Ginkgo biloba: Contraindications. Practice Points. FAQ

Contraindications and Precautions

If unusual bleeding or bruising occurs, stop use immediately. Although new clinical evidence suggests that Ginkgo biloba does not affect clotting times, it may be prudent to suspend use for 1 week prior to major surgery.

CEREBRAL HAEMORRHAGE AND EPILEPSY

Recent, rare case reports have suggested that ginkgo should be used with caution in people with known risk factors for cerebral haemorrhage and epilepsy until further investigation can clarify its safety.

Pregnancy Use

Not recommended in pregnancy as insufficient reliable evidence is available to determine safety.

Practice Points / Patient Counselling

Ginkgo biloba is a complex herb that contains many different active constituents and works by means of multiple mechanisms. Therefore, it has applications in many varied conditions.

• It is an effective treatment in conditions of acquired cognitive impairment, including dementia of any degree of severity and intermittent claudication, according to evidence from meta-analyses.

• Positive evidence also exists for premenstrual syndrome, sudden deafness, Raynaud’s syndrome and depression when associated with cognitive decline.

• Largely based on the herb’s physiological actions, ginkgo is also used to treat chilblains, haemorrhoids, prevent macular degeneration, glaucoma, sexual dysfunction, impotence, allergies and asthma and improve wellbeing.

• The form of ginkgo most often tested and used is a preparation known as EGb 761, which is standardised to 24% ginkgo flavonol glycosides and 6% terpene lactones.

• Overall, Ginkgo biloba is a very safe herb and is extremely well tolerated.

Answers to Patients’ Frequently Asked Questions

What will this herb do for me?

Ginkgo is a very popular herbal treatment that increases peripheral circulation, beneficially influences brain chemicals, protects nerve cells from damage, and may stimulate immune function and reduce inflammation. Scientific evidence has shown it can improve brain function in both healthy and memory-impaired people. It has also been found to improve symptoms of intermittent claudication and may be useful in chilblains, PMS, vitiligo and seasonal affective disorder and possibly sexual dysfunction such as impotence.

When will it start to work?

This will depend on the condition treated and the dose used. Generally, Ginkgo biloba is a slow-acting herb that can take anywhere from 4 weeks to 3 months to exert maximal effects.

Are there any safety issues?

Ginkgo has been extensively studied and appears to be extremely safe with virtually no side-effects in healthy people. Some contraindications and interactions are possible, so it is recommended it be taken under professional supervision.