//fpnotebook.com/
Ginkgo Biloba
Aka: Ginkgo Biloba
- Indications (Purported benefits)
- Alzheimer's Disease
- Multiple-Infarct Dementia
- Used in Germany for:
- Intermittent Claudication
- Vertigo
- Tinnitus
- Efficacy: Cognitive effects
- Preliminary studies suggest possible benefit
- Benefits likely to offer only modest effect
- Dementia Study, n=309, 120 mg qd for 1 year, RDBCT
- Ginkgo patients scored higher on cognitive tests
- Caregivers rated Ginkgo patients higher score
- Clinicians ratings found no difference
- Patients completing study: <50%
- Le Bars (1997) JAMA 278:1327 [PubMed]
- Van Dongen study found no benefit
- No benefit in Dementia
- No benefit in memory Impairment
- Van Dongen (2000) Am Geriatr Soc 48:1183-94 [PubMed]
- NIH DBPCT with n=2000 over 6 years is ongoing
- Sierpina (2003) Am Fam Physician 68(5):923-6 [PubMed]
- Efficacy: Non-cognitive uses
- Peripheral Vascular Disease
- Study showed longer walking distance and less pain
- Peters (1998) Vasa 27:106-10 [PubMed]
- Tinnitus
- Modest effect on reduction or Tinnitus resolution
- Ernst (1999) Clin Otolaryngol 24:164-7 [PubMed]
- Mechanism
- Components
- Flavonoids and Terpenoids are antioxidants
- Ginkgolide B (terpenoid)
- Inhibits Platelet activating factor
- Interferes with Platelet aggregation and blood clot
- Pharmacokinetics
- Readily absorbed
- Peak concentration in 2-3 hours after ingestion
- Excreted by Kidney, Liver
- Half life: 5 hours
- Dosing
- Standardized extract: 120 to 160 mg divided bid to tid
- Standardized extract components
- Flavone glycosides: 24%
- Terpene lactones: 6%
- Adverse Effects
- Mild Gastrointestinal symptoms (Vomiting, Diarrhea)
- Headache
- Serious bleeding complications (e.g. Subdural Hematoma)
- Associated with Aspirin and Warfarin use
- Due to Platelet Dysfunction
- Exacerbated by Garlic, Feverfew, Ginseng
- Seizures
- Reports of Seizures in those with Epilepsy and previously controlled on prophylaxis
- Contraindications: Avoid use with Anticoagulants
- Aspirin
- Warfarin (Coumadin)
- Ticlopidine (Ticlid)
- Clopidogrel (Plavix)
- Dipyridamole (Persantine)
- Herbals with Anticoagulant activity
- Feverfew
- Garlic
- Ginseng
- Dong Quai
- Red Clover
- Precautions
- Stop Ginkgo 36 hours to 14 days before surgery
- References
- Shaughnessy (1997) Fam Practice Recert 19(10):53-6
- Ang-Lee (2001) JAMA 286:208-16 [PubMed]
- Cupp (1999) Am Fam Physician 59(5):1239-44 [PubMed]
- Sierpina (2003) Am Fam Physician 68(5):923-6 [PubMed]
- Zink (1998) Am Fam Physician 58(5):1133-40 [PubMed]