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Precautions
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.
GBE is considered to be safe and side effects are rare. In a few cases, gastrointestinal upset, headaches, skin reactions, and dizziness were reported.
Because gingko decreases platelet aggregation (stickiness), there is some concern that it may increase risk of intracranial (brain) hemorrhage. In fact, there have been several reports of bleeding complications associated with ginkgo use. However, it is not clear whether ginkgo or another factor (such as the combination of ginkgo and blood-thinning medications including aspirin) caused the bleeding complications.
Pregnant and breastfeeding women should avoid using ginkgo preparations. In addition, ginkgo use should be discontinued at least 36 hours prior to surgery due to the risk of bleeding complications.
Do not ingest Ginkgo biloba fruit.
Possible Interactions
If you are currently being treated with any of the following medications, you should not use ginkgo without first talking to your healthcare provider:
Ginkgo and Anticonvulsant medications
High doses of Ginkgo biloba could decrease the effectiveness of anticonvulsant therapy in patients taking carbamazepine or valproic acid to control seizures.
Ginkgo and Blood-thinning medications
Ginkgo has blood-thinning properties and therefore should not be used if you are taking anticoagulant (blood-thinning) medications, such as aspirin, clopidogrel, dipyridamole, heparin, ticlopidine, or warfarin.
Ginkgo and Cylosporine
Ginkgo biloba may be beneficial during treatment with cyclosporine because of its ability to protect cell membranes from damage.
Ginkgo and MAOIs (Monoamine oxidase inhibitors)
Ginkgo may enhance the effects (both good and bad) of antidepressant medications known as MAOIs, such as phenelzine and tranylcypromine.
Ginkgo and Papaverine
The combination of papaverine and ginkgo may be effective for the treatment of erectile dysfunction in patients who do not respond to papaverine alone.
Ginkgo and Thiazide diuretics
Although there has been one literature report of increased blood pressure associated with the use of ginkgo during treatment with thiazide diuretics, this interaction has not been verified by clinical trials. Nevertheless, you should consult with your healthcare provider before using ginkgo if you are taking thiazide diuretics.
Ginkgo and Trazodone
Additionally, there has been a report of an adverse interaction between ginkgo and trazodone, an antidepressant medication, that resulted in an elderly patient going into a coma.
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