Overview

Ginkgo (Ginkgo biloba) is a large tree with fan-shaped leaves. The leaves are commonly included in supplements and taken by mouth for memory problems.

The ginkgo tree is thought to be one of the oldest living trees, dating back more than 200 million years. It is native to China, Japan, and Korea, but is also now grown in Europe and the United States. It seems to improve blood circulation, and might also act as an antioxidant to slow down changes in the brain.

Because ginkgo has been around for so long, people have used it for many purposes. It's commonly taken by mouth for memory and thought problems, anxiety, vision problems, and many other conditions, but there is no good scientific evidence to support most of these uses.

How does it work ?

Uses & Effectiveness ?

Possibly Effective for

  • Anxiety. Taking a specific ginkgo extract called EGb 761 (Dr. Willmar Schwabe Pharmaceuticals) by mouth for 4 weeks can reduce symptoms of anxiety by a small amount.
  • Diseases, such as Alzheimer disease, that interfere with thinking (dementia). Taking ginkgo 240 mg by mouth daily may slightly improve dementia symptoms. Ginkgo doesn't seem to prevent dementia from developing or getting worse.
  • Premenstrual syndrome (PMS). Taking ginkgo leaf extract by mouth seems to relieve breast tenderness and other symptoms associated with PMS. For this use, it is started during the 16th day of the menstrual cycle and continued until the 5th day of the following cycle.
  • Schizophrenia. Taking ginkgo leaf extract by mouth daily in addition to conventional antipsychotic medications for 8-16 weeks can reduce some symptoms of schizophrenia. It might also reduce side effects from antipsychotic medications, like thirst, constipation, and tardive dyskinesia, a movement disorder.
  • Stroke. Taking ginkgo extract by mouth or by IV along with standard therapy seems to improve thinking, memory, and the ability to complete activities of daily living in people who are recovering from a stroke. Taking ginkgo extract by mouth might not be as effective as IV. But IV products can only be given by a healthcare provider.
  • Dizziness (vertigo). Taking ginkgo leaf extract by mouth seems to improve symptoms of dizziness and balance disorders.

Possibly Ineffective for

  • Decline in memory and thinking skills that occurs normally with age. Taking ginkgo by mouth doesn't improve memory and thinking skills in elderly people.
  • Sexual problems caused by antidepressants (antidepressant-induced sexual dysfunction). Taking ginkgo leaf extract by mouth doesn't improve sexual problems caused by antidepressant drugs.
  • Heart disease. Taking ginkgo by mouth doesn't reduce the chance of having a heart attack, chest pain, or stroke in elderly people.
  • Decline in memory and thinking skills in people treated with cancer drugs. Taking gingko by mouth does not prevent thinking problems caused by chemotherapy in people being treated for breast cancer.
  • High blood pressure. Taking ginkgo leaf extract by mouth for up to 6 years does not reduce blood pressure in older people with high blood pressure.
  • Multiple sclerosis (MS). Taking ginkgo leaf extract or ginkgolide B, a specific chemical found in ginkgo extract, by mouth doesn't improve mental function or disability in people with multiple sclerosis.
  • Ringing in the ears (tinnitus). Taking ginkgo leaf extract by mouth does not seem to improve ringing in the ears.
There is interest in using ginkgo for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Ginkgo LEAF EXTRACT is likely safe for most people. It can cause some minor side effects such as stomach upset, headache, dizziness, and allergic skin reactions. There is also some concern that ginkgo leaf extract might increase the risk of bruising and bleeding or cause arrhythmia.

The ROASTED SEED or CRUDE GINKGO PLANT are possibly unsafe when taken by mouth. Eating more than 10 roasted seeds daily can cause serious side effects such as seizures. Eating FRESH SEEDS may lead to death. They are poisonous and considered dangerous.

When applied to the skin: There isn't enough reliable information to know if ginkgo is safe.

Special Precautions and Warnings

Pregnancy: 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.

Breast-feeding: There isn't enough reliable information to know if ginkgo is safe to use when breast-feeding. Stay on the safe side and avoid use.

Children: Ginkgo leaf extract is possibly safe when taken by mouth for a short time. 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. 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.

Cross-reactivity: People who are allergic to poison ivy, poison oak, poison sumac, mango rind, or cashew shell oil might also be allergic to ginkgo.

Diabetes: Ginkgo might interfere with the management of diabetes. If you have diabetes, monitor your blood sugar closely.

Seizures: 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 who 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 the 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.

Interactions ?

    Major Interaction

    Do not take this combination

  • Ibuprofen interacts with GINKGO

    Ginkgo can slow blood clotting. Ibuprofen can also slow blood clotting. Taking ginkgo with ibuprofen can slow blood clotting too much and increase the chance of bruising and bleeding.

  • Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with GINKGO

    Ginkgo can 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), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

  • Warfarin (Coumadin) interacts with GINKGO

    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.

    Moderate Interaction

    Be cautious with this combination

  • Buspirone (BuSpar) interacts with GINKGO

    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) interacts with GINKGO

    Taking ginkgo along with St. John's wort, other herbs 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).

  • Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interacts with GINKGO

    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) interacts with GINKGO

    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.

  • Alprazolam (Xanax) interacts with GINKGO

    Taking Ginkgo along with alprazolam might decrease the effects of alprazolam.

  • Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with GINKGO

    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 change 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 this 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) interacts with GINKGO

    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 change 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) interacts with GINKGO

    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 diabetes (Antidiabetes drugs) interacts with GINKGO

    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) interacts with GINKGO

    Some medications increase the chance of having a seizure. Taking ginkgo might cause seizures in some people. Taking medications that increase the chance of having a seizure along with ginkgo might greatly increase the risk 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 used to prevent seizures (Anticonvulsants) interacts with GINKGO

    Medications used to prevent seizures affect chemicals in the brain. Ginkgo can also affect chemicals in the brain. By affecting chemicals in the brain, ginkgo might 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) interacts with GINKGO

    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).

  • Efavirenz (Sustiva) interacts with GINKGO

    Efavirenz is used to treat HIV infection. Taking efavirenz along with ginkgo extract might decrease the effects of efavirenz. Before taking ginkgo, talk to your healthcare provider if you take medications for HIV.

    Minor Interaction

    Be watchful with this combination

  • Omeprazole (Prilosec) interacts with GINKGO

    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.

  • Hydrochlorothiazide interacts with GINKGO

    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 professional if you take medications for high blood pressure.

Dosing

Ginkgo has most often been used by adults in doses of 60-240 mg by mouth daily for up to 6 months. Dosing might vary depending on the specific formulation used. Products that have been studied the most are often standardized to contain ginkgo leaf extracts. Speak with a healthcare provider to find out what dose might be best for a specific condition.

Keep in mind that quality issues are common with ginkgo products. Lower quality manufacturers might use cheaper ingredients, like rutin and quercetin, instead of ginkgo. These chemicals both occur naturally in ginkgo, so adding them to ginkgo products can make the products look like ginkgo on some tests. But these products would not have the same effects as ginkgo.
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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. © Therapeutic Research Faculty 2018.