Suggested Dosing
Altitude Sickness, Prevention
Leaf extract: 80 mg PO BID
Cognitive Function
Leaf extract: 120-600 mg/d PO BID
Dementia
Leaf extract: 120-240 mg/d PO div BID-TID
Intermittent Claudication
Leaf extract: 120-240 mg/d PO div BID-TID
Premenstrual Syndrome
Leaf extract: 80 mg PO BID; start on day 16 and continue until day 5 of next cycle
SSRI-induced Sexual Dysfunction
Leaf extract: 60-240 mg PO BID
Vertigo/tinnitus
Leaf extract: 120-160 mg/d PO div BID-TID
Raynaud's Disease
Leaf extract: 360 mg/d PO div TID
Normal Tension Glaucoma
Leaf extract: 40 mg PO TID x 4 weeks
Other Information
Standardized to 24% flavonoids, 6% terpenes
Suggested Uses
Altitude sickness (prevention), cerebral vascular insufficiency, cognitive disorders, dementia, dizziness/vertigo, intermittent claudication, macular degeneration/glaucoma, memory loss, premenstrual syndrome, SSRI-induced sexual dysfunction, vasodilator
Efficacy
Documented incr in cerbral blood flow (greater effect in patients >50 years old)
Documented increase in peripheral blood flow in diabetes, intermittent claudication, hearing loss
Studies underway for SSRI-induced erectile dysfunction; initial results positive
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (71)
- aceclofenac
aceclofenac and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- acemetacin
acemetacin and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- agrimony
agrimony and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- alfalfa
alfalfa and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- alteplase
alteplase and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- American ginseng
American ginseng and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- antithrombin alfa
antithrombin alfa and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- antithrombin III
antithrombin III and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- argatroban
argatroban and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- aspirin
aspirin and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- aspirin rectal
aspirin rectal and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- bemiparin
bemiparin and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- bivalirudin
bivalirudin and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- celecoxib
celecoxib and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- choline magnesium trisalicylate
choline magnesium trisalicylate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- cinnamon
cinnamon and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- cordyceps
cordyceps and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- dabigatran
dabigatran and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- dalteparin
dalteparin and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- diclofenac
diclofenac and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- diflunisal
diflunisal and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- dong quai
dong quai and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- enoxaparin
enoxaparin and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- epoprostenol
epoprostenol and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- etodolac
etodolac and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- fennel
fennel and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- fenoprofen
fenoprofen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- feverfew
feverfew and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- flibanserin
ginkgo biloba will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
- flurbiprofen
flurbiprofen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- fondaparinux
fondaparinux and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- forskolin
forskolin and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- garlic
garlic and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- ginger
ginger and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- heparin
heparin and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- horse chestnut seed
ginkgo biloba and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
- ibuprofen
ibuprofen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- ibuprofen IV
ibuprofen IV and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- indomethacin
indomethacin and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- ketoprofen
ketoprofen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- ketorolac
ketorolac and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- ketorolac intranasal
ketorolac intranasal and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- lomitapide
ginkgo biloba increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
- lornoxicam
lornoxicam and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- meclofenamate
meclofenamate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- mefenamic acid
mefenamic acid and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- meloxicam
meloxicam and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- mistletoe
ginkgo biloba increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nabumetone
nabumetone and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- naproxen
naproxen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- nettle
ginkgo biloba increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxaprozin
oxaprozin and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- panax ginseng
ginkgo biloba and panax ginseng both increase anticoagulation. Use Caution/Monitor.
- parecoxib
parecoxib and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- pau d'arco
ginkgo biloba and pau d'arco both increase anticoagulation. Use Caution/Monitor.
- phenindione
phenindione and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- phytoestrogens
ginkgo biloba and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
- piroxicam
piroxicam and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- protamine
protamine and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- reishi
ginkgo biloba and reishi both increase anticoagulation. Use Caution/Monitor.
- reteplase
reteplase and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- salicylates (non-asa)
salicylates (non-asa) and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- salsalate
salsalate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- Siberian ginseng
ginkgo biloba and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
- sulfasalazine
sulfasalazine and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- sulindac
sulindac and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- tenecteplase
tenecteplase and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- tolfenamic acid
tolfenamic acid and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- tolmetin
tolmetin and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- vitamin K1 (phytonadione)
ginkgo biloba increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (13)
- abciximab
ginkgo biloba, abciximab. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- anagrelide
ginkgo biloba, anagrelide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- anamu
anamu and ginkgo biloba both increase anticoagulation. Minor/Significance Unknown.
- cilostazol
ginkgo biloba, cilostazol. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- clopidogrel
ginkgo biloba, clopidogrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- danshen
danshen and ginkgo biloba both increase anticoagulation. Minor/Significance Unknown.
- devil's claw
devil's claw and ginkgo biloba both increase anticoagulation. Minor/Significance Unknown.
- dipyridamole
ginkgo biloba, dipyridamole. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- eptifibatide
ginkgo biloba, eptifibatide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- green tea
green tea, ginkgo biloba. Other (see comment). Minor/Significance Unknown. Comment: Use caution when combining green tea with herbs that exhibit antiplatelet effects or anticoagulant activity.
- prasugrel
ginkgo biloba, prasugrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- ticlopidine
ginkgo biloba, ticlopidine. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- tirofiban
ginkgo biloba, tirofiban. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
Adverse Effects
Frequency Not Defined
Allergic skin reactions
Bleeding disorders
Constipation
Contact dermatitis (topical use)
Diarrhea
Dizziness
Impaired fertility
GI upset
Headache
Nausea/vomiting
Palpitations
Restlessness
Seizures
Subdural hematoma
Weakness
Vertigo (rare)
Case reports of sponataneous bleeding from iris when used with aspirin
Warnings
Contraindications
Hypersensitivity
Avoid prior to surgery: may cause bleeding
Attempting conception
Cautions
Bleeding disorders, concurrent seizure threshold lowering drugs, diabetes mellitus, seizure disorder
WARNING: seeds & fruit pulp are toxic
May modulate some CYP 450 enzymes but clinical significance unknown, monitor when using concomitant substrates (eg, CYP3A4)
Pregnancy & Lactation
Pregnancy Category: N/A
Lactation: N/A
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Metabolism: N/A
Excretion: N/A
Mechanism of Action
Ginkgoflavone glycosides: reduce capillary fragility, act as antioxidants
Ginkgolides: inhib. platelet activating factor