Ginkgo Biloba GING-ko bi-LOH-ba

What are other names for this remedy?

Type of medicine: natural remedy

Scientific and common names: Ginkgo biloba, maidenhair tree, kew tree, fossil tree, ginkyo, yinhsing, Japanese silver apricot, ginkgo leaf

What is ginkgo?

The ginkgo is the world's oldest living tree species. Female trees produce a plumlike, gray-tan fruit. The seed of the fruit looks like an almond and can be eaten. Leaves from the tree are used for medicine.

What is it used for?

This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider. There may be other uses that are not listed below.

Ginkgo has been used to treat:

• altitude sickness
• Alzheimer's disease and dementia
• anxiety
• cerebral vascular insufficiency (not enough blood reaching the brain)
• eye problems such as glaucoma, macular degeneration, and color vision problems in people with diabetes
• heart problems
• leg pain when due to poor blood flow (claudication)
• lung problems such as asthma and bronchitis
• premenstrual syndrome (PMS)
• problems with memory and concentration
• Raynaud's disease
• sexual problems related to antidepressant medicines
• tinnitus (ringing in the ear)
• vertigo

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is it taken?

Ginkgo comes in the form of a tincture, extract, tablets, or capsules. Follow the directions printed on the product label or given by your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Do not take this remedy if you have:

• a seizure disorder such as epilepsy
• a bleeding disorder

Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this remedy. It may cause you to bleed more.

Avoid skin contact with the ginkgo plant. It can cause a severe allergic reaction.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may have different strengths and effects. They may be contaminated.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Seizures, unusual bruising or bleeding.

Other: Headache, dizziness, fast or irregular heartbeat, weakness, decreased muscle tone, diarrhea, constipation, nausea, vomiting, rash.

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects. Before taking this remedy, talk to your healthcare provider if you are taking:

• antianxiety medicines such as alprazolam (Xanax) and triazolam (Halcion)
• antidepressants such as amitriptyline, desipramine (Norpramin), and fluoxetine (Prozac)
• antipsychotics such as clozapine (Clozaril), olanzapine (Zyprexa), and trazodone
• antiseizure medicines such as carbamazepine (Tegretol), gabapentin (Neurontin), phenobarbital, phenytoin (Dilantin), topiramate (Topamax), and valproic acid (Depakote)
• birth control pills and hormones such as estradiol (Estrace, Estratab), conjugated estrogens (Premarin), medroxyprogesterone (Provera), megestrol (Megace), norethindrone (Aygestin, Micronor), and norgestrel (Ovrette)
• blood pressure medicines such as diltiazem (Cardizem) and metoprolol (Lopressor, Toprol XL)
• buspirone (BuSpar)
• clarithromycin (Biaxin)
• cyclosporine (Neoral, Gengraf, Sandimmune)
• donepezil (Aricept)
• flecainide (Tambocor)
• hydrochlorothiazide
• indinavir (Crixivan)
• medicine that reduces the chance of blood clots forming such as aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, pentoxifylline (Trental), and warfarin (Coumadin)
• medicines to treat diabetes such as glipizide (Glucotrol), glyburide (DiaBeta, Glynase), insulin, metformin (Glucophage), pioglitazone (Actos), and rosiglitazone (Avandia)
• natural remedies such as angelica, anise, arnica, borage seed oil, capsicum, chamomile, clove, EDTA, evening primrose oil, fenugreek, garlic, ginger, glutamine, horse chestnut, horseradish, hyssop, licorice, melatonin, melatonin, Panax ginseng, papain, passionflower, red clover, rosemary, sage, St. John's wort, turmeric, and willow,
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• ondansetron (Zofran)
• pain medicines such as codeine, fentanyl (Duragesic), meperidine (Demerol), methadone (Dolophine), and tramadol (Ultram)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

Keep all natural remedies and medicines out of the reach of children.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.