Ginkgo biloba is a standardized herbal extract derived from the leaves of the Ginkgo biloba tree (Maidenhair tree). The 40mg dose typically refers to a standardized extract containing 24% flavonoid glycosides and 6% terpene lactones (ginkgolides and bilobalide). It functions primarily as a vasoactive agent, platelet-activating factor (PAF) antagonist, and antioxidant, improving cerebral and peripheral blood flow and protecting neuronal cells from oxidative damage. In India, it is widely used as a phytopharmaceutical for cognitive support and peripheral vascular disorders.
Adult: 120 mg to 240 mg daily in 2 or 3 divided doses. A common regimen is 40 mg three times daily. For cognitive disorders, a minimum of 12 weeks of therapy is recommended to assess efficacy.
Note: Administer orally with a glass of water, preferably with meals to minimize potential gastrointestinal upset. The tablet/capsule should be swallowed whole, not crushed or chewed. Consistent daily intake is important for chronic conditions.
Ginkgo biloba extract exerts multifactorial effects: 1) Vasodilation: Improves microcirculation and blood rheology by modulating nitric oxide (NO) and prostacyclin pathways. 2) Neuroprotection: Scavenges free radicals (antioxidant), reduces neuronal apoptosis, and modulates neurotransmitter systems (e.g., cholinergic, serotonergic). 3) Platelet Inhibition: Acts as a Platelet-Activating Factor (PAF) receptor antagonist, reducing platelet aggregation and thrombus formation. 4) Membrane Stabilization: Improves mitochondrial function and neuronal glucose uptake.
Pregnancy: CONTRANDICATED. Ginkgo seeds contain ginkgotoxin (4'-O-methylpyridoxine) which is antagonistic to vitamin B6 and may cause seizures. The extract may have uterine stimulant effects. Risk Category: Not assigned, but avoid.
Driving: May cause dizziness in some individuals. Patients should not drive or operate machinery if they experience dizziness after taking Ginkgo.
| Warfarin, Acenocoumarol | Increased risk of bleeding due to additive anticoagulant effect (PAF antagonism). May increase INR. | Major |
| Aspirin, Clopidogrel, NSAIDs (e.g., Ibuprofen) | Increased risk of gastrointestinal and other bleeding. | Major |
| SSRIs (e.g., Sertraline, Fluoxetine) | Increased risk of serotonin syndrome (theoretical) and bleeding. | Moderate |
| Antihypertensives (e.g., Amlodipine, Lisinopril) | Potential additive hypotensive effect. | Moderate |
| Antidiabetics (e.g., Metformin, Glimepiride) | May potentiate hypoglycemic effect. | Moderate |
| Omeprazole, Pantoprazole (PPIs) | May alter gastric pH and affect absorption of Ginkgo. | Minor |
| Cytochrome P450 substrates (e.g., Diazepam, Simvastatin) | Ginkgo may induce CYP2C19 and CYP3A4, potentially reducing efficacy of these drugs. | Moderate |
| Trazodone | Case reports of coma when combined. | Major |