Ginkgo + Propranolol Hydrochloride
Propranolol Hydrochloride brand name: Hemangeol.
Propranolol Hydrochloride falls into 3 drug categories that Ginkgo can interact with; the most serious is rated moderate. Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full interaction reportGinkgo and Propranolol Hydrochloride
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Ginkgo interacts with whole categories of medication. Propranolol Hydrochloride falls into 3 of those categories, so it can interact with Ginkgo in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
SEIZURE THRESHOLD LOWERING DRUGS
1 of 3Why this applies to Propranolol Hydrochloride
Propranolol Hydrochloride falls under SEIZURE THRESHOLD LOWERING DRUGS — the group Ginkgo interacts with.
Ginkgo seeds contain ginkgotoxin. Large amounts of ginkgotoxin can cause neurotoxicity and seizure. Ginkgotoxin is present in much larger amounts in ginkgo seeds than leaves. Ginkgo leaf extract contains trace amounts of ginkgotoxin. The amount of ginkgotoxin in ginkgo leaf and leaf extract seems unlikely to cause toxicity. However, there are anecdotal reports of seizure occurring after use of ginkgo leaf both in patients without a history of seizure disorder and in those with previously well-controlled epilepsy.
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.
Here's the thing to know about this pairing. Propranolol is grouped with medicines that can slightly lower the seizure threshold, meaning they may make a seizure a little easier to trigger in rare cases. Ginkgo contains a natural compound called ginkgotoxin that, in large amounts, can also nudge things toward seizures. The worry is that combining the two could add up.
I'd keep this in perspective, though. This is theoretical and based only on scattered anecdotal reports, and ginkgo leaf extract has just trace amounts of that toxin (the seeds are the real concern). Since this propranolol solution is used for infants with hemangiomas, please don't add ginkgo or any supplement without first checking with your child's pharmacist or doctor.
- Gregory PJ. Seizure associated with Ginkgo biloba? Ann Intern Med 2001;134:344.
- Granger AS. Ginkgo biloba precipitating epileptic seizures. Age Ageing 2001;30:523-5. PubMed
- Miwa H, Iijima M, Tanaka S, Mizuno Y. Generalized convulsions after consuming a large amount of gingko nuts. Epilepsia 2001;42:280-1. DOI
- Arenz A, Kelin M, Flehe K, et al. Occurrence of neurotoxic 4'-O-methylpyridoxine in ginkgo biloba leaves, ginkgo medications and Japanese ginkgo food. Planta Med 1996;62:548-51.
- Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol 2005:755-8. PubMed
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
2 of 3Propranolol Hydrochloride also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.
Some clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce CYP2C19 enzymes and potentially decrease levels of drugs metabolized by these enzymes. However, other clinical research shows that taking ginkgo 120 mg twice daily for 12 days has no effect on levels of drugs metabolized by CYP2C19.
Interaction 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..
Here's the gist for propranolol (the Hemangeol solution given to babies for hemangiomas). Ginkgo may speed up a liver enzyme called CYP2C19, which is one pathway that helps break down propranolol. If that happens, your baby's body could clear the medicine a little faster, which in theory might make it work less well on the hemangioma. Propranolol is an active drug, not a prodrug, so faster clearance points toward a weaker effect rather than a stronger one.
Honestly, the evidence here is shaky. One study suggested ginkgo can rev up this enzyme, but another found no effect, so this is mostly theoretical. I wouldn't lose sleep, but since this is a tiny patient, please run any ginkgo use past your pediatrician or pharmacist first.
- Yin OQ, Tomlinson B, Waye MM, et al. Pharmacogenetics and herb-drug interactions: experience with Ginkgo biloba and omeprazole. Pharmacogenetics 2004;14:841-50. PubMed
- Lei, H. P., Wang, G., Wang, L. S., Ou-yang, D. S., Chen, H., Li, Q., Zhang, W., Tan, Z. R., Fan, L., He, Y. J., and Zhou, H. H. Lack of effect of Ginkgo biloba on voriconazole pharmacokinetics in Chinese volunteers identified as CYP2C19 poor and extensiv
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
3 of 3Propranolol Hydrochloride also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
Laboratory research suggests that ginkgo leaf extract can mildly inhibit CYP1A2 enzymes. However, clinical research suggests ginkgo might not affect CYP1A2. Until more is known, use ginkgo cautiously in patients taking drugs metabolized by these enzymes.
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.
Here's the gist for propranolol. Your liver uses an enzyme called CYP1A2 to help clear this medicine out. In a test tube, ginkgo can gently slow that enzyme down, which in theory could let a bit more propranolol build up. If that happened, you might notice slightly stronger beta-blocker effects, like a slower heart rate, lower blood pressure, tiredness, or cold hands and feet.
The reassuring part: actual studies in people suggest ginkgo probably does not meaningfully change CYP1A2, so this is mostly a theoretical concern. Since propranolol oral solution is given to babies for hemangiomas, never add ginkgo or any supplement to their routine without checking first with your pediatrician or pharmacist.
- Gurley BJ, Gardner SF, Hubbard MA. Clinical assessment of potential cytochrome P450-mediated herb-drug interactions. AAPS Ann Mtg & Expo Indianapolis, IN: 2000; Oct 29 - Nov 2:presentation #3460.
- Galluzzi S, Zanetti O, Binetti G, et al. Coma in a patient with Alzheimer's disease taking low dose trazodone and Ginkgo biloba. J Neurol Neurosurg Psychiatry 2000;68:679-80. DOI
- Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Ginkgo Also Interacts With Other Medications
Ginkgo has 1 major, 1,264 moderate known drug interactions in our database — the Propranolol Hydrochloride one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Ginkgo
We haven’t checked that one against Ginkgo yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Ginkgo. Pick one to open its full report.
Questions About Ginkgo or Propranolol Hydrochloride
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 Propranolol Hydrochloride, 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:
- Can I Take Ginkgo With Apixaban (Eliquis) and Atorvastatin? ›
- Does Lisinopril Interact With Ginkgo Biloba? ›
- Supplements for Leg Circulation Safe With Citalopram and Lisinopril ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Propranolol Hydrochloride
This page covers Ginkgo only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Propranolol Hydrochloride page lists 236 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Indian Snakeroot (major) and Tyramine (major).
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 Propranolol Hydrochloride 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:
Where Ginkgo and Propranolol Hydrochloride 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.
#60 of 1,452 supplements looked up here in the last 7 days
#1,045 of 2,830 medications looked up here in the last 7 days
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.
About Ginkgo
What is 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.
About Propranolol (Infantile Hemangioma)
What Is Propranolol (Infantile Hemangioma) Used For?
Brand name: Hemangeol
This intravenous (IV) form of propranolol is used in hospital settings to treat serious, life-threatening heart rhythm problems. It works on several types of abnormal rhythms, including those that happen during anesthesia or are caused by drug toxicity.
Specific uses include fast heart rhythms coming from the upper chambers of the heart (supraventricular tachycardia), dangerous rhythms caused by too much digitalis in the body, and certain fast rhythms triggered by excess stress hormones (catecholamines) during surgery.
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.
No drugs match “”.
1 interaction
1,264 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Diphenhydramine ›
- Aspirin ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Methylphenidate ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Amoxicillin ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Chloroquine ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Penicillin V Potassium ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Amphotericin B ›
- Ampicillin ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Ceftazidime ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
Showing 60 of 1,264 moderate interactions — see all 1,264 on the Ginkgo page.
No interaction 1,564 drugs checked — show the list
We also checked Ginkgo against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Hydroxyurea ›
- Methamphetamine ›
- Sumatriptan ›
- Lisdexamfetamine ›
- Lisinopril ›
- Pregabalin ›
- Azithromycin ›
- Dextroamphetamine ›
- Isotretinoin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Spironolactone ›
- Thyroid Hormone ›
- Factor 7a ›
- Mitomycin ›
- Ezetimibe ›
- Minoxidil ›
- Lenvatinib ›
- Azelaic Acid ›
- Phenylephrine ›
- Hethylphenidate Hcl ›
- Vancomycin ›
- Triptorelin ›
- Bentoquatam ›
- Hydroxychloroquine ›
- Dirithromycin ›
- Pizotifen ›
- Procainamide ›
- Tocainide ›
- Dextrothyroxine ›
- Lomustine ›
- Rocuronium ›
- Hydrochlorothiazide ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Flecainide ›
- Telmisartan ›
- Mitomycin C ›
- Hydrochlorothiazide, Lisinopril ›
- Digitoxin ›
- Chenodiol ›
- Desflurane ›
- Succimer ›
- Gestodene ›
- Niacin (prescription Drug) ›
- Halothane ›
- Caspofungin ›
- Cabergoline ›
Showing the 60 most looked-up of 1,564 medications checked with no known interaction — see the full Ginkgo list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Propranolol Hydrochloride Is Linked to Lower Levels of One Nutrient
Natural Medicines records Propranolol Hydrochloride as a medicine that can lower these. This is not an interaction with Ginkgo — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Propranolol Hydrochloride nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Ginkgo and Propranolol Hydrochloride Together: Common Questions
Can you take Ginkgo with Propranolol Hydrochloride?
Why are there 3 interactions listed for Ginkgo and Propranolol Hydrochloride?
How serious is the Ginkgo and Propranolol Hydrochloride interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Propranolol Hydrochloride 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.