Drug information of Ginkgo biloba

Ginkgo biloba

Drug group: medicinal herbs

Ginkgo Biloba has been used in alternative medicine as a possibly effective aid in improving mental function or treating anxiety, dementia, leg pain caused by blood circulation problems, premenstrual symptoms, vision problems caused by glaucoma or diabetes, vertigo (dizziness), or a movement disorder (tardive dyskinesia) caused by taking certain antipsychotic drugs.

Mechanism of effect

Ginkgoflavone glycosides: reduce capillary fragility, act as antioxidants

Ginkgolides: inhib. platelet activating factor

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

Pharmacodynamic

The mechanism by which ginkgo biloba is thought to be effective for these conditions appears to be in part through active "ginkgolides" terpenoids and flavinoids that appear to inhibit platelet aggregation, neutrophil degranulation, and the induction of oxygen-free radical production

Pharmacokinetics

Not Available

Drug indications

vertigo , memory loss , glaucoma , Premenstrual Dysphoric Disorder , Dementia , cerebrovascular disorders , age-related macular degeneration

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

Dosage

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

Drug contraindications

surgery , Hypersensitivity to this drug

Hypersensitivity

Avoid prior to surgery: may cause bleeding

Attempting conception

Side effects

Diarrhea , Headache , Seizures , vertigo , palpitations , Restlessness , allergic reactions

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

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Alerts

Bleeding disorders, concurrent seizure threshold lowering drugs, diabetes mellitus, seizure disorder

 seeds & fruit pulp are toxic

May modulate some CYP 450 enzymes but clinical significance unknown, monitor when using concomitant substrates (eg, CYP3A4)

Points of recommendation

Do not use different forms (leaf extract, roasted seeds, tablets, tincture, teas, etc) of Ginkgo Biloba at the same time without medical advice. Using different formulations together increases the risk of an overdose.

Ginkgo Biloba can affect blood-clotting and may increase your risk of bleeding. If you need surgery, dental work, or a medical procedure, stop taking Ginkgo Biloba at least 2 weeks ahead of time.

Pregnancy level

use with caution

Information regarding safety and efficacy in pregnancy and lactation is lacking. Ginkgo should be used with caution during pregnancy, particularly around labor due to risk of prolonged bleeding time .

Breast feeding warning

Information regarding safety and efficacy in pregnancy and lactation is lacking. and should be avoided during lactation.

Drug forms

Eun-haeng, fossil tree, ginko biloba, ginkyo, icho, ityo, Japanese silver apricot, kew tree, maidenhair tree, salisburia, silver apricot

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