ginkgo
5 interactions related to ginkgo
aspirin + ginkgo
Ginkgo biloba can inhibit platelet-activating factor (PAF) and platelet aggregation, which may add to aspirin's irreversible inhibition of cyclooxygenase-1 and thromboxane A2. Observational data suggest a modest increase in minor bleeding events when the two are combined, and there are case reports of more serious bleeds in vulnerable patients, though a controlled trial found no measurable added effect on platelet function.
rivaroxaban + ginkgo
Rivaroxaban is a Factor Xa inhibitor and ginkgo has mild antiplatelet activity, so combining them was theorized to add to bleeding risk. However, a controlled trial in healthy subjects found standardized EGb 761 ginkgo extract did not change rivaroxaban's pharmacokinetics, anti-Factor Xa activity, or coagulation parameters, and caused no bleeding-related adverse events.
warfarin + ginkgo
Warfarin and ginkgo act on clotting through different pathways, raising a plausible but not firmly proven bleeding concern.
clopidogrel + ginkgo
Clopidogrel blocks the platelet P2Y12 ADP receptor, while ginkgo biloba inhibits platelet-activating factor through a separate pathway. A controlled healthy-volunteer study found no measurable added platelet inhibition, but case reports and an observational analysis link the combination to bleeding. The realistic concern is a modest, additive bleeding risk, most relevant in older patients and those also taking aspirin.
ginkgo + phosphatidylserine
Pairing a standardized ginkgo biloba extract with phosphatidylserine appears to improve absorption of ginkgo's active fraction. In one small placebo-controlled crossover trial, the ginkgo-phosphatidylserine complex produced modest improvements in memory performance and speed in healthy young adults, where the same dose of ginkgo alone did not.