Drug & supplement interaction

Ginger + Cilostazol

Cilostazol brand name: Pletal.

Moderate Interaction
The bottom line Moderate

Cilostazol falls into 2 drug categories that Ginger can interact with; the most serious is rated moderate. Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ginger and Cilostazol

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Ginger interacts with whole categories of medication. Cilostazol falls into 2 of those categories, so it can interact with Ginger in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Cilostazol

Cilostazol falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Ginger interacts with.

Ginger may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, research is conflicting.
Laboratory research suggests that ginger inhibits thromboxane synthetase and decreases platelet aggregation. However, this has not been demonstrated unequivocally in humans, with mixed results from clinical trials. Theoretically, excessive amounts of ginger might increase the risk of bleeding when used with anticoagulant/antiplatelet drugs.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep in mind with this combo. Cilostazol already works as an antiplatelet medicine, meaning it makes your platelets a little less sticky to improve blood flow in your legs. Ginger may do something similar in the body, so stacking the two could, in theory, nudge your bleeding risk up a bit. Realistically, that might show up as easier bruising, nosebleeds, bleeding gums, or cuts that take longer to stop.

I'll be honest though, the human evidence here is shaky and mixed. The ginger you cook with or sprinkle in tea is very unlikely to cause a problem. Concentrated ginger supplements are where I'd be more cautious. Before adding one, just run it by your pharmacist or doctor.

References
  1. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 1989;35:183-5. PubMed
  2. Thomson M, Al-Qattan KK, Al-Sawan SM, et al. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475-8. PubMed
  3. Backon J. Ginger as an antiemetic: possible side effects due to its thromboxane synthetase activity. Anaesthesia. 1991;46(8):705-6.. PubMed
  4. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27:391-401. PubMed
  5. Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000;15:139-43.
  6. Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS One. 2015;10(10):e0141119. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Cilostazol also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the deal with cilostazol (Pletal) and ginger. Your liver uses an enzyme called CYP3A4 to help clear cilostazol from your body. Lab studies hint that ginger might nudge that enzyme either way, so in theory it could either slow cilostazol's breakdown (letting it build up) or speed it up (making it less effective). Cilostazol is not a prodrug, so more drug in your system would mean stronger effects.

If levels crept up, you might notice headache, dizziness, a pounding or racing heartbeat, loose stools, or easier bruising. The honest truth is this is based on test-tube and animal data, not real people taking these two together, so I wouldn't lose sleep over a little ginger in your food. Just give your pharmacist a heads-up before starting concentrated ginger supplements.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  2. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  3. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ginger Also Interacts With Other Medications

Ginger has 873 moderate, 133 minor known drug interactions in our database — the Cilostazol one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ginger

Covers the 2,830 medications we’ve checked against Ginger. Pick one to open its full report.

From our Q&A

Questions About Ginger or Cilostazol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ginger or Cilostazol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Cilostazol

This page covers Ginger only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cilostazol page lists 286 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 41 minor.

Open the Cilostazol interaction page

One more smart check

Taking Ginger as Part of a Dietary Supplement Product? Check It for Interactions

We hold 9,640 real supplement products containing Ginger, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ginger. Your product may carry other ingredients that interact with Cilostazol too, on top of Ginger — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ginger and Cilostazol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ginger
Top 5%

#22 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cilostazol
Steady interest

#1,670 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ginger

What is Ginger?

Ginger
  • Nausea and vomiting
  • Motion sickness
  • Morning sickness in pregnancy
  • Digestive upset
  • Menstrual cramps
  • Joint pain and inflammation

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pregnancy, and chemotherapy. It is generally safe in food and supplement amounts for most people, though it may cause mild stomach upset. Talk with your pharmacist or doctor before using ginger supplements, especially if you are pregnant, have a bleeding disorder, or take other medicines.

Read the full Ginger monograph & all interactions
Medication

About Cilostazol

What Is Cilostazol Used For?

Brand name: Pletal

Cilostazol tablets are approved to reduce the symptoms of intermittent claudication (cramping leg pain that comes on during walking due to reduced blood flow in the arteries). The goal is to help you walk farther before pain forces you to stop.

See full Cilostazol drug information
Keep checking

Other Drugs & Ginger

Browse every other medication we’ve checked against Ginger — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
873Moderate
133Minor
1,823No known interaction
Moderate

873 interactions

Showing 60 of 873 moderate interactions — see all 873 on the Ginger page.

Minor

133 interactions

Showing 60 of 133 minor interactions — see all 133 on the Ginger page.

No interaction 1,823 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Ginger and Cilostazol Together: Common Questions

Can you take Ginger with Cilostazol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Ginger and Cilostazol?
Cilostazol belongs to more than one drug category, and Ginger interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Ginger and Cilostazol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.