Meta Information
ID:ginkgo-biloba
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulant and Antiplatelet Drugs
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo inhibits platelet aggregation, and when combined with blood-thinning medications (e.g., warfarin, clopidogrel, apixaban, aspirin), it significantly increases the risk of serious, uncontrolled bleeding.
Actionable advice:
Avoid taking Ginkgo with any anticoagulant or antiplatelet medication unless explicitly approved by your physician.
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo leaf extract contains ginkgotoxin, which can interfere with GABA neurotransmission and lower the seizure threshold, potentially triggering seizures in individuals with epilepsy.
Actionable advice:
Do not take Ginkgo if you have a history of seizures or epilepsy.
Target id:
/procedure/surgery-elective
Target name:
Elective Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
48
Description:
Ginkgo's significant antiplatelet effect increases the risk of excessive and difficult-to-control bleeding during and after surgical or dental procedures.
Actionable advice:
Stop taking Ginkgo at least 14 days before any scheduled surgery and do not resume until cleared by your surgeon.
Target id:
/class/maois
Target name:
Monoamine Oxidase Inhibitors (MAOIs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo may have weak MAO-inhibiting activity, which could dangerously potentiate the effects of prescribed MAOI medications, leading to a hypertensive crisis or serotonin syndrome.
Actionable advice:
Do not take Ginkgo if you are using an MAOI medication.
Target id:
/intervention/trazodone
Target name:
Trazodone
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
A case report documented a coma in a patient taking both Ginkgo and trazodone, suggesting a potentially severe interaction that enhances sedative effects.
Actionable advice:
Avoid combining Ginkgo with trazodone due to the risk of severe central nervous system depression.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Due to its effects on blood clotting and a lack of safety data, Ginkgo poses a risk of increased bleeding during delivery and its effects on the fetus are unknown.
Actionable advice:
Avoid Ginkgo completely during pregnancy.
Target id:
/intervention/efavirenz
Target name:
Efavirenz
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo has been shown to significantly reduce blood levels of efavirenz, an antiretroviral medication for HIV, which can lead to loss of virologic control and treatment failure.
Actionable advice:
Do not take Ginkgo if you are being treated for HIV with efavirenz.
Target id:
/dietary/ginkgo-seeds
Target name:
Raw or Roasted Ginkgo Seeds
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Unlike standardized leaf extracts, ginkgo seeds contain high concentrations of ginkgotoxin and can cause severe poisoning, leading to seizures, loss of consciousness, or death.
Actionable advice:
Never consume ginkgo seeds; only use standardized leaf extract supplements.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Like prescription blood thinners, NSAIDs (e.g., ibuprofen, naproxen) also have antiplatelet effects. Combining them with Ginkgo increases the risk of gastrointestinal bleeding and bruising.
Actionable advice:
Use extreme caution and consult a doctor before combining Ginkgo with regular NSAID use.
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo may unpredictably affect blood glucose levels and insulin secretion, potentially interfering with the action of diabetes medications and leading to poor glycemic control.
Actionable advice:
If you have diabetes, monitor blood sugar very closely and consult your doctor before using Ginkgo.
Target id:
/class/ssris-snris
Target name:
SSRI & SNRI Antidepressants
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining Ginkgo with SSRIs or SNRIs increases the risk of bleeding, as both agents affect platelet function. A theoretical risk of serotonin syndrome also exists, though it is very rare.
Actionable advice:
Consult your physician before combining Ginkgo with SSRI or SNRI antidepressants due to increased bleeding risk.
Target id:
/class/cyp2c19-substrates
Target name:
CYP2C19 Substrates
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo can induce (speed up) the CYP2C19 enzyme, which accelerates the breakdown of certain drugs (like omeprazole, clopidogrel), reducing their blood levels and effectiveness.
Actionable advice:
Consult a pharmacist if you take medications metabolized by CYP2C19, as their dose may need adjustment.
Target id:
/class/cyp2c9-substrates
Target name:
Drugs Metabolized by CYP2C9
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo may inhibit (slow down) the CYP2C9 enzyme, which can increase the levels of certain drugs (like ibuprofen, losartan), raising the risk of toxicity and side effects.
Actionable advice:
Use caution when combining Ginkgo with drugs metabolized by CYP2C9, especially those with a narrow therapeutic window.
Target id:
/class/anticonvulsants
Target name:
Anticonvulsant Medications
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
By lowering the seizure threshold, Ginkgo may work against the action of anticonvulsant drugs (e.g., valproic acid, carbamazepine), reducing their effectiveness in preventing seizures.
Actionable advice:
Avoid using Ginkgo if you are taking medication to control seizures.
Target id:
/class/herbal-anticoagulants
Target name:
Other Blood-Thinning Supplements
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining Ginkgo with other supplements that have blood-thinning properties (e.g., high-dose fish oil, garlic, ginger, vitamin E) can have an additive effect, increasing the overall risk of bleeding.
Actionable advice:
Avoid combining Ginkgo with other supplements known to thin the blood.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if components of Ginkgo are excreted in breast milk or what effects they may have on a nursing infant.
Actionable advice:
Avoid Ginkgo while breastfeeding due to the lack of safety information.
Target id:
/class/cyp3a4-substrates
Target name:
CYP3A4 Substrates
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Some evidence suggests Ginkgo may induce the CYP3A4 enzyme, potentially accelerating the metabolism of a wide range of medications and slightly reducing their effectiveness.
Actionable advice:
Be aware that Ginkgo could slightly reduce the effectiveness of medications metabolized by CYP3A4.
Target id:
/class/cyp1a2-substrates
Target name:
CYP1A2 Substrates
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo may weakly induce the CYP1A2 enzyme, which could slightly increase the metabolism of substrates like caffeine or theophylline, potentially reducing their effects.
Actionable advice:
Monitor for any minor changes in the effects of medications or substances like caffeine that are metabolized by CYP1A2.
Target id:
/class/p-glycoprotein-substrates
Target name:
P-glycoprotein Substrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Ginkgo may alter the function of the P-glycoprotein drug transporter, which could unpredictably change the absorption and concentration of certain medications like digoxin.
Actionable advice:
Be aware of a potential for altered effects of P-glycoprotein substrate drugs when taking Ginkgo.