Ginkgo biloba (Hunter Smith , University of Mississippi School of Pharmacy

Hunter Smith, Student Pharmacist Spring 2022

Scientific Name: Ginkgo biloba

Common Names: Ginkgo, Kew Tree, Maidenhair Tree

Background:

Ginkgo biloba is a large dioecious tree, part of the Ginkgoaceae family. Ginkgo trees nearly went extinct during the last ice age with only a few tertiary relict trees surviving in China. Ginkgo has been used medically for over a thousand years. The leaves have traditionally been used for asthma, and the seeds were used as a digestive aid and prevent drunkenness. Medical use of ginkgo in western medicine began in the 1960s to inhibit platelet activating factors and as free radical scavengers.

https://media.naheed.pk/catalog/product/cache/49dcd5 d85f0fa4d590e132d0368d8132/1/1/1137102-1.jpg

Dosing:

Ginkgo is commonly dosed at daily doses of 120 – 240 mg.

Pharmacology:

Ginkgo biloba has many mechanisms of action from its two main active ingredients, terpene lactones and ginkgo flavone glycosides. 1. Ginkgo biloba acts as an antioxidant by acting as a free radical scavenger. 2. Triggers the release of endothelium-derived relaxing factor and prostacyclin 3. Moderate nitric oxide production for vasodilation with inflammatory conditions 4. Antagonize platelet-activating factor. 5. In animal studies ginkgo extract reversibly inhibits the uptake of serotonin and dopamine as well as inhibit anticholinesterase.

http://www.infiniteunknown.net/wp-content/uploads/2016/05/GingkoBiloba-Tree.jpg

Common Uses:

• Cardiovascular protection • Chemopreventative • Dementia • Schizophrenia • Stroke • Cognitive function • Sexual dysfunction • Tinnitus

Dosage Forms:

• Tea • Liquids • Colas • Capsules • Extracts • Tablets • Sprays • Bars

Safety:

Ginkgo biloba is considered a safe supplement. There are no contraindications and adverse effects are rare. There could be weak interactions with CYP3A4 inducers if doses are taken higher than the recommended doses.

Effectiveness:

Several studies have been conducted to determine the efficacy of Ginkgo biloba, but there is not enough evidence to support ginkgo for any indication.

Interactions:

No interactions are expected at recommended doses. Weak interactions with CYP3A4 inducers, such as warfarin, omeprazole, and grape fruit juice, at higher doses.

Professional Opinion:

In my opinion, ginkgo biloba could have many positive effects for human health. With no drug or food interactions and rare adverse effects ginkgo biloba could be an adjunctive therapy for many health issues. Although I do think ginkgo biloba can have positive effects, I would not recommend this product to patients do to lack of evidence for indications. ~ H. Smith

Adverse Effects and Toxicities:

Adverse effects are rare but they include: • Headache • Dizziness • Heart palpitations • GI reactions • Dermatologic reactions Toxicities are also rare but are possible. • Possible carcinogen • Toxic syndrome

https://healthjade.net/ginkgo-biloba-reviews/ https://thumbs.dreamstime.com/b/ginkgo-biloba-leaves-pillsmortar-40867354.jpg

References

• Hohmann N, Wolf EM, Rigault P, et al. Ginkgo biloba's footprint of dynamic Pleistocene history dates back only 390,000 years ago. BMC genomics. 2018;19:299-299. • Kluwer W. Ginkgo biloba. Shibboleth authentication request. https://online-lexicom.umiss.idm.oclc.org/lco/action/doc/retrieve/docid/fc_rnp2/3750163?cesid=8ZBfp2cLUFN&search

Url=%2Flco%2Faction%2Fsearch%3Fq%3DGinkgo%252520biloba%26t%3Dname%26va%3DGinkgo%22 520biloba#dis. Published 2022. Accessed March 4, 2022. • Nguyen T. Ginkgo biloba. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK541024/.

Published July 9, 2021. Accessed March 4, 2022. 74