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Ginkgo Biloba

    Brands

    DEA Class; (Herb/Suppl)

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

    • Neurology & Psychiatry, Herbals

    Pharmacology

    Metabolism: N/A

    Excretion: N/A

    Mechanism of Action

    Ginkgoflavone glycosides: reduce capillary fragility, act as antioxidants

    Ginkgolides: inhib. platelet activating factor

    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

    Hypersensitivity

    Avoid prior to surgery: may cause bleeding

    Attempting conception

    • 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

    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 Category: N/A

    Lactation: N/A

    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

    Ginkgo Biloba