Ginkgo Biloba (Eun-haeng, fossil tree, ginko biloba, ginkyo, icho, ityo, Japanese silver apricot, kew tree, maidenhair tree, salisburia, silver apricot)
Classes: Neurology & Psychiatry, Herbals
Suggested dosing of Eun-haeng, fossil tree (ginkgo biloba)
Altitude Sickness, Prevention
Leaf extract: 80 mg PO BId
Cognitive Function
Leaf extract: 120-600 mg/d PO BId
Dementia
Leaf extract: 120-240 mg/d PO div BID-TId
Intermittent Claudication
Leaf extract: 120-240 mg/d PO div BID-TId
Premenstrual Syndrome
Leaf extract: 80 mg PO BID; start on day 16 and continue until day 5 of next cycle
SSRI-induced Sexual Dysfunction
Leaf extract: 60-240 mg PO BId
Vertigo/tinnitus
Leaf extract: 120-160 mg/d PO div BID-TId
Raynaud's Disease
Leaf extract: 360 mg/d PO div TId
Normal Tension Glaucoma
Leaf extract: 40 mg PO TID x 4 weeks
Other Information
Standardized to 24% flavonoids, 6% terpenes
Suggested uses of Eun-haeng, fossil tree (ginkgo biloba)
Altitude sickness (prevention), cerebral vascular insufficiency, cognitive disorders, dementia, dizziness/vertigo, intermittent claudication, macular degeneration/glaucoma, memory loss, premenstrual syndrome, SSRI-induced sexual dysfunction, vasodilator
Efficacy
Documented incr in cerbral blood flow (greater effect in patients >50 years old)
Documented increase in peripheral blood flow in diabetes, intermittent claudication, hearing loss
Studies underway for SSRI-induced erectile dysfunction; initial results positive
Eun-haeng, fossil tree (ginkgo biloba) adverse (side) effects
Frequency not defined
Allergic skin reactions
Bleeding disorders
Constipation
Contact dermatitis (topical use)
Diarrhea
Dizziness
Impaired fertility
GI upset
Headache
Nausea/vomiting
Palpitations
Restlessness
Seizures
Subdural hematoma
Weakness
Vertigo (rare)
Case reports of sponataneous bleeding from iris when used with aspirin
Warnings
Contraindications
Hypersensitivity
Avoid prior to surgery: may cause bleeding
Attempting conception
Cautions
Bleeding disorders, concurrent seizure threshold lowering drugs, diabetes mellitus, seizure disorder
WARNING: seeds & fruit pulp are toxic
May modulate some CYP 450 enzymes but clinical significance unknown, monitor when using concomitant substrates (eg, CYP3A4)
Pregnancy and lactation
Pregnancy category: N/A
Lactation: N/A
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Eun-haeng, fossil tree (ginkgo biloba)
Metabolism: N/A
Excretion: N/A
Mechanism of action
Ginkgoflavone glycosides: reduce capillary fragility, act as antioxidants
Ginkgolides: inhib. platelet activating factor
