Ginkgo and Nicardipine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nicardipine
Ginkgo
No brand names on record
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.
What happens
Reduced niCARdipine effectiveness
Interaction Deep Dive
Ginkgo biloba extract reduced the hypotensive effect of niCARdipine in rats, suggested to be due to induction of cytochrome P450 (CYP) 3A21. Gingko increased expression of cytochrome P450 enzymes CYP2B1/2, CYP3A1, and CYP3A2 and did not affect CYP1A1, 1A2, 2C11, or 4A1 1. The effect of this interaction in humans is unknown. Caution is advised.
Why it happens (mechanism)
Induction of cytochrome P450 enzymes, specifically CYP3A2, by ginkgo
Literature reports
1 report — tap to read
a) Ginkgo biloba extract (GBE) reduced the hypotensive effect of niCARdipine and increased expression of cytochrome P450 isoenzymes CYP2B1/2, CYP3A1, and CYP3A2 in rats. Rats were fed a control diet with or without GBE 0.5% for 4 weeks, then given niCARdipine 30 milligrams/kilogram orally or intravenously. Four hours after oral niCARdipine administration, control rats had significantly lower systolic and diastolic blood pressure than GBE-fed rats (p less than 0.01). Within 4 minutes of intravenous niCARdipine, GBE-fed rats had significantly higher blood pressure than controls (p less than 0.05). GBE significantly increased liver weight 1.4-fold and P450 content 3-fold at 4 weeks. Levels of CYP2B1/2, CYP3A1, and CYP3A2 were increased in GBE-fed rats versus controls. Levels of CYP1A2, 2C11, 2E1, and 4A1 were unchanged 1.
Common questions
Can I take Ginkgo and Nicardipine together?
Reduced niCARdipine effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ginkgo and Nicardipine 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 Nicardipine 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 (1)
- Shinozuka K, Umegaki K, Kubota Y, et al: Feeding of Ginkgo biloba extract (GBE) enhances gene expression of hepatic cytochrome P-450 and attenuates the hypotensive effect of nicardipine in rats. Life Sci 2002; 70(23):2783-2792. PubMed
Keep reading about Nicardipine
Keep reading about Ginkgo
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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