Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Ginkgo biloba may cause your body to process tolbutamide more quickly.
What might happen:
When these two medicines are taken together, you may experience symptoms of hyperglycemia (high blood sugar) including pale skin, blurred vision, loss of consciousness, increased thirst, increased urination, or fatigue.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together or if you stop taking ginkgo. Monitor your blood glucose levels closely. If the control of your blood sugar gets worse, or if you develop one or more of the symptoms listed above, contact your doctor.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Uchida S, Yamada H, Li XD, Maruyama S, Ohmori Y, Oki T, Watanabe H, Umegaki K, Ohashi K, Yamada S. Effects of Ginkgo biloba extract on pharmacokinetics and pharmacodynamics of tolbutamide and midazolam in healthy volunteers. J Clin Pharmacol 2006 Nov;46(11):1290-8..