ginkgo-adverse

Side effects: The side effect profile for GBE is substantially better than that of the synthetic drugs available for the treatment of dementias (tacrine, piracetam, pyritinol, ergot alkaloids, nicergoline, nimodopine). Although similar side effects occur (stomach problems, headache, constipation, allergy, anxiety, sleep disturbance), their incidence is less than 2 % for GBE as compared with over 5% for the other agents.¹⁸ GBE in large doses can be associated with restlessness, nausea, vomiting, diarrhea, and weakness.³

Adverse events: In a review of >70 clinical trials, adverse events occurred in <1% of subjects.¹⁹ One patient in a clinical trial developed a maculopapular rash, which resolved when the subject discontinued ginkgo. Another subject developed bleeding gums.⁹ Additionally, in one study, side effects in the elderly were greater at 240mg/day than at 120mg/day.

Ginkgo has been associated with bleeding disorders and spontaneous subdural hematoma in case reports, ²⁰ but systematic studies have failed to show and effect on bleeding parameters when used for 7 days at recommended doses (120 mg EGb761, b.i.d.). Of note, the 52-week EGb trial of LeBars et al. showed only one case of subdural hematoma in 309 patients, but this event occurred in the placebo group.

Serious allergic skin reactions occur rarely.³

Precautions/contraindications: Ginkgo should be stopped 48 hours prior to surgery. Persons with allergic hypersensitivity should avoid it.³⁰ Ginkgo should not be used in patients with bleeding disorders or in patients with nosebleeds.^6,31 or patients with a history of epilepsy due to anecdotal reports on reduction of seizure threshold with ginkgo. It is also wise to discontinue the use of ginkgo, or any herbal product, within one week of elective surgical procedures.⁶

The potential for ginkgo to interfere with apoptosis and at least one type of anticancer drug indicates that it should be avoided during cancer chemotherapy.

No long-term investigation of safety of GBE in pregnancy or lactation available.⁶

Key Constiuents and Pharmacololgy	History and Traditional Use	Botanical Characteristics
Interactions withHerbs/Drugs/Disease	Adverse Effects/Contraindications	References	Ginkgo-Home

	Ginkgo (Ginkgo biloba)
Adverse Effects/Side Effects/Contraindications
*Side effects: The side effect profile for GBE is substantially better than that of the synthetic drugs available for the treatment of dementias (tacrine, piracetam, pyritinol, ergot alkaloids, nicergoline, nimodopine). Although similar side effects occur (stomach problems, headache, constipation, allergy, anxiety, sleep disturbance), their incidence is less than 2 % for GBE as compared with over 5% for the other agents.¹⁸ GBE in large doses can be associated with restlessness, nausea, vomiting, diarrhea, and weakness.³ Adverse events: In a review of >70 clinical trials, adverse events occurred in <1% of subjects.¹⁹ One patient in a clinical trial developed a maculopapular rash, which resolved when the subject discontinued ginkgo. Another subject developed bleeding gums.⁹ Additionally, in one study, side effects in the elderly were greater at 240mg/day than at 120mg/day. Ginkgo has been associated with bleeding disorders and spontaneous subdural hematoma in case reports, ²⁰ but systematic studies have failed to show and effect on bleeding parameters when used for 7 days at recommended doses (120 mg EGb761, b.i.d.). Of note, the 52-week EGb trial of LeBars et al. showed only one case of subdural hematoma in 309 patients, but this event occurred in the placebo group. Serious allergic skin reactions occur rarely.³ Precautions/contraindications:* Ginkgo should be stopped 48 hours prior to surgery. Persons with allergic hypersensitivity should avoid it.³⁰ Ginkgo should not be used in patients with bleeding disorders or in patients with nosebleeds.^6,31 or patients with a history of epilepsy due to anecdotal reports on reduction of seizure threshold with ginkgo. It is also wise to discontinue the use of ginkgo, or any herbal product, within one week of elective surgical procedures.⁶ The potential for ginkgo to interfere with apoptosis and at least one type of anticancer drug indicates that it should be avoided during cancer chemotherapy. No long-term investigation of safety of GBE in pregnancy or lactation available.⁶

Ginkgo (Ginkgo biloba)