Drug Interaction Report

Ginkgo and Dalteparin Injection: Interaction Details

A pharmacist-reviewed analysis of the Ginkgo and Dalteparin Injection interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dalteparin Injection

Fragmin Fragmin®
+

Ginkgo

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 70 documented Ginkgo interactions, 54 are rated moderate — including this one.
Onset
delayed
Evidence
theoretical
Severity
Moderate

What happens

An increased risk of bleeding

Interaction Deep Dive

Theoretically, concomitant use of Ginkgo and low molecular weight heparin (LMWH) may increase the risk of bleeding complications. A 78-year-old patient developed left parietal hemorrhage after two months of therapy with the combination of warfarin and Ginkgo1. A case of spontaneous hyphema has been reported following concomitant use of aspirin and Ginkgo 2. Cases of subarachnoid hemorrhage, subdural hematoma, intracerebral hemorrhage, and postoperative bleeding have been reported in patients taking Ginkgo alone 345678. Ginkgolide B has been shown to inhibit PAF-induced platelet aggregation 910. Patients taking medications which affect platelet aggregation or blood coagulation may be at increased risk for potentially serious bleeding disorders. Until this potential interaction is better characterized, concomitant use of Gingko and LMWH should be avoided.

Why it happens (mechanism)

Ginkgolide B may inhibit platelet activating factor (PAF) induced platelet aggregation

Common questions

Can I take Ginkgo and Dalteparin Injection together?

An increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.

How serious is the Ginkgo and Dalteparin Injection interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Ginkgo or Dalteparin Injection need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (10)

  1. Matthews MK: Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998; 50:1933-1934.
  2. Rosenblatt M & Mindel J: Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997; 336:1108.
  3. Benjamin J, Muir T, Briggs K, et al: A case of cerebral haemorrhage - can Ginkgo biloba be implicated?. Postgrad Med J 2001; 77(904):112-113.
  4. Fessenden JM, Wittenborn W, & Clarke L: Ginkgo biloba: A case report of herbal medicine and bleeding postoperatively from a laparoscopic cholescystectomy. Am Surg 2001; 67(1):33-35.
  5. Norred CL & Finlayson CA: Hemorrhage after the preoperative use of complementary and alternative medicines. AANA J 2000; 68:217-220.
  6. Vale S: Subarachnoid hemorrhage associated with Ginkgo biloba. Lancet 1998; 352:36.
  7. Lewis SL & Rowin J: Ginkgo biloba. Neurology 1997; 48:1137.
  8. Rowin J & Lewis SL: Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology 1996; 46:1775-1776. PubMed
  9. Wilkens JH, Wilkens H, Uffmann J, et al: Effects of a PAF-antagonist (BN 52063) on bronchoconstriction and platelet activation during exercise induced asthma. Br J Clin Pharmac 1990; 29:85-91. DOI
  10. Chung KF, McCusker M, Page CP, et al: Effect of a ginkgolide mixture (BN 52063) in antagonizing skin and platelet responses to platelet activating factor in man. Lancet 1987; 1:248-251.
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