Herbs (Global Traditional) · Traditional Chinese Medicine
Ginkgo Biloba (Ginkgo biloba) (Ginkgo biloba)
Strong Evidencebotanical
Hermetica Superfood Encyclopedia
Ginkgo biloba contains flavonoids and terpenoids that enhance cerebral blood flow and provide neuroprotection. Clinical studies demonstrate significant cognitive improvements in Alzheimer's patients and enhanced daily living activities in dementia.
Ginkgo biloba is derived from the leaves of the Ginkgo biloba tree, a living fossil native to China used in traditional medicine for centuries. The standardized extract (e.g., EGb 761) is produced by extracting dried leaves with acetone and water, followed by purification to remove impurities like ginkgolic acids, resulting in an herbal extract rich in flavonoids and terpenoids.
Multiple meta-analyses support Ginkgo biloba for cognitive impairment, with a 2020 analysis of 7 RCTs (N=939, PMID: 32658034) showing nearly double the cognitive improvement versus placebo. A 2023 meta-analysis of 18 RCTs (N=1,642, PMID: 36960422) demonstrated that combining Ginkgo with donepezil was superior to donepezil alone (RR=1.23), while a 2015 analysis of 21 RCTs (N=2,608, PMID: 26268332) found significant MMSE improvements.
Standardized EGb 761 extract (24% flavone glycosides, 6% terpene lactones): 120-240mg daily for dementia/Alzheimer's disease, typically administered as 240mg/day for mild dementia or 120mg/day for longer-term use. For peripheral artery disease: 120mg/day. For neuropsychiatric symptoms: 160-240mg/day over 24 weeks. Consult a healthcare provider before starting any new supplement.
Ginkgo biloba leaf extract is not a significant source of macronutrients (negligible protein <1%, fats <1%, carbohydrates minimal in standardized extracts). Its profile is defined by standardized bioactive compounds: **Flavonoid glycosides (24% in EGb 761 standardized extract)** — primarily quercetin glycosides (~9-10 mg/g), kaempferol glycosides (~8-9 mg/g), and isorhamnetin glycosides (~2-3 mg/g); these are hydrolyzed to aglycones post-absorption with moderate bioavailability (~70-80% for quercetin derivatives). **Terpene lactones (6% in EGb 761)** — ginkgolides A, B, C, J (total ~3.1-3.4 mg/g) and bilobalide (~2.6-2.9 mg/g); ginkgolide B is the most pharmacologically active PAF antagonist; oral bioavailability of ginkgolides ~80%, bilobalide ~72%. **Ginkgolic acids** — potentially toxic alkylphenols, regulated to <5 ppm (<5 µg/g) in quality extracts (USP/EMA standard). **Proanthocyanidins** — present at ~7% in crude leaf, reduced in standardized extracts; include catechin and epicatechin oligomers. **Other polyphenols** — biflavonoids (amentoflavone, bilobetin, ginkgetin) at ~0.2-0.5 mg/g; notable as CYP3A4 inhibitors but poorly bioavailable (~20-30%) due to low solubility. **Minerals** — trace amounts: potassium (~3.2 mg/g dry leaf), calcium (~8.1 mg/g dry leaf), magnesium (~2.1 mg/g dry leaf); negligible in concentrated extracts. **Vitamins** — minimal: trace vitamin C (~0.5-1.2 mg/g in fresh leaf, degraded in extract processing), trace beta-carotene. **Fiber** — crude leaf contains ~15-18% dietary fiber, essentially absent in standardized liquid/tablet extracts. Standard clinical dose of 120-240 mg EGb 761 extract delivers approximately 28.8-57.6 mg flavonoid glycosides and 7.2-14.4 mg terpene lactones. Bioavailability is enhanced by lipid co-administration for terpene lactones; Tmax for ginkgolide B ~2 hours, half-life ~4-4.5 hours; Tmax for flavonol aglycones ~1.5-2.5 hours post-hydrolysis.
Ginkgo biloba's flavonoids (quercetin, kaempferol) and terpenoids (ginkgolides A, B, C) enhance cerebral blood flow by inhibiting platelet-activating factor and improving endothelial function. The compounds also provide neuroprotection through antioxidant activity and modulation of neurotransmitter systems including acetylcholine and dopamine.
A meta-analysis of 7 randomized controlled trials (N=939) showed ginkgo biloba nearly doubled the likelihood of cognitive improvement in Alzheimer's patients (RR=1.98). Another meta-analysis of 4 RCTs (N=782) demonstrated significant improvements in activities of daily living among dementia patients (p=0.01). Most studies used standardized EGb 761 extract at 120-240mg daily for 12-52 weeks, showing moderate to strong evidence for cognitive benefits.
Ginkgo biloba may increase bleeding risk and should be avoided with anticoagulants like warfarin and aspirin. Common side effects include headache, dizziness, and gastrointestinal upset in 2-10% of users. The supplement may interact with seizure medications and should be discontinued 2 weeks before surgery. Pregnancy and breastfeeding safety data is insufficient, making use inadvisable during these periods.
7 documented interactions for Ginkgo Biloba (Ginkgo biloba). Click any row to read the full explanation. Always consult your healthcare provider before combining supplements with medications.
Ginkgo thins blood. Warfarin thins blood. Together, bleeding risk is dangerous — including internal bleeding and hemorrhagic stroke.
What to do: When combining Ginkgo Biloba with Warfarin, tell your doctor before any surgery or dental procedure. Watch for unusual bruising, bleeding gums, blood in stool, or prolonged bleeding from cuts.
Timing: Use caution. Many botanicals affect blood clotting — ginkgo, garlic, ginger, turmeric, and dong quai all have antiplatelet activity that can amplify Warfarin. St. John's Wort can REDUCE anticoagulant effectiveness. Take at separate times and inform your prescriber about all herbal supplements. Request more frequent INR monitoring if on warfarin.
Full interaction details →Combining Ginkgo with Eliquis significantly increases bleeding complications risk.
What to do: When combining Ginkgo Biloba with Apixaban, tell your doctor before any surgery or dental procedure. Watch for unusual bruising, bleeding gums, blood in stool, or prolonged bleeding from cuts.
Timing: Use caution. Many botanicals affect blood clotting — ginkgo, garlic, ginger, turmeric, and dong quai all have antiplatelet activity that can amplify Apixaban. St. John's Wort can REDUCE anticoagulant effectiveness. Take at separate times and inform your prescriber about all herbal supplements. Request more frequent INR monitoring if on warfarin.
Full interaction details →Ginkgo and Xarelto together increase bleeding risk significantly.
What to do: When combining Ginkgo Biloba with Rivaroxaban, tell your doctor before any surgery or dental procedure. Watch for unusual bruising, bleeding gums, blood in stool, or prolonged bleeding from cuts.
Timing: Use caution. Many botanicals affect blood clotting — ginkgo, garlic, ginger, turmeric, and dong quai all have antiplatelet activity that can amplify Rivaroxaban. St. John's Wort can REDUCE anticoagulant effectiveness. Take at separate times and inform your prescriber about all herbal supplements. Request more frequent INR monitoring if on warfarin.
Full interaction details →Ginkgo and Plavix both prevent blood clotting. Together, the bleeding risk is serious.
What to do: When combining Ginkgo Biloba with Clopidogrel, tell your doctor before any surgery or dental procedure. Watch for unusual bruising, bleeding gums, blood in stool, or prolonged bleeding from cuts.
Timing: Use caution. Many botanicals affect blood clotting — ginkgo, garlic, ginger, turmeric, and dong quai all have antiplatelet activity that can amplify Clopidogrel. St. John's Wort can REDUCE anticoagulant effectiveness. Take at separate times and inform your prescriber about all herbal supplements. Request more frequent INR monitoring if on warfarin.
Full interaction details →Both Ginkgo and aspirin thin blood through different mechanisms. Together, significantly higher bleeding risk.
What to do: When combining Ginkgo Biloba with Aspirin, tell your doctor before any surgery or dental procedure. Watch for unusual bruising, bleeding gums, blood in stool, or prolonged bleeding from cuts.
Timing: Take Aspirin with food. Ginkgo Biloba can be taken at the same or different meal. Anti-inflammatory botanicals (turmeric, boswellia, willow bark) may have additive effects with NSAIDs — this could be beneficial but also increases GI irritation risk. Willow bark contains salicin (aspirin-like) and should not be doubled up with NSAIDs.
Full interaction details →Ginkgo and ibuprofen both affect blood clotting. Using together increases bruising and bleeding risk.
What to do: When taking Ginkgo Biloba with Ibuprofen, monitor for unusual bruising or bleeding. Culinary amounts of Ginkgo Biloba are generally safe; supplemental doses carry more risk. Inform your doctor about this combination.
Timing: Take Ibuprofen with food. Ginkgo Biloba can be taken at the same or different meal. Anti-inflammatory botanicals (turmeric, boswellia, willow bark) may have additive effects with NSAIDs — this could be beneficial but also increases GI irritation risk. Willow bark contains salicin (aspirin-like) and should not be doubled up with NSAIDs.
Full interaction details →Ginkgo and Aleve both affect clotting. Together they increase bruising and bleeding risk.
What to do: When taking Ginkgo Biloba with Naproxen, monitor for unusual bruising or bleeding. Culinary amounts of Ginkgo Biloba are generally safe; supplemental doses carry more risk. Inform your doctor about this combination.
Timing: Take Naproxen with food. Ginkgo Biloba can be taken at the same or different meal. Anti-inflammatory botanicals (turmeric, boswellia, willow bark) may have additive effects with NSAIDs — this could be beneficial but also increases GI irritation risk. Willow bark contains salicin (aspirin-like) and should not be doubled up with NSAIDs.
Full interaction details →Educational information only. Always consult a qualified healthcare provider before changing your supplement or medication regimen.
