multiple times per day might increase levels of talinolol. This might increase the effects and side effects of talinolol. But taking a single dose of ginkgo does not seem to affect talinolol levels.

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 serious bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Herbs and supplements that increase the risk of seizure

Ginkgo seeds contain a chemical that can cause seizures in high doses. People who are already taking supplements that may increase seizure risk might be at greater risk if they also take ginkgo. Seizures after using ginkgo leaf have been reported in people with no history of seizure as well as in people with well-controlled epilepsy or seizure disorders.

It’s best to avoid taking ginkgo with herbs and supplements that can increase the risk of seizure. These herbs and supplements include: butanediol (BD), cedar leaf, Chinese club moss, EDTA, folic acid, gamma butyrolactone (GBL), gamma hydroxybutyrate (GHB), glutamine, huperzine A, hydrazine sulfate, hyssop oil, juniper, L-carnitine, melatonin, rosemary, sage, wormwood, and others.

Herbs and supplements that might slow blood clotting

Using herbs and supplements that slow blood clotting along with ginkgo could increase the risk of bleeding in some people. This is because ginkgo might slow blood clotting. Some other herbs of this type include angelica, clove, danshen, garlic, ginger, Panax ginseng, and others.

Horse chestnut

Horse chestnut extract and ginkgo are both broken down in the liver. Ginkgo might interfere with the breakdown of horse chestnut and increase side effects. One person given injections of both ginkgo extract and horse chestnut extract after surgery had kidney failure possibly due to this interaction.

St. John’s wort

Ginkgo, in combination with buspirone (BuSpar), fluoxetine (Prozac), melatonin, and St. John’s wort might cause manic symptoms like hyperactivity in people with depression. No one knows whether ginkgo alone, or in combination with St. John’s wort, can cause these symptoms.

There are no known interactions with foods.

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.


 

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