Drug & supplement interaction

Ginkgo + Glimepiride

Glimepiride brand name: Amaryl.

Moderate Interaction
The bottom line Moderate

Glimepiride falls into 2 drug categories that Ginkgo can interact with; the most serious is rated moderate. Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.

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

Ginkgo and Glimepiride

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

Why Are There 2 Interactions?

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

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Glimepiride

Glimepiride falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Ginkgo interacts with.

Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
In vitro, a specific standardized extract of ginkgo leaf (EGb 761) inhibits CYP2C9 activity . The terpenoid (ginkgolides) and flavonoid (quercetin, kaempferol, etc.) constituents seem to be responsible for this effect. Most ginkgo extracts contain some amount of these constituents. Therefore, other ginkgo leaf extracts might also inhibit the CYP2C9 enzyme. However, clinical research suggests that ginkgo might not have a significant effect on CYP2C9 in humans. Ginkgo does not seem to significantly affect the pharmacokinetics of CYP2C9 substrates diclofenac or tolbutamide.
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 gist with glimepiride and ginkgo. Your liver uses an enzyme called CYP2C9 to clear glimepiride from your body. In test-tube studies, ginkgo can slow that enzyme down a bit. If that happened in a real person, glimepiride could hang around longer and push your blood sugar lower than expected, raising the risk of low blood sugar (shakiness, sweating, dizziness, confusion, or feeling faint).

The reassuring part: this concern comes only from lab work, not from people. Human studies haven't shown ginkgo meaningfully changing how the body handles CYP2C9 drugs. So this is mostly theoretical. Still, since glimepiride already lowers blood sugar, it's smart to mention any ginkgo use to your pharmacist or doctor and keep an eye on your readings.

References
  1. Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. J Altern Complement Med 2005;11:433-9.
  2. Gaudineau C, Beckerman R, Welbourn S, Auclair K. Inhibition of human P450 enzymes by multiple constituents of the Ginkgo biloba extract. Biochem Biophys Res Comm 2004;318:1072–8. PubMed
  3. Mohutsky MA, Anderson GD, Miller JW, Elmer GW. Ginkgo biloba: evaluation of CYP2C9 drug interactions in vitro and in vivo. Am J Ther 2006;13:24-31. PubMed
Moderate

ANTIDIABETES DRUGS

2 of 2

Glimepiride also falls under ANTIDIABETES DRUGS.

Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Ginkgo leaf extract seems to alter insulin secretion and metabolism, and might affect blood glucose levels in people with type 2 diabetes. The effect of ginkgo seems to differ depending on the insulin and treatment status of the patient. In diet-controlled diabetes patients with hyperinsulinemia, taking ginkgo does not seem to significantly affect insulin or blood glucose levels. In patients with hyperinsulinemia who are treated with oral hypoglycemic agents, taking ginkgo seems to decrease insulin levels and increase blood glucose following an oral glucose tolerance test. Researchers speculate that this could be due to ginkgo-enhanced hepatic metabolism of insulin. In patients with pancreatic exhaustion, taking ginkgo seems to stimulate pancreatic beta-cells, resulting in increased insulin and C-peptide levels, but with no significant change in blood glucose levels in response to an oral glucose tolerance test.
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 deal with combining ginkgo and glimepiride. Glimepiride works by pushing your pancreas to release more insulin, which lowers your blood sugar. Ginkgo seems to nudge how your body handles insulin and sugar, but the direction isn't simple. In some people taking oral diabetes pills like glimepiride, ginkgo may actually raise blood sugar a bit, which could make your medication work less well. In others, it may lower it.

This is mostly theoretical and based on limited studies, so I don't want you to panic. But because your sugar control could shift either way, it's worth checking your glucose more closely if you start ginkgo. Watch for signs of low sugar (shakiness, sweating, confusion) or high sugar, and chat with your pharmacist or doctor before adding it.

References
  1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract on pancreatic beta-cell function in response to glucose loading in normal glucose tolerant individuals. J Clin Pharmacol 2000;40:647-54.
  2. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
  3. Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.

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

Ginkgo Also Interacts With Other Medications

Ginkgo has 1 major, 1,264 moderate known drug interactions in our database — the Glimepiride 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 Ginkgo

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

From our Q&A

Questions About Ginkgo or Glimepiride

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ginkgo or Glimepiride, 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 Glimepiride

This page covers Ginkgo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Glimepiride page lists 306 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Siberian Cocklebur (major), Acai (moderate), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 256 moderate · 48 minor.

From our pharmacist’s overview on the Glimepiride page

“Glimepiride (Amaryl) is a sulfonylurea, a diabetes pill that prompts the pancreas to release insulin, so anything that further lowers blood sugar can tip you into hypoglycemia, and that describes most of this list. Of the 306 supplement and herbal ingredients on file, 239 can move blood sugar on their own.”

Reviewed by 2 · Jul 18, 2026

Open the Glimepiride interaction page

One more smart check

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

We hold 4,399 real supplement products containing Ginkgo, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ginkgo. Your product may carry other ingredients that interact with Glimepiride too, on top of Ginkgo — 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 Ginkgo and Glimepiride 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 Ginkgo
Top 5%

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

29 days ago today
Medication Glimepiride
Top half

#729 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 Ginkgo

What is Ginkgo?

Ginkgo
  • Memory and cognitive support
  • Age-related mental decline
  • Circulation problems
  • Tinnitus (ringing in the ears)
  • Dizziness or vertigo

Ginkgo is one of the world's most popular herbal supplements, mostly taken to support memory and circulation. The evidence for these uses is mixed and generally weak, and it is not proven to prevent memory loss or dementia. It is usually well tolerated in healthy adults, but it can thin the blood, so talk to your pharmacist or doctor before using it.

Read the full Ginkgo monograph & all interactions
Medication

About Glimepiride

What Is Glimepiride Used For?

Brand name: Amaryl

Glimepiride tablets are used to improve blood sugar control in adults with type 2 diabetes. It is always used together with a healthy diet and regular exercise — it is not a replacement for those habits.

Glimepiride is not intended for type 1 diabetes or diabetic ketoacidosis (a serious complication where the body produces high levels of blood acids called ketones). It would not be effective in those situations.

See full Glimepiride drug information
Keep checking

Other Drugs & Ginkgo

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

1Major
1,264Moderate
0Minor
1,564No known interaction
Major

1 interaction

Moderate

1,264 interactions

Showing 60 of 1,264 moderate interactions — see all 1,264 on the Ginkgo page.

No interaction 1,564 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 Ginkgo and Glimepiride Together: Common Questions

Can you take Ginkgo with Glimepiride?
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 Ginkgo and Glimepiride?
Glimepiride belongs to more than one drug category, and Ginkgo 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 Ginkgo and Glimepiride 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

Still Have a Question About Glimepiride and Ginkgo?

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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.