Supplements Details

Ginkgo

What other names is Ginkgo known by?

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.

What is Ginkgo?

Ginkgo is an herb. The leaves are generally used to make medicine. However, a few medicines are made from the seed, but these are not well studied.

Is Ginkgo effective?

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...

  • Alzheimer's disease and other forms of dementia.
  • Improving thinking problems caused by old age.
  • Improving thinking in young people.
  • Raynaud's syndrome (a painful response to cold especially in the fingers and toes).
  • Leg pain when walking due to poor blood flow (claudication).
  • Vertigo and dizziness.
  • Premenstrual syndrome (PMS).
  • Improving color vision in people with diabetes.
  • Treating some kinds of eye diseases (glaucoma and eye damage caused by diabetes).

Possibly Ineffective for...

  • Ringing in the ears (tinnitus).
  • Winter depression in people with seasonal affective disorder (SAD).
  • Sexual problems related to antidepressant medicines.
  • Sexual problems in women.
  • Preventing symptoms of mountain or altitude sickness in climbers.

Insufficient Evidence to Rate Effectiveness for...

  • Age-related macular degeneration (AMD), anxiety, attention deficit-hyperactivity disorder (ADHD), blood clots, heart disease, stroke, high cholesterol, "hardening" of the arteries (atherosclerosis), colorectal cancer, ovarian cancer, hearing loss, schizophrenia, and other conditions when the extract is used.
  • Coughs, asthma, bronchitis, urinary problems, cognitive problems related to Lyme disease, digestion disorders, chronic fatigue syndrome (CFS), scabies, and skin sores when the seeds are used.

How does Ginkgo work?

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 the changes in the brain that interfere with thinking.

Ginkgo seeds contain substances that might kill bacteria and fungi which cause infections in the body. The seeds also contain a toxin that can cause side effects like seizure and loss of consciousness.

Are there safety concerns?

Ginkgo is safe for most people when used appropriately. 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 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.

Some research suggests that a specific combination of ginkgo leaf extract plus American ginseng might be safe in children when used short-term.

Ginkgo seeds might not be safe. Long-term use or use of medicinal amounts can cause serious side effects including stomachache, nausea, diarrhea, vomiting, restlessness, difficulty breathing, weak pulse, shock, seizures, loss of consciousness, and death.

Do not take ginkgo if:

  • You are pregnant or breast-feeding.
  • You are scheduled for surgery in the next two weeks. It might increase the risk of bleeding.
  • You have a bleeding problem.
  • You have seizures, convulsions, or epilepsy.
  • You are trying to get pregnant or father a child.

Are there any interactions with medications?



Efavirenz (Sustiva)
Interaction Rating: Major Do not take this combination.

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 medications for HIV.



Talinolol
Interaction 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.



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.



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).



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.



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 affect how quickly the liver breaks down some medications, and lead to a variety of effects and 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 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.

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



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.



Hydrochlorothiazide
Interaction 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.



Nifedipine
Interaction 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 and cause increased side effects, including headaches, dizziness, and hot flushes. However, when taking nifedipine intravenously (by IV) along with 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.

Dosing considerations for Ginkgo.

The following doses have been studied in scientific research:

BY MOUTH:

  • For dementia syndromes: a dosage of 120-240 mg per day of ginkgo leaf extract, divided in two or three doses.
  • For cognitive function improvement in healthy young people: dosages of 120-600 mg per day.
  • For Raynaud's disease: a dosage of 360 mg per day of ginkgo leaf extract, divided into three doses.
  • For walking pain due to poor circulation (claudication, peripheral vascular disease): a dosage of 120-240 mg per day of ginkgo leaf extract, divided into two or three doses, has been used; however, the higher dose may be more effective.
  • For vertigo: dosages of 120-160 mg per day of ginkgo leaf extract, divided into two or three doses.
  • For premenstrual syndrome (PMS): 80 mg twice daily, starting on the sixteenth day of the menstrual cycle until the fifth day of the next cycle.
  • For the treatment of normal tension glaucoma: ginkgo leaf extract 40 mg 3 times daily up to four weeks.

For all uses, start at a lower dose of not more than 120 mg per day to avoid gastrointestinal (GI) side effects. Increase to higher doses indicated as needed. Dosing may vary depending on the specific formulation used. Most researchers used specific standardized Ginkgo biloba leaf extracts. Some people take 0.5 mL of a standard 1:5 tincture of the crude ginkgo leaf three times daily.

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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