Ginkgo
Herbal products and dietary supplements
Herbal products and dietary supplementsPregnancy: avoid
Avoid in pregnancy. It may be unsafe in pregnancy; use near delivery might cause early labour or extra bleeding.
Leaf extract of the Ginkgo biloba tree, promoted for memory. Large trials found no protection against dementia; it may raise bleeding risk.
Also called: Ginkgo biloba, Ginkgo folium
Quick facts
- Group
- Herbal products and dietary supplements
- Target
- Platelet-activating factor and vascular tone (proposed)
- Used for
- Promoted for memory and dementia
- Key effects
- Headache and dizziness · Stomach upset
- Monitor
- Signs of bleeding and INR · Cognitive status
- ATC
- N06DX02
No doses: the clinician sets them by the current guideline.
Mechanism of action
Ginkgo leaf extract contains flavonoids and terpenoids such as the ginkgolides. In animal and laboratory studies it antagonises platelet-activating factor, reduces blood viscosity and promotes vasodilation, and the flavonoids act as antioxidants. These effects explain the theoretical bleeding risk; they have not translated into proven clinical benefit.
- Ginkgolides and flavonoids are absorbed from the extract
- Platelet-activating factor is antagonised; vessels dilate
- Platelet function may be reduced
- Bleeding risk rises with anticoagulants
Indications
- Promoted for memory and dementia; large trials in older adults found it did not reduce dementia risk Dementia (major neurocognitive disorder) →
- Also promoted for tinnitus, peripheral artery disease and anxiety, without conclusive evidence Peripheral artery disease →
Adverse effects
Common
- Headache and dizziness
- Stomach upset
- Allergic skin reactions
Contraindications
- Use with anticoagulants or antiplatelet drugs without supervision
- Before surgery
Key interactions
- Warfarin
- Higher bleeding risk
- Acetylsalicylic acid, clopidogrel and other antiplatelets
- Additive antiplatelet effect
What is monitored
- Signs of bleeding and INR in patients on warfarin
- Cognitive status in patients using it for memory complaints
Pregnancy and breastfeeding
Avoid in pregnancy. It may be unsafe in pregnancy; use near delivery might cause early labour or extra bleeding.
Nursing care
- Ask every patient about herbal products and supplements and record them with the medicine list
- Ask about ginkgo before surgery and procedures with bleeding risk
- Teach that «natural» does not mean safe and that supplements are not approved as medicines before sale
Pharmacokinetics
- Absorption
- Taken by mouth as a standardised leaf extract
Test yourself
Think of the answer, then tap the question to see it.
Did ginkgo prevent dementia in large trials?
No; large trials in older adults found no reduction in dementia or Alzheimer disease.
Which interaction makes ginkgo important before surgery?
It may increase bleeding, especially with warfarin or antiplatelet drugs.
Which part of the ginkgo plant is toxic when eaten?
The seeds, especially fresh ones.
Connections
← Back to the class: Herbal products and dietary supplements
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Ginkgo: Usefulness and Safety (National Center for Complementary and Integrative Health (NCCIH), 2025); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.