Ginkgo biloba

Common name: Ginkgo, Maidenhair tree

Family: Ginkgoaceae

Part used: Leaf

Constituents:

Medicinal actions:

Medicinal uses:

Improves brain metabolism of glucose and oxygen while promoting blood flow to the brain, improving memory, concentration, and brain function.
A strong antioxidant effects useful in peripheral vascular disease and restricted blood flow for any reason.
Can inhibit platelet aggregation, relax blood vessels & improve their tone, and can be used topically as an anti-inflammatory.
May be efficacious in the treatment of a wide array of conditions associated with age-related physical and mental deterioration, including Alzheimer’s disease/senile dementia, cardiovascular disease & cerebral vascular insufficiency and impaired cerebral performance

Pharmacy:

Infusion: 1 tbsp/cup, infuse 5 min, TID. (note: terpenes will not be extracted into water)
Standardized Extract: 120-160 mg, QD-BID, standardized to ~24% flavone glycosides and ~6% terpenoid content (e.g. ginkgolides & bilobalide)
Whole herb: 3 -12 g/day, divided
Tincture: (1:5, 40-50%), 2-4 ml TID.
Note: May take 6 weeks to see effects.

Pharmacology:

Flavonoids are antioxidant and protect blood vessels, brain and heart from free radical damage. Increase oxygen and glucose utilization & blood flow, therefore tissue oxygenation and nutriton.
Terpenoids, ginkgolides may be responsible for neuroprotective effects.
Flavonoids are antioxidant and protect blood vessels, brain and heart from free radical damage. They also increase oxygen and glucose utilization & blood flow, therefore improving tissue oxygenation and nutrition. •
Terpenes (Ginkgolides) appear primarily responsible for neuroprotective effects.
Ginkgolide B is a potent anti-inflammatory and platelet-activating factor antagonist and helps suppress cerebral vasospasm.
Extract has demonstrated ability to reduce plasma superoxide dismutase activity (SOD) and protect hippocampal neurons in vitro.

Contraindications:

Use caution with patients on anticoagulant or anti-platelet medication such as warfarin and aspirin, in cases of excessive bleeding, or within 14 days prior to surgery.
Avoid if on anti-convulsants or TCAs and with history of bleeding or seizure disorder.

Toxicity:

Interactions:

*Prolongation of bleeding and/or increased bleeding tendency concern based on anti-platelet activity. Bleeding events associated with Ginkgo alone or in combination with anticoagulants and other drugs have been reported but a causal relationship has not conclusively been established.
Use caution and monitor INR in patients taking anticoagulants such as aspirin, cilostazol, clopidogrel or ticlopidine.
May decrease the effectiveness of drug anticonvulsant medications (e.g. carbamazepine); Increasing the intake of vitamin B6 may be advisable if used concurrently, and may increase risk of seizure when combined with any medication known to lower seizure threshold.
May potentiate the efficiency antipsychotic medications (e.g. haloperidol, olanzapine, clozapine, risperidone) in patients with schizophrenia and may induce hypomania in combination with SSRIs, MAOIs, trazadone, TCAs, buspirone, and St. John’s Wort may increase risk of serotonin syndrome and seizures.
May alter drug levels of some antiretroviral drugs (HIV integrase inhibitors, e.g. raltegravir), benzodiazepines (e.g. alprazolam, diazepam, midazolam.

References:

Find a complete list of references for this monograph as well as images and a review of its evidence based applications in Dr. Marciano’s Herbal Textbook.

Ginkgo 2

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