ginkgo biloba
4 interactions related to ginkgo biloba
phenytoin + ginkgo
Ginkgo biloba induces CYP2C19, the primary enzyme responsible for phenytoin metabolism. A published case report described a fatal breakthrough seizure in a patient on phenytoin and valproate whose autopsy revealed subtherapeutic anticonvulsant levels and self-administration of ginkgo biloba. Ginkgo also has independent pro-convulsant potential at high doses and through ginkgotoxin contamination.
warfarin + ginkgo
Ginkgo biloba inhibits platelet-activating factor and can prolong bleeding time, adding an antiplatelet effect on top of warfarin's vitamin-K-antagonist anticoagulation. A 2025 PLOS One analysis of 2,647 prescriptions found ginkgo co-prescription was associated with a significantly higher rate of bleeding adverse events (hazard ratio ~1.38) and abnormal coagulation profiles.
ibuprofen + ginkgo
Ibuprofen inhibits platelet aggregation through COX-1, and Ginkgo biloba inhibits platelet-activating factor through ginkgolide B. Combining them increases the risk of bleeding, with case reports of fatal intracerebral hemorrhage.
ginkgo + phosphatidylserine
Ginkgo biloba improves cerebral blood flow and has antioxidant effects; complexing it with phosphatidylserine substantially enhances absorption of its active terpene lactones and flavone glycosides. The Virtiva complex (ginkgo + phosphatidylserine) showed improved secondary memory and faster memory task performance versus ginkgo alone in a placebo-controlled crossover trial.