Ginkgo+ Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Ginkgo+ against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Ginkgo+ is a dietary supplement by NS Natural Stacks with 3 active ingredients. Its ingredients are commonly taken for memory and cognitive support, age-related mental decline, circulation problems.Based on those ingredients, 1,540 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Ginkgo biloba Leaf Extract, Panax ginseng Root Extract, Bacopa monnieri Whole Plant Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Ginkgo+ by NS Natural Stacks
Ask about any prescription or over-the-counter medication and we check it for interactions with Ginkgo+ by NS Natural Stacks — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Ginkgo+ by NS Natural Stacks
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
Ginkgo+ contains 3 active ingredients. Ginkgo biloba leaf extract has been used traditionally to support blood flow and mental clarity.
Panax ginseng root extract is an adaptogenic herb traditionally used to support energy and stamina. Bacopa monnieri whole plant extract is traditionally used for cognitive support.
The capsule also contains cellulose as an inactive ingredient.
Does it work?
Moderate evidence
The evidence we hold shows ginkgo biloba is possibly effective for hearing loss, stroke recovery, schizophrenia, premenstrual syndrome, dementia, and anxiety. Panax ginseng is possibly effective for erectile dysfunction, sexual arousal, influenza, cognitive function, and multiple sclerosis-related fatigue.
For bacopa monnieri, the evidence we hold does not establish effectiveness for any condition—there is insufficient reliable evidence to rate it for Alzheimer disease, sexual dysfunction, ADHD, back pain, cognitive function, or cognitive impairment.
How safe is it?
Well-documented data
Orally, ginkgo leaf extract is generally well tolerated when used for up to 6 years, though it may increase bleeding risk; use with caution. The seed and crude plant contain toxic constituents and should be avoided.
Cardiac arrhythmias have been rarely reported—there are at least 162 international reports, with roughly a third considered serious. Spontaneous bleeding is one of the most concerning potential side effects; most cases involved other bleeding risk factors such as other medications, advanced age, or recent surgery.
Panax ginseng is generally well tolerated short-term but long-term safety is less clear due to possible hormone-like effects; the most common side effect is insomnia. Bacopa monnieri is generally well tolerated in studies, though gastrointestinal side effects (abdominal cramps, diarrhea, nausea) have been reported in roughly 12% to 30% of users.
During pregnancy, ginkgo is rated possibly unsafe and best avoided; Panax ginseng and bacopa monnieri do not have enough safety data and should be avoided. While breastfeeding, safety has not been established for any of the three ingredients, so they should be avoided.
Meds to double-check
Major interaction found
Before taking this product, check with your own doctor or pharmacist if you take blood thinners like warfarin, beta-blockers like talinolol, sedatives like midazolam or alprazolam, antidepressants (especially MAOIs or trazodone), insulin, drugs broken down by liver enzymes (CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4), cholesterol drugs like simvastatin, anticholinergic or cholinergic drugs, or any HIV, Parkinson's, thyroid, or immunosuppressant medications. No interactions are documented for the ingredients we could check only if one truly exists; since all three ingredients have documented interactions, this does not apply here.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This product may be worth considering if you're looking to support cognitive function or energy and don't take medications that interact with ginkgo, ginseng, or bacopa. If you take any blood thinners, heart medications, psychiatric drugs, insulin, or any drug metabolized by the liver, you should double-check with your own doctor or pharmacist before starting.
Pregnant or breastfeeding individuals should avoid this product. Talk it over with your healthcare provider if you're unsure whether it's right for you.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 21, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Ginkgo+, straight from the product label.
| Brand | NS Natural Stacks |
|---|---|
| Barcode (UPC) | 850038130190 |
| Net contents | 60 Vegan Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Apr 21, 2023 |
| DSLD ID | 293798 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years) |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Ginkgo+ by NS Natural Stacks, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Ginkgo biloba Leaf Extract | 125 mg | -- |
| Panax ginseng Root Extract | 200 mg | -- |
| Bacopa monnieri Whole Plant Extract | 200 mg | -- |
Other ingredients: Cellulose
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions
Suggested use: Take 1-2 capsules daily or as recommended by a healthcare practitioner.
Formula
Gingko+ is a synergistic formula of extra-strength ginkgo biloba extract with panax ginseng and bacopa monnieri.
Ginkgo+ 125 mg Ginseng+ 200 mg Bacopa+ 200 mg
Formulation
Research suggests that the natural compounds in ginkgo+ support mental performance and brain health.
Extra-strength brain support
3rd Party Lab Tested
Precautions
Warning: Consult a healthcare practitioner before taking this or any nutritional supplement if you are pregnant/nursing, have or suspect a medical condition (especially diabetes, hypoglycemia, bleeding disorders or, a heart condition), or are taking any medications.
Discontinue use of product two weeks prior to surgery. Do not use if safety seal is broken or missing.
Keep out of reach of children.
Storage
Store in a cool dry place.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Seals/Symbols
Certified Open Source Full label disclosure
U.S.A. manufactured in a cGMP certified facility with globally sourced ingredients.
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Ginkgo+ by NS Natural Stacks label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Ginkgo+ by NS Natural Stacks
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Ginkgo biloba Leaf Extract
Interacts with1,266 drugs
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...
Ginkgo biloba Leaf Extract monograph & interactionsPanax ginseng Root Extract
Interacts with1,130 drugs
Panax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and m...
Panax ginseng Root Extract monograph & interactionsBacopa monnieri Whole Plant Extract
Interacts with930 drugs
Bacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for s...
Bacopa monnieri Whole Plant Extract monograph & interactionsOther (inactive) ingredients: Cellulose. These complete the product’s ingredient list but are not active constituents.
Ginkgo+ by NS Natural Stacks Drug Interactions
HelloPharmacist Interaction Report
Ginkgo+ by NS Natural Stacks contains three active ingredients—ginkgo biloba leaf extract, Panax ginseng root extract, and bacopa monnieri whole plant extract—that together interact with a significant number of medications.
The most serious interaction is ginkgo's effect on talinolol (a beta-blocker), which is rated Major: taking ginkgo with talinolol can raise talinolol blood levels by roughly a third when taken regularly over two weeks, potentially increasing side effects.
Read the full breakdown — every affected drug type, severity by severity
Ginkgo also carries Moderate interactions with blood thinners like warfarin (raising bleeding risk), anti-anxiety drugs like alprazolam (reducing their effectiveness), cholesterol drugs like simvastatin (reducing their effectiveness), antidepressants like trazodone (raising levels and effects), the HIV drug efavirenz (reducing its effectiveness), the diabetes drug rosiglitazone (reducing its effectiveness), and the immunosuppressant tacrolimus (raising its levels). Panax ginseng has Moderate interactions with sedatives like midazolam, drugs broken down by the liver enzyme CYP2D6, water pills like furosemide, mood-stabilizing antidepressants (MAOIs), Parkinson's drugs like selegiline, insulin, the HIV drug raltegravir, and warfarin.
Bacopa monnieri carries Moderate interactions with drugs broken down by liver enzymes CYP1A2, CYP2C19, CYP2C9, and CYP3A4, as well as anticholinergic drugs, cholinergic drugs, and the Sjögren syndrome drug cevimeline; it also has a Minor interaction with thyroid hormone.
Altogether, these interactions span 1,541 individual medications. Because this product contains multiple interacting ingredients, the range of affected drug types is broad.
Check your exact medications with the tool on this page before starting.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Ginkgo+?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Ginkgo+ interact with 1,540 drugs. Click any drug to see the details.
3 of the 3 ingredients in Ginkgo+ interact with drugs. Each result below shows which ingredient is responsible. Ginkgo biloba Leaf Extract Panax ginseng Root Extract Bacopa monnieri Whole Plant Extract
Adalimumab-fkjpHulio
How Adalimumab-fkjp interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Panax Ginseng Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full Panax Ginseng Root Extract + Adalimumab-fkjp interactionAerosphere Budesonide, Formoterol Fumarate, GlycopyrrolateBreztri
How Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Anticholinergic Drugs +1 Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP2C19 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionPanax Ginseng Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Panax Ginseng Root Extract + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionGinkgo Biloba Leaf ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Read the full Ginkgo Biloba Leaf Extract + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionAfatinib DimaleateGilotrif
How Afatinib Dimaleate interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba Leaf Extract + Afatinib Dimaleate interactionAgomelatineValdoxan
How Agomelatine interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
Read the full Ginkgo Biloba Leaf Extract + Agomelatine interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP2C9 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Agomelatine interactionAlbiglutideTanzeum
How Albiglutide interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba Leaf Extract + Albiglutide interactionPanax Ginseng Root ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Panax Ginseng Root Extract + Albiglutide interactionAlefaceptAmevive
How Alefacept interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Panax Ginseng Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full Panax Ginseng Root Extract + Alefacept interactionAlemtuzumabCampath
How Alemtuzumab interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Panax Ginseng Root ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Read the full Panax Ginseng Root Extract + Alemtuzumab interactionAlfentanilAlfenta
How Alfentanil interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Alfentanil interactionGinkgo Biloba Leaf ExtractSeizure Threshold Lowering Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba Leaf Extract + Alfentanil interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Alfentanil interactionAlfuzosinUroxatral
How Alfuzosin interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Alfuzosin interactionPanax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Alfuzosin interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Alfuzosin interactionAliskirenTekturna
How Aliskiren interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Aliskiren interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Aliskiren interactionPanax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Aliskiren interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Almotriptan interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Almotriptan interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba Leaf Extract + Alogliptin interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Alogliptin interactionPanax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with antidiabetes drugs might alter the response to antidiabetes drugs.
Read the full Ginkgo Biloba Leaf Extract + Alogliptin, Metformin interactionPanax Ginseng Root ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Panax Ginseng Root Extract + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractAntidiabetes Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Panax Ginseng Root Extract + Alogliptin, Pioglitazone interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Antidiabetes Drugs Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Alogliptin, Pioglitazone interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Alogliptin, Pioglitazone interactionAlpelisibPiqray
How Alpelisib interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Alpelisib interactionPanax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Alpelisib interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Alpelisib interactionAlprazolamNiravam, Xanax
How Alprazolam interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Alprazolam (xanax) Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Alprazolam interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Alprazolam interactionPanax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Alprazolam interactionAlteplase, TpaActilyse, Activase
How Alteplase, Tpa interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Panax Ginseng Root Extract + Alteplase, Tpa interactionGinkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Alteplase, Tpa interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs, Seizure Threshold Lowering Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionPanax Ginseng Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6.
Read the full Panax Ginseng Root Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Read the full Panax Ginseng Root Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionGinkgo Biloba Leaf ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Read the full Ginkgo Biloba Leaf Extract + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAlvimopanEntereg
How Alvimopan interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractP-glycoprotein Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba Leaf Extract + Alvimopan interactionAmantadineGocovri, Osmolex ER, Symmetrel
How Amantadine interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractAnticholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use might decrease the effectiveness of both agents.
Read the full Bacopa Monnieri Whole Plant Extract + Amantadine interactionAmbenonium ChlorideMytelase
How Ambenonium Chloride interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractCholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.
Read the full Bacopa Monnieri Whole Plant Extract + Ambenonium Chloride interactionPanax Ginseng Root ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Panax Ginseng Root Extract + Ambenonium Chloride interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Read the full Panax Ginseng Root Extract + Ambrisentan interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Ambrisentan interactionGinkgo Biloba Leaf ExtractP-glycoprotein Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
Read the full Ginkgo Biloba Leaf Extract + Ambrisentan interactionAmifampridineRuzurgi
How Amifampridine interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba Leaf Extract + Amifampridine interactionBacopa Monnieri Whole Plant ExtractCholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.
Read the full Bacopa Monnieri Whole Plant Extract + Amifampridine interactionAmifampridine PhosphateFirdapse
How Amifampridine Phosphate interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractCholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.
Read the full Bacopa Monnieri Whole Plant Extract + Amifampridine Phosphate interactionGinkgo Biloba Leaf ExtractSeizure Threshold Lowering Drugs Moderate
Interaction Summary
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
Read the full Ginkgo Biloba Leaf Extract + Amifampridine Phosphate interactionAminoglutethimideCytadren
How Aminoglutethimide interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Bacopa Monnieri Whole Plant ExtractAnticholinergic Drugs Moderate
Interaction Summary
Theoretically, concurrent use might decrease the effectiveness of both agents.
Read the full Bacopa Monnieri Whole Plant Extract + Aminoglutethimide interactionAminophylline, Amobarbital, EphedrineAmesec
How Aminophylline, Amobarbital, Ephedrine interacts with Ginkgo+ — through 2 ingredients. Tap an ingredient for the detail:
Ginkgo Biloba Leaf ExtractAnticonvulsants Moderate
Interaction Summary
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
Read the full Ginkgo Biloba Leaf Extract + Aminophylline, Amobarbital, Ephedrine interactionPanax Ginseng Root ExtractStimulant Drugs Moderate
Interaction Summary
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Read the full Panax Ginseng Root Extract + Aminophylline, Amobarbital, Ephedrine interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractQt Interval-prolonging Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias.
Read the full Panax Ginseng Root Extract + Amiodarone interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Amiodarone interactionGinkgo Biloba Leaf ExtractCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
Read the full Ginkgo Biloba Leaf Extract + Amiodarone interactionAmisulprideBarhemsys
How Amisulpride interacts with Ginkgo+ — through 1 ingredient. Tap an ingredient for the detail:
Panax Ginseng Root ExtractQt Interval-prolonging Drugs Moderate
Interaction Summary
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias.
Read the full Panax Ginseng Root Extract + Amisulpride interactionAmitriptylineElavil
How Amitriptyline interacts with Ginkgo+ — through 3 ingredients. Tap an ingredient for the detail:
Panax Ginseng Root ExtractQt Interval-prolonging Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias.
Read the full Panax Ginseng Root Extract + Amitriptyline interactionGinkgo Biloba Leaf ExtractCytochrome P450 2c9 (cyp2c9) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +2 Moderate
Interaction Summary
Theoretically, ginkgo might increase levels of drugs metabolized by CYP2C9.
Read the full Ginkgo Biloba Leaf Extract + Amitriptyline interactionBacopa Monnieri Whole Plant ExtractCytochrome P450 3a4 (cyp3a4) Substrates, Anticholinergic Drugs +3 Moderate
Interaction Summary
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Read the full Bacopa Monnieri Whole Plant Extract + Amitriptyline interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Ginkgo+ with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Ginkgo biloba Leaf Extract
Talinolol
Taking ginkgo with talinolol seems to increase blood levels of talinolol.
There is some evidence that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of talinolol by 36% in healthy male individuals. However, single doses of ginkgo do not seem to affect talinolol pharmacokinetics.
Alprazolam (Xanax)
Theoretically, ginkgo might decrease the levels and clinical effects of alprazolam.
In clinical research, ginkgo extract (Ginkgold) 120 mg twice daily seems to decrease alprazolam levels by about 17%. However, ginkgo does not appear to decrease the elimination half-life of alprazolam. This suggests that ginkgo is more likely to decrease absorption of alprazolam rather than induce hepatic metabolism of alprazolam.
Anticoagulant/Antiplatelet Drugs
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin. Theoretically, ginkgo might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. However, population and clinical studies have produced mixed results. Some evidence shows that short-term use of ginkgo leaf does not significantly reduce platelet aggregation and blood clotting. A study in healthy males who took a specific ginkgo leaf extract (EGb 761) 160 mg twice daily for 7 days found no change in prothrombin time. An analysis of a large medical record database suggests that ginkgo increases the risk of a bleeding adverse event by 38% when taken concurrently with warfarin. It has been suggested that ginkgo has to be taken for at least 2-3 weeks to have a significant effect on platelet aggregation. However, a meta-analysis of 18 studies using standardized ginkgo extracts, 80-480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. In addition, a single dose of ginkgo plus clopidogrel or ticlopidine does not seem to significantly increase bleeding time or platelet aggregation. Also, taking ginkgo leaf extract daily for 8 days in conjunction with rivaroxaban does not affect anti-factor Xa activity; however, this study did not evaluate bleeding time.
Anticonvulsants
Theoretically, ginkgo might reduce the effectiveness of anticonvulsants.
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.
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.
Atorvastatin (Lipitor)
Theoretically, ginkgo might decrease the levels and clinical effects of atorvastatin.
In humans, intake of ginkgo extract appears to increase atorvastatin clearance, reducing the area under the curve of atorvastatin by 10% to 14% and the maximum concentration by 29%. However, this interaction does not appear to affect cholesterol synthesis and absorption. Further, a model in rats with hyperlipidemia suggests that administering ginkgo extract does not impact blood levels of atorvastatin and leads to lower total cholesterol, low-density lipoprotein cholesterol, and triglycerides when compared with rats given atorvastatin alone.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, ginkgo might increase levels of drugs metabolized by CYP1A2.
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.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP2C19.
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.
Cytochrome P450 2C9 (Cyp2C9) Substrates
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.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, ginkgo might decrease levels of drugs metabolized by CYP3A4.
There is conflicting evidence about whether ginkgo induces or inhibits CYP3A4. Ginkgo does not appear to affect hepatic CYP3A4. However, it is not known if ginkgo affects intestinal CYP3A4. Preliminary clinical research suggests that taking ginkgo does not significantly affect levels of donepezil, lopinavir, or ritonavir, which are all CYP3A4 substrates. Other clinical research also suggests ginkgo does not significantly affect CYP3A4 activity. However, there are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4).
Efavirenz (Sustiva)
Theoretically, ginkgo might decrease the levels and clinical effects of efavirenz.
There are two case reports of decreased efavirenz concentrations and increased viral load in patients taking ginkgo. In one case, an HIV-positive male experienced over a 50% decrease in efavirenz levels over the course of 14 months while taking ginkgo extract. HIV-1 RNA copies also increased substantially, from less than 50 to more than 1500. It is suspected that terpenoids from the ginkgo extract reduced drug levels by inducing cytochrome P450 3A4 (CYP3A4). In another case report, a patient stable on antiviral therapy including efavirenz for 10 years, had an increase in viral load from <50 copies/mL to 1350 copies/mL after 2 months of taking a combination of supplements including ginkgo. After stopping ginkgo, the viral load was again controlled with the same antiviral therapy regimen.
Ibuprofen (Advil, Others)
Theoretically, ginkgo might increase the risk of bleeding when used with ibuprofen.
Ginkgo might have antiplatelet effects and has been associated with several case reports of spontaneous bleeding. In one case, a 71-year-old male had taken a specific ginkgo extract (Gingium, Biocur) 40 mg twice daily for 2.5 years. About 4 weeks after starting ibuprofen 600 mg daily he experienced a fatal intracerebral hemorrhage. However, the antiplatelet effects of ginkgo have been questioned. A meta-analysis and other studies have not found a significant antiplatelet effect with standardized ginkgo extracts, 80 mg to 480 mg taken daily for up to 32 weeks.
P-Glycoprotein Substrates
Theoretically, taking ginkgo with P-glycoprotein substrates might increase the levels and adverse effects of these substrates.
A small clinical study in healthy volunteers shows that using ginkgo leaf extract 120 mg orally three times daily for 14 days can increase levels of the P-glycoprotein substrate, talinolol, by 36% in healthy male individuals. However, single doses of ginkgo do not have the same effect.
Risperidone (Risperdal)
Theoretically, taking ginkgo with risperidone might increase the levels and adverse effects of risperidone.
A single case of priapism has been reported for a 26-year-old male with schizophrenia who used risperidone 3 mg daily along with ginkgo extract 160 mg daily. Risperidone is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4. CYP3A4 activity might be affected by ginkgo. Theoretically, ginkgo may inhibit the metabolism of risperidone and increase the risk of adverse effects.
Rosiglitazone (Avandia)
Theoretically, ginkgo might decrease the levels and clinical effects of rosiglitazone.
Animal research shows that ginkgo leaf extract orally 100 or 200 mg/kg daily for 10 days alters the pharmacodynamics of rosiglitazone in a dose-dependent manner. The 100 mg/kg and 200 mg/kg doses reduce the area under the concentration time curve (AUC) of rosiglitazone by 39% and 52%, respectively, and the half-life by 28% and 39%, respectively. It is hypothesized that these changes may be due to induction of cytochrome P450 2C8 by ginkgo.
Seizure Threshold Lowering Drugs
Theoretically, taking ginkgo with drugs that lower the seizure threshold might increase the risk for convulsions.
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.
Simvastatin (Zocor)
Theoretically, ginkgo might decrease the levels and clinical effects of simvastatin.
Clinical research shows that taking ginkgo extract can reduce the area under the curve and maximum concentration of simvastatin by 32% to 39%. However, ginkgo extract does not seem to affect the cholesterol-lowering ability of simvastatin.
Sofosbuvir (Sovaldi)
Theoretically, ginkgo might increase the levels and clinical effects of sofosbuvir.
Animal research in rats shows that giving a ginkgo extract 25 mg/kg orally daily for 14 days increases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 11%, increases the half-life by 60%, and increases the plasma concentration at 4 hours by 38%. This interaction appears to be related to the inhibition of intestinal P-glycoprotein by ginkgo.
Tacrolimus (Prograf)
Theoretically, ginkgo might increase the blood levels of tacrolimus.
In vitro evidence suggests that certain biflavonoids in ginkgo leaves (i.e. amentoflavone, ginkgetin, bilobetin) may inhibit the metabolism of tacrolimus by up to 50%. This interaction appears to be time-dependent and due to inhibition of cytochrome P450 (CYP) 3A4 by these bioflavonoids. In rats given tacrolimus 1 mg/kg orally, amentoflavone was shown to increase the area under the concentration time curve (AUC) of tacrolimus by 3.8-fold.
Trazodone (Desyrel)
Theoretically, ginkgo might increase the levels and clinical effects of trazodone.
In a case report, an Alzheimer patient taking trazodone 20 mg twice daily and ginkgo leaf extract 80 mg twice daily for four doses became comatose. The coma was reversed by administration of flumazenil (Romazicon). Coma might have been induced by excessive GABA-ergic activity. Ginkgo flavonoids are thought to have GABA-ergic activity and act directly on benzodiazepine receptors. Ginkgo might also increase metabolism of trazodone to active GABA-ergic metabolites, possibly by inducing cytochrome P450 3A4 (CYP3A4) metabolism.
Warfarin (Coumadin)
Ginkgo has been shown to increase the risk of bleeding in some people when taken with warfarin.
Several pharmacodynamic studies suggest that ginkgo inhibits platelet aggregation. It is thought that the ginkgo constituent, ginkgolide B, displaces platelet-activating factor (PAF) from its binding sites, decreasing blood coagulation. Several case reports have documented serious bleeding events in patients taking ginkgo. Information from a medical database suggests that when taken concurrently with warfarin, ginkgo increases the risk of a bleeding adverse event by 38%. There is also some evidence that ginkgo leaf extract can inhibit cytochrome P450 2C9, an enzyme that metabolizes warfarin. This could result in increased warfarin levels. However, population and clinical research has produced mixed results. Clinical research in healthy people suggests that ginkgo has no effect on INR, or the pharmacokinetics or pharmacodynamics of warfarin. A meta-analysis of 18 studies using standardized ginkgo extracts, 80 mg to 480 mg daily for up to 32 weeks, did not find a significant effect on platelet aggregation, fibrinogen concentration, or PT/aPTT. There is also some preliminary clinical research that suggests ginkgo might not significantly increase the effects of warfarin in patients that have a stable INR.
Nifedipine (Procardia)
Theoretically, taking ginkgo with oral, but not intravenous, nifedipine might increase levels and adverse effects of nifedipine.
Animal research and some clinical evidence suggests that taking ginkgo leaf extract orally in combination with oral nifedipine might increase nifedipine levels and cause increased side effects, such as headaches, dizziness, and hot flushes. However, taking ginkgo orally does not seem to affect the pharmacokinetics of intravenous nifedipine.
Omeprazole (Prilosec)
Theoretically, taking ginkgo with omeprazole might decrease the levels and clinical effects of omeprazole.
Clinical research shows that a specific ginkgo leaf extract (Remembrance, Herbs Product LTD) 140 mg twice daily can induce cytochrome P450 (CYP) 2C19 enzymes and decrease levels of omeprazole by about 27% to 42%.
Panax ginseng Root Extract
Anticoagulant/Antiplatelet Drugs
Although Panax ginseng has shown antiplatelet effects in the laboratory, it is unlikely to increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that ginsenoside constituents in Panax ginseng might decrease platelet aggregation. However, research in humans suggests that ginseng does not affect platelet aggregation. Animal research indicates low oral bioavailability of Rb1 and rapid elimination of Rg1, which might explain the discrepancy between in vitro and human research. Until more is known, use with caution in patients concurrently taking anticoagulant or antiplatelet drugs.
Antidiabetes Drugs
Theoretically, taking Panax ginseng with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Monitor blood glucose levels closely.
Caffeine
Theoretically, taking Panax ginseng with caffeine might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects. Theoretically, caffeine might have an additive effect on the stimulant effects of Panax ginseng.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, Panax ginseng might increase levels of drugs metabolized by CYP2D6. However, research is conflicting.
There is some evidence that Panax ginseng can inhibit the CYP2D6 enzyme by approximately 6%. In addition, in animal research, Panax ginseng inhibits the metabolism of dextromethorphan, a drug metabolized by CYP2D6, by a small amount. However, contradictory research suggests Panax ginseng might not inhibit CYP2D6. Until more is known, use Panax ginseng cautiously in patients taking drugs metabolized by these enzymes.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, Panax ginseng might increase or decrease levels of drugs metabolized by CYP3A4.
Panax ginseng may affect the clearance of drugs metabolized by CYP3A4. One such drug is imatinib. Inhibition of CYP3A4 was believed to be responsible for a case of imatinib-induced hepatotoxicity. In contrast, Panax ginseng has been shown to increase the clearance of midazolam, another drug metabolized by CYP3A4. Clinical research shows that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng. Until more is known, use Panax ginseng cautiously in combination with CYP3A4 substrates.
Estrogens
Theoretically, concomitant use of large amounts of Panax ginseng might interfere with hormone replacement therapy.
Laboratory research and some case reports suggest that Panax ginseng can have estrogenic effects due to competition for estrogen receptors. The estrogenic activity is attributed to the ginsenoside constituents of Panax ginseng.
Furosemide (Lasix)
Theoretically, Panax ginseng might reduce the effects of furosemide.
There is some concern that Panax ginseng might contribute to furosemide resistance. There is one case of resistance to furosemide diuresis in a patient taking a germanium-containing ginseng product.
Imatinib (Gleevec)
Theoretically, Panax ginseng might increase the effects and adverse effects of imatinib.
A case of imatinib-induced hepatotoxicity has been reported for a 26-year-old male with chronic myelogenous leukemia stabilized on imatinib for 7 years. The patient took imatinib 400 mg along with a Panax ginseng-containing energy drink daily for 3 months. Since imatinib-associated hepatotoxicity typically occurs within 2 years of initiating therapy, it is believed that Panax ginseng affected imatinib toxicity though inhibition of cytochrome P450 3A4. CYP3A4 is the primary enzyme involved in imatinib metabolism.
Immunosuppressants
Theoretically, Panax ginseng use might interfere with immunosuppressive therapy.
Panax ginseng might have immune system stimulating properties.
Insulin
Theoretically, taking Panax ginseng with insulin might increase the risk of hypoglycemia.
Clinical research suggests that Panax ginseng might decrease blood glucose levels. Insulin dose adjustments might be necessary in patients taking Panax ginseng; use with caution.
Midazolam (Versed)
Theoretically, Panax ginseng may increase the clearance of midazolam.
Midazolam is metabolized by cytochrome P450 3A4 (CYP3A4). Clinical research suggests that Panax ginseng can reduce midazolam area under the curve by 44%, maximum plasma concentration by 26%, and time to reach maximum plasma concentration by 29%. Midazolam metabolism was also increased in animals given Panax ginseng.
Monoamine Oxidase Inhibitors (Maois)
Theoretically, Panax ginseng can interfere with MAOI therapy.
Concomitant use of Panax ginseng with phenelzine (Nardil) is associated with insomnia, headache, tremors, and hypomania.
Nifedipine (Procardia)
Theoretically, taking Panax ginseng with nifedipine might increase serum levels of nifedipine and the risk of hypotension.
Preliminary clinical research shows that concomitant use can increase serum levels of nifedipine in healthy volunteers. This might cause the blood pressure lowering effects of nifedipine to be increased when taken concomitantly with Panax ginseng.
Qt Interval-Prolonging Drugs
Theoretically, Panax ginseng has an additive effect with drugs that prolong the QT interval and potentially increase the risk of ventricular arrhythmias. However, research is conflicting.
Clinical research shows that short-term use of Panax ginseng can increase the QT interval. However, no changes in QT interval have been identified with prolonged use.
Raltegravir (Isentress)
Theoretically, taking Panax ginseng with raltegravir might increase the risk of liver toxicity.
A case report suggests that concomitant use of Panax ginseng with raltegravir can increase serum levels of raltegravir, resulting in elevated liver enzymes levels.
Selegiline (Eldepryl)
Theoretically, Panax ginseng might increase or decrease levels of selegiline, possibly altering the effects and side effects of selegiline.
Animal research shows that taking selegiline with a low dose of Panax ginseng extract (1 gram/kg) reduces selegiline bioavailability, while taking a high dose of Panax ginseng extract (3 grams/kg) increases selegiline bioavailability. More research is needed to confirm these effects.
Stimulant Drugs
Theoretically, taking Panax ginseng with stimulant drugs might increase the risk of adverse stimulant effects.
Panax ginseng has been shown to have stimulant effects.
Warfarin (Coumadin)
Panax ginseng might affect the clearance of warfarin. However, this interaction appears to be unlikely.
There has been a single case report of decreased effectiveness of warfarin in a patient who also took Panax ginseng. However, it is questionable whether Panax ginseng was the cause of this decrease in warfarin effectiveness. Some research in humans and animals suggests that Panax ginseng does not affect the pharmacokinetics of warfarin. However, other research in humans suggests that Panax ginseng might modestly increase the clearance of the S-warfarin isomer. More evidence is needed to determine whether Panax ginseng causes a significant interaction with warfarin.
Fexofenadine (Allegra)
Theoretically, Panax ginseng might decrease blood levels of oral or intravenous fexofenadine.
Animal research suggests that taking Panax ginseng in combination with oral or intravenous fexofenadine may reduce the bioavailability of fexofenadine. Some scientists have attributed this effect to the ability of Panax ginseng to increase the expression of P-glycoprotein.
Lopinavir/Ritonavir (Kaletra)
Although Panax ginseng has demonstrated variable effects on cytochrome P450 3A4 (CYP3A4), which metabolizes lopinavir, Panax ginseng is unlikely to alter levels of lopinavir/ritonavir.
Lopinavir is metabolized by CYP3A4 and is administered with the CYP3A4 inhibitor ritonavir to increase its plasma concentrations. Panax ginseng has shown variable effects on CYP3A4 activity in humans. However, taking Panax ginseng (Vitamer Laboratories) 500 mg twice daily for 14 days did not alter the pharmacokinetics of lopinavir/ritonavir in 12 healthy volunteers.
Bacopa monnieri Whole Plant Extract
Anticholinergic Drugs
Theoretically, concurrent use might decrease the effectiveness of both agents.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels, which could counteract the effects of anticholinergic drugs. Similarly, anticholinergic drugs might counteract the cholinergic effects of bacopa.
Cevimeline (Evoxac)
Theoretically, bacopa might increase the effects and adverse effects of cevimeline.
In one case, a 58-year-old female taking cevimeline long-term for Sjogren syndrome experienced hyperhidrosis, malaise, nausea, and tachycardia shortly after taking a single dose of bacopa. Symptoms resolved after two days. Cevimeline is metabolized by cytochrome P450 (CYP) 2D6 and CYP3A4, and researchers theorize that bacopa may have inhibited these isoenzymes. However, it is unclear if bacopa causes clinically significant inhibition of either CYP2D6 or CYP3A4.
Cholinergic Drugs
Theoretically, concurrent use of bacopa with other cholinergic drugs might have additive effects.
Bacopa seems to inhibit acetylcholinesterase and might increase acetylcholine levels. Theoretically, this could result in additive cholinergic effects when used with cholinergic drugs.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP1A2 substrates.
Research on the effects of bacopa extracts on CYP1A2 enzymes is conflicting. Some in vitro evidence shows that bacopa extract can moderately and non-competitively inhibit CYP1A2, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP2C19 substrates.
In vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C19 enzymes. It is not known whether this is clinically significant.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP2C9 substrates.
Research on the effect of bacopa extracts on CYP2C9 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and non-competitively inhibit CYP2C9, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, bacopa might increase the levels and adverse effects of CYP3A4 substrates.
Research on the effects of bacopa extracts on CYP3A4 enzymes is conflicting. Some in vitro evidence suggests that bacopa extract can moderately and competitively inhibit CYP3A4, while other in vitro evidence suggests that any effect is unlikely to be clinically significant.
Thyroid Hormone
Theoretically, bacopa might have additive effects when used with thyroid hormone.
Animal research suggests that bacopa increases thyroxine (T4) levels in mice by about 40%.
Brand information
Manufacturer and brand details for Ginkgo+, from the product label.
NS Natural Stacks
See all NS Natural Stacks products- Name
- NS 360, Inc.
- Street Address
- 4241 24th Ave W
- City
- Seattle
- State
- WA
- ZipCode
- 98199
- Phone Number
- 1-855-678-2257
- Web Address
- www.naturalstacks.com
Ginkgo+ by NS Natural Stacks: Common Questions
Does Ginkgo+ by NS Natural Stacks interact with any medications?
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Ginkgo+’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Ginkgo
Interacts with 1,266 drugsGinkgo 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...
Read the full Ginkgo monograph → Herb & supplement monographPanax Ginseng
Interacts with 1,130 drugsPanax ginseng is a popular traditional herb used to boost energy, ease stress, and support overall wellness, though scientific evidence is mixed and mostly preliminary. It is generally well...
Read the full Panax Ginseng monograph → Herb & supplement monographBacopa
Interacts with 930 drugsBacopa is an Ayurvedic herb most often used for memory and thinking. Some small studies suggest it may modestly help memory when taken regularly for several weeks, but the evidence is limite...
Read the full Bacopa monograph →Sources & How We Checked
Ginkgo+'s label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 175 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Ginkgo 97 references
- Davydov L, Stirling AL. Stevens-Johnson syndrome with Ginkgo biloba. J Herb Pharmacother 2001;1:65-9. DOI
- Benjamin J, Muir T, Briggs K, Pentland B. A case of cerebral haemorrhage-can Ginkgo biloba be implicated? Postgrad Med J 2001;77:112-3.
- Matthews, MK. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1934.
- Rowin J, Lewis SL. Spontaneous bilateral subdural hemotomas with chronic Ginkgo biloba ingestion. Neurology 1996;46:1775-6.
- Rosenblatt M, Mindel T. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108.
- Fessenden JM, Wittenborn W, Clarke L. Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg 2001;67:33-5. DOI
- 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.
- Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-43. PubMed
- 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.
- Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
- Cesarani A, Meloni F, Alpini D, et al. Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders. Adv Ther 1998;15:291-304.
- 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
- 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
- Kajiyama Y, Fujii K, Takeuchi H, Manabe Y. Ginkgo seed poisoning. Pediatrics 2002;109:325-7. 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
- Burschka MA, Hassan HA, Reineke T, et al. Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Eur Arch Otorhinolaryngol 2001;258:213- PubMed
- Miller LG, Freeman B. Possible subdural hematoma associated with Ginkgo biloba. J Herb Pharmacother 2002;2:57-63.
- Kudolo GB, Dorsey S, Blodgett J. Effect of the ingestion of Ginkgo biloba extract on platelet aggregation and urinary prostanoid excretion in healthy and Type 2 diabetic subjects. Thromb Res 2002;108:151-60.. PubMed
- Fong KC, Kinnear PE. Retrobulbar haemorrhage associated with chronic Ginkgo biloba ingestion. Postgrad Med J 2003;79:531-2..
- 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
- Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol 2002;17:279-84.
- 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.
- Yasui-Furukori N, Furukori H, Kaneda A, et al. The effects of Ginkgo biloba extracts on the pharmacokinetics and pharmacodynamics of donepezil. J Clin Pharmacol 2004;44:538-42.
- Markowitz JS, Donovan JL, Lindsay DeVane C, et al. Multiple-dose administration of Ginkgo biloba did not affect cytochrome P-450 2D6 or 3A4 activity in normal volunteers. J Clin Psychopharmacol 2003;23:576-81. PubMed
- 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.
- Engelsen J, Nielsen JD, Winther K. Effect of coenzyme Q10 and Ginkgo biloba on warfarin dosage in stable, long-term warfarin treated outpatients. A randomised, double blind, placebo-crossover trial. Thromb Haemost 2002;87:1075-6. DOI
- 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
- Kohler S, Funk P, Kieser M. Influence of a 7-day treatment with Ginkgo biloba special extract EGb 761 on bleeding time and coagulation: a randomized, placebo-controlled, double-blind study in healthy volunteers. Blood Coagul Fibrinolysis 2004;15:303–9. PubMed
- Jiang X, Williams KM, Liauw WS, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32. PubMed
- Destro MW, Speranzini MB, Cavalheiro Filho C, et al. Bilateral haematoma after rhytidoplasty and blepharoplasty following chronic use of Ginkgo biloba. Br J Plast Surg 2005;58:100-1. PubMed
- 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
- Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with Ginkgo biloba: a case report and systematic review of the literature. J Gen Intern Med 2005;20;657-61. DOI
- Meisel C, Johne A, Roots I. Fatal intracerebral mass bleeding associated with Ginkgo biloba and ibuprofen. Atherosclerosis 2003;167:367. PubMed
- Bebbington A, Kulkarni R, Roberts P. Ginkgo biloba: Persistent bleeding after total hip arthroplasty caused by herbal self-medication. J Arthroplasty 2005;20:125-6. .
- Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol 2005:755-8. PubMed
- Hauser D, Gayowski T, Singh N. Bleeding complications precipitated by unrecognized Gingko biloba use after liver transplantation. Transpl Int 2002;15:377-9. DOI
- 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
- 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.
- Pennisi RS. Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba. Med J Aust 2006;184:583-4. PubMed
- Yagmur E, Piatkowski A, Groger A, et al. Bleeding complication under Gingko biloba medication. Am J Hematol 2005;79:343-4. PubMed
- Vale S. Subarachnoid haemorrhage associated with Ginkgo biloba. Lancet 1998;352:36. PubMed
- Aruna D, Naidu MU. Pharmacodynamic interaction studies of Ginkgo biloba with cilostazol and clopidogrel in healthy human subjects. Br J Clin Pharmacol 2007;63:333-8.
- Dugoua JJ, Mills E, Perri D, Koren G. Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e277-84.
- Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006;46:1370-8. PubMed
- Woelk H, Arnoldt KH, Kieser M, Hoerr R. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: a randomized, double-blind, placebo-controlled trial. J Psychiatr Res 2007;41:472-80. PubMed
- DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for prevention of dementia. JAMA 2008;300:2253-62.
- Dodge HH, Zitzelberger T, Oken BS, et al. A randomized placebo-controlled trial of ginkgo biloba for the prevention of cognitive decline. Neurology 2008;70(19 Pt 2):1809-17. PubMed
- Wiegman DJ, Brinkman K, Franssen EJ. Interaction of Ginkgo biloba with efavirenz. AIDS 2009;23:1184-5. PubMed
- Kim BH, Kim KP, Lim KS, et al. Influence of Ginkgo biloba extract on the pharmacodynamic effects and pharmacokinetic properties of ticlopidine: An open-label, randomized, two-period, two-treatment, two-sequence, single-dose crossover study in healthy Kor
- Salehi B, Imani R, Mohammadi MR, et al. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:76-80. PubMed
- Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy 2011;31:490-502.
- Kuller LH, Ives DG, Fitzpatrick AL, et al. Does Ginkgo biloba reduce the risk of cardiovascular events? Circ Cardiovasc Qual Outcomes 2010;3:41-7.
- Naccarato M, Yoong D, Gough K. A potential drug-herbal interaction between Ginkgo biloba and efavirenz. J Int Assoc Physicians AIDS Care (Chic). 2012;11(2):98-100. doi: 10.1177/1545109711435364. Epub 2012 Feb 9.
- Engelsen, J., Nielsen, J. D., and Hansen, K. F. [Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial]. Ugeskr.Laeger 4-28-2003;165(18):18
- Parsad, D., Pandhi, R., and Juneja, A. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp.Dermatol. 2003;28(3):285-287.
- Bal Dit, Sollier C., Caplain, H., and Drouet, L. No alteration in platelet function or coagulation induced by EGb761 in a controlled study. Clin Lab Haematol. 2003;25(4):251-253. PubMed
- Yoshioka, M., Ohnishi, N., Koishi, T., Obata, Y., Nakagawa, M., Matsumoto, T., Tagagi, K., Takara, K., Ohkuni, T., Yokoyama, T., and Kuroda, K. Studies on interactions between functional foods or dietary supplements and medicines. IV. Effects of ginkgo b
- Yoshioka, M., Ohnishi, N., Sone, N., Egami, S., Takara, K., Yokoyama, T., and Kuroda, K. Studies on interactions between functional foods or dietary supplements and medicines. III. Effects of ginkgo biloba leaf extract on the pharmacokinetics of nifedipi
- Lovera, J., Bagert, B., Smoot, K., Morris, C. D., Frank, R., Bogardus, K., Wild, K., Oken, B., Whitham, R., and Bourdette, D. Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebo-controlled trial. Mult.S PubMed
- Lin, Y. Y., Chu, S. J., and Tsai, S. H. Association between priapism and concurrent use of risperidone and Ginkgo biloba. Mayo Clin Proc 2007;82(10):1289-1290.
- Robertson, S. M., Davey, R. T., Voell, J., Formentini, E., Alfaro, R. M., and Penzak, S. R. Effect of Ginkgo biloba extract on lopinavir, midazolam and fexofenadine pharmacokinetics in healthy subjects. Curr Med Res Opin 2008;24(2):591-599. PubMed
- Penzak, S. R., Busse, K. H., Robertson, S. M., Formentini, E., Alfaro, R. M., and Davey, R. T., Jr. Limitations of using a single postdose midazolam concentration to predict CYP3A-mediated drug interactions. J Clin Pharmacol 2008;48(6):671-680. PubMed
- May, B. H., Yang, A. W., Zhang, A. L., Owens, M. D., Bennett, L., Head, R., Cobiac, L., Li, C. G., Hugel, H., Story, D. F., and Xue, C. C. Chinese herbal medicine for Mild Cognitive Impairment and Age Associated Memory Impairment: a review of randomised
- Choi, W. S., Choi, C. J., Kim, K. S., Lee, J. H., Song, C. H., Chung, J. H., Ock, S. M., Lee, J. B., and Kim, C. M. To compare the efficacy and safety of nifedipine sustained release with Ginkgo biloba extract to treat patients with primary Raynaud's phe
- 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
- Russo, V., Stella, A., Appezzati, L., Barone, A., Stagni, E., Roszkowska, A., and Delle, Noci N. Clinical efficacy of a Ginkgo biloba extract in the topical treatment of allergic conjunctivitis. Eur J Ophthalmol. 2009;19(3):331-336. PubMed
- Fan, L., Tao, G. Y., Wang, G., Chen, Y., Zhang, W., He, Y. J., Li, Q., Lei, H. P., Jiang, F., Hu, D. L., Huang, Y. F., and Zhou, H. H. Effects of Ginkgo biloba extract ingestion on the pharmacokinetics of talinolol in healthy Chinese volunteers. Ann Phar PubMed
- Ozgoli, G., Selselei, E. A., Mojab, F., and Majd, H. A. A randomized, placebo-controlled trial of Ginkgo biloba L. in treatment of premenstrual syndrome. J Altern.Complement Med 2009;15(8):845-851.
- Singh, V., Singh, S. P., and Chan, K. Review and meta-analysis of usage of ginkgo as an adjunct therapy in chronic schizophrenia. Int J Neuropsychopharmacol. 2010;13(2):257-271.
- Kim, T. E., Kim, B. H., Kim, J., Kim, K. P., Yi, S., Shin, H. S., Lee, Y. O., Lee, K. H., Shin, S. G., Jang, I. J., and Yu, K. S. Comparison of the pharmacokinetics of ticlopidine between administration of a combined fixed-dose tablet formulation of ticl
- Nicolai, S. P., Gerardu, V. C., Kruidenier, L. M., Prins, M. H., and Teijink, J. A. From the Cochrane library: Ginkgo biloba for intermittent claudication. Vasa 2010;39(2):153-158. PubMed
- Patel, N. Herbal remedies. Br.Dent.J 8-28-2010;209(4):153.
- Pedroso, J. L., Henriques Aquino, C. C., Escorcio Bezerra, M. L., Baiense, R. F., Suarez, M. M., Dutra, L. A., Braga-Neto, P., and Povoas Barsottini, O. G. Ginkgo biloba and cerebral bleeding: a case report and critical review. Neurologist. 2011;17(2):89 PubMed
- Russo, V., Rago, A., Russo, G. M., Calabro, R., and Nigro, G. Ginkgo biloba: an ancient tree with new arrhythmic side effects. J Postgrad.Med 2011;57(3):221.
- Zhou, Y. and Zeng, R. [Effects of Ginkgo biloba extract on anticoagulation and blood drug level of warfarin in healthy wolunteers]. Zhongguo Zhong Yao Za Zhi 2011;36(16):2290-2293. DOI
- Skogh, M. Extracts of Ginkgo biloba and bleeding or haemorrhage. Lancet 10-3-1998;352(9134):1145-1146. PubMed
- Fessenden JM, Wittenborn W, and Clarke L. Ginkgo biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg 2001;67(1):33-35.
- Burkard G. [The efficacy and safety of ginkgo biloba extract in dementia]. Fortschr Med [Supp] 1991;109(107):6-8.
- Dai LL, Fan L, Wu HZ, Tan ZR, Chen Y, Peng XD, Shen MX, Yang GP, Zhou HH. Assessment of a pharmacokinetic and pharmacodynamic interaction between simvastatin and Ginkgo biloba extracts in healthy subjects. Xenobiotica 2013;43(10):862-7.
- Guo CX, Pei Q, Yin JY, Peng XD, Zhou BT, Zhao YC, Wu LX, Meng XG, Wang G, Li Q, Ouyang DS, Liu ZQ, Zhang W, Zhou HH. Effects of Ginkgo biloba extracts on pharmacokinetics and efficacy of atorvastatin based on plasma indices. Xenobiotica 2012;42(8):784-90.
- Stoddard GJ, Archer M, Shane-McWhorter L, Bray BE, Redd DF, Proulx J, Zeng-Treitler Q. Ginkgo and Warfarin Interaction in a Large Veterans Administration Population. AMIA Annu Symp Proc. 2015 Nov 5;2015:1174-83.
- Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
- Carlile PV. Unexplained alveolar hemorrhage associated with ginkgo and ginseng use. J Bronchology Interv Pulmonol. 2015;22(2):170-2. doi: 10.1097/LBR.0000000000000150. PubMed
- Han EJ, Park HL, Kim SH. Allergic Reaction to Ginkgo Nut on FDG PET/CT. Clin Nucl Med. 2016 Sep;41(9):716-7. doi: 10.1097/RLU.0000000000001276. PubMed
- Rho SS, Woo YS, Bahk WM. Ginkgo biloba induced mood dysregulation: a case report. BMC Complement Altern Med. 2018 Jan 15;18(1):14. PubMed
- 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.
- World Health Organization. WHO pharmaceuticals newsletter: 2020, No. 3. Available at: https://www.who.int/medicines/publications/WHO_Pharmaceuticals_Newslet3_20.pdf?ua=1. Accessed June 23, 2021.
- Health Canada. Ginkgo biloba-containing products and the risk of cardiac arrhythmias. Health Product InfoWatch. February 2021. Available at: https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/health-product-infowatch/fe
- Wasef AK, Wahdan SA, Saeed NM, El-Demerdash E. Effects of aged garlic and ginkgo biloba extracts on the pharmacokinetics of sofosbuvir in rats. Biopharm Drug Dispos. 2022;43(4):152-62. PubMed
- Xing X, Kong M, Hou Q, Li J, Qian W, Chen X, Li H, Yang C. Effects of ginkgo leaf tablet on the pharmacokinetics of rosiglitazone in rats and its potential mechanism. Pharm Biol. 2022;60(1):1190-7. PubMed
- Hoerr R, Zimmermann A, Seitz F, Dienel A. Single and repeated doses of EGb 761® do not affect pharmacokinetics or pharmacodynamics of rivaroxaban in healthy subjects. Front Pharmacol. 2022 Apr 20;13:868843. PubMed
- Bai J, Zhang C. Metabolic interaction between biflavonoids in Ginkgo biloba leaves and tacrolimus. Biopharm Drug Dispos 2023;44(2):157-164.
- Wang Q, Liu Z, Wang R, et al. Effect of Ginkgo biloba extract on pharmacology and pharmacokinetics of atorvastatin in rats with hyperlipidaemia. Food Funct 2023;14(7):3051-3066.
- Burnett CL, Bergfeld WF, Belsito DV, et al. Safety Assessment of Ginkgo biloba-Derived Ingredients as Used in Cosmetics. Int J Toxicol. 2023 Nov 6:10915818231210792.
- Yao Y, Zhao J, Li C, et al. Ginkgo biloba extract safety: Insights from a real-world pharmacovigilance study of FDA adverse event reporting system (FAERS) events. J Ethnopharmacol 2025;337(Pt 3):119010. PubMed
Panax Ginseng 66 references
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- Oh, K. J., Chae, M. J., Lee, H. S., Hong, H. D., and Park, K. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. J Sex Med 2010;7(4 Pt 1):1469-1477. PubMed
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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.
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