Ginkgo Biloba

(BAN, USAN, rINN)
Synonyms: Árbol de los cuarenta escudos; EGB-761; Fossil Tree; GBE-761; Ginkgo, feuille de (ginkgo leaf); Ginkgo folium (ginkgo leaf); Ginkgoblad (ginkgo leaf); Ginkmedžiu lapai (ginkgo leaf); Jinanový list (ginkgo leaf); Kew Tree; Maidenhair Tree; Neidonhiuspuunlehti (ginkgo leaf); Páfrányfenyo˝levél(ginkgo leaf); Salisburia adiantifolia.
Cyrillic synonym: Гинкго Билоба.

💊 Chemical information

ATC — N06DX02.
ATC Vet — QN06DX02.

Pharmacopoeias.

In Chin., Eur., and US. Eur. also includes Ginkgo Dry Extract, Refined and Quantified. US includes a powdered extract.

Ph. Eur. 6.2

(Ginkgo Leaf). The whole or fragmented dried leaf of Ginkgo biloba containing not less than 0.5% of flavonoids, calculated as flavone glycosides with reference to the dried drug. The leaf is greyish or yellowish-green or yellowish-brown.

USP 31

(Ginkgo). The dried leaf of Ginkgo biloba (Ginkgoaceae) containing not less than 0.5% of flavonoids, calculated as flavonol glycosides, with a mean molecular mass of 756.7, and not less than 0.1% of terpene lactones, both on the dried basis. The leaf is khaki green to greenish-brown. Protect from light and moisture.

💊 Adverse Effects

Adverse effects include headaches, dizziness, palpitations, gastrointestinal disturbances, bleeding disorders, and skin hypersensitivity reactions.

Poisoning.

Reports1,2 of convulsions induced by ingestion of large amounts of ginkgo seeds. Convulsions were thought to be due to the presence of 4-metoxypyridoxine, a competitive antagonist of pyridoxine; giving suitable quantities of a vitamin-B6source may be of benefit in preventing such convulsions.2
1. Miwa H, et al. Generalized convulsions after consuming a large amount of gingko nuts. Epilepsia 2001; 42: 280–1
2. Kajiyama Y, et al. Ginkgo seed poisoning. Pediatrics 2002; 109: 325–7.

💊 Interactions

It has been suggested that ginkgo biloba should be used with caution in patients receiving anticoagulants or drugs that affect platelet aggregation. For reference to a possible interaction with warfarin.

💊 Uses and Administration

An extract from the leaves of Ginkgo biloba has been used in cerebrovascular and peripheral vascular disorders. It is also being investigated in Alzheimer’s disease, multi-infarct dementia, and in tinnitus. Ginkgo biloba is a source of ginkgolides (below).

Homoeopathy.

Ginkgo biloba has been used in homoeopathic medicines under the following names: Ginkgo.

Cerebrovascular disorders.

A systematic review1 of 10 randomised or quasi-randomised studies concluded that the routine use of ginkgo biloba extracts to promote recovery after ischaemic stroke was not supported by any convincing evidence, and that larger better quality studies were required.
1. Zeng X, et al. Ginkgo biloba for acute ischaemic stroke. Available in the Cochrane Database of Systematic Reviews; Issu
4. Chichester: John Wiley; 2005 (accessed 23/05/06).

Dementia.

Ginkgo biloba extracts have been tried in the treatment of dementia including Alzheimer’s disease. Metaanalyses1-3 have found the extracts to be more effective than placebo in some cases but results are inconsistent and unconvincing3 and the authors of all analyses commented that further investigation is needed to establish any clinical value. A subsequent study found no evidence of benefit.4 Another study assessing whether ginkgo biloba can prevent cognitive decline in very elderly people with normal memory function found positive effects only after adjustment for noncompliance.5 In this study5 a greater number of cases of stroke or transient ischaemic attacks was noted in those given ginkgo biloba but further study is required to confirm any link to use of ginkgo.
1. Oken BS, et al. The efficacy of ginkgo biloba on cognitive function in Alzheimer disease. Arch Neurol 1998; 55: 1409–15
2. Ernst E, Pittler MH. Ginkgo biloba for dementia: a systematic review of double-blind, placebo-controlled trials. Clin Drug Invest 1999; 17: 301–8
3. Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Available in The Cochrane Database of Systematic Reviews; Issu
2. Chichester: John Wiley; 2007 (accessed 02/05/08)
4. McCarney R, et al. Ginkgo biloba for mild to moderate dementia in a community setting: a pragmatic, randomised, parallel-group, double-blind, placebo-controlled trial. Int J Geriatr Psychiatry 2008. Available at: doi: 10.1002/gps.205
5. Dodge HH, et al. A randomized placebo-controlled trial of Ginkgo biloba for the prevention of cognitive decline. Neurology 2008; 70: 1809–17.

Peripheral vascular disorders.

Ginkgo biloba extracts have been tried in the treatment of peripheral vascular disorders. A meta-analysis1 found the extracts to be more effective than placebo in the symptomatic treatment of intermittent claudication, although the authors considered the size of the effect to be modest and of uncertain clinical relevance.
1. Pittler MH, Ernst E. Ginkgo biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials. Am J Med 2000; 108: 276–81.

Tinnitus.

Ginkgo biloba extracts have been tried in the treatment of tinnitus. A systematic review1 of 5 randomised controlled studies cautiously concluded that these results were favourable, although a later systematic review2 failed to show benefit.
1. Ernst E, Stevinson C. Ginkgo biloba for tinnitus: a review. Clin Otolaryngol 1999; 24: 164–7
2. Hilton M, Stuart E. Ginkgo biloba for tinnitus. Available in The Cochrane Database of Systematic Reviews; Issu
2. Chichester: John Wiley; 2004 (accessed 23/05/06).

💊 Preparations

USP 31: Ginkgo Capsules; Ginkgo Tablets.

Proprietary Preparations

Arg.: Clarvix; Herbaccion Cerebral†; Kalter; Tanakan; Austral.: Proginkgo†; Tavonin†; Austria: Cerebokan; Ceremin; Gingohexal; Gingol; Tebofortan; Tebonin; Belg.: Memfit; Tanakan; Tavonin; Braz.: Binko†; Bioflavin; Clibium†; Dinaton; Equitam; Gibilon; Ginbiloba; Gincobem; Gincolin; Ginkoba; Ginkobil†; Ginkofarma†; Ginkogreen; Ginkolab; Ginkomed; Ginkoplus; Gyncobem; Kiadon†; Kirsan; Mensana†; Oxian; Tanakan; Tebonin; Chile: Kiadon; Memokit; Ment Vital†; Nokatar; Rokan; Tebokan†; Cz.: Gingio; Gingium†; Tanakan; Tebokan; Fr.: Ginkogink; Tanakan; Tramisal; Ger.: Alz†; Duogink; Gincuran†; Gingiloba; Gingium; Gingobeta; Gingopret; Ginkobil; Ginkodilat; Ginkokan†; Ginkopur; Isoginkgo; Kaveri; Rokan; Tebonin; Gr.: Tanacain; Tebokan; Hong Kong: Ebamin; Ginkolin; Tanakan; Hung.: Bilobil; Gingium; Ginkgold; Tanakan; Tebofortan; Tebonin†; Indon.: Brenax; Gingkan; Ginkgoforce; Ginkona; Lanaginkola; Ital.: Ginkoba; Novel Ginkgo†; Malaysia: Appeton Memocap†; Giloba; Gincare; Ginkocer†; Tanakan; Mex.: Bilogink†; Kolob†; Nemoril; Tanakan†; Tebonin; Vasodil; Neth.: Tavonin; Philipp.: Ginkocer; Tebokan; Pol.: Bilobil; Geriacaps; Ginkgomax; Ginkofar; Herbabiloba; Memoplant; Tanakan; Port.: Abolibe; Biloban; Gincoben; Ginkoftal†; Vasactife; Rus.: Bilobil (Билобил); Ginos (Гинос); Memoplant (Мемоплант); Tanakan (Танакан); Singapore: Gincare; Ginexin-F†; Ginkapran; Ginkosen; Gitako; Neuroxin; Tanakan; Tebonin; Spain: Fitokey Ginkgo; Normocir†; Tanakene; Switz.: Demonatur Ginkgo; Geriaforce; Gingosol; Oxivel†; Symfona; Tanakene; Tebofortin†; Tebokan; Valverde Vitalite dragees†; Thai.: Tanakan; Turk.: Gingobil; Tanakan; UK: Ginkovital; USA: BioGinkgo; Venez.: Kiadon; Neukob; Tanakan; Tebokan; Varginko. Multi-ingredient: Arg.: Centellase de Centella Queen; Flebitol; Garcinol Max†; GB 100; Ginkgo Biloba Forte; Ginkgo Biloba Memo Diates; Ginkgo Forte; Herbaccion Celfin; Herbaccion Memory; Neuroton; SCV 300; Snell Patch; Snell Progress; Top Life Memory†; Venoful; VNS 45; Austral.: Bilberry Plus Eye Health; Bioglan Vision-Eze; Bioglan Zellulean with Escin; Clements Tonic; Extralife Extra-Brite; Extralife Eye-Care; Extralife Leg-Care; Eye Health Herbal Plus Formula 4; For Peripheral Circulation Herbal Plus Formula 5; Gingo A†; Ginkgo Biloba Plus†; Ginkgo Complex†; Ginkgo Plus Herbal Plus Formula 10†; Herbal Arthritis Formula†; Herbal Capillary Care†; Lifechange Circulation Aid†; Lifechange Multi Plus Antioxidant†; Lifesystem Herbal Formula 6 For Peripheral Circulation†; Lifesystem Herbal Plus Formula 11 Ginkgo†; Lifesystem Herbal Plus Formula 5 Eye Relief†; Prophthal†; Vig; Braz.: Composto Anticelulitico†; Derm’attive Solaire†; Traumed†; Canad.: Ginkoba†; Chile: Celltech Gold; Gincosan; GingoTher†; Mentania; Sebium AKN; Cz.: Gincosan; Ginkor Fort; Fr.: Ginkor; Ginkor Fort; Photoderm Flush†; Sebium AKN; Ger.: Perivar†; Veno-Tebonin N†; Hong Kong: Flavo-C; Ginkgo Plus Vivo-Livo†; Ginkgo-PS†; Ginkor Fort; Hung.: Ginkor Fort; Indon.: Cereton; Ginokan; Hemaviton Brain Nutrient; Proseval; Ital.: Angioton; Angiovein; Forticrin; Ginkoba Active; Ginkoftal; Ginkoret; Memoactive†; Memorandum; Neuralta Migren; Pik Gel; Pollingel con Ginkgo Biloba†; Pulsalux; Varicofit; Vasobrain; Vasobrain Plus; Vasopt; Venalta; Vertiginkgo; Malaysia: Cerestar†; Circarol; Ginkor Fort; Total Man†; Mex.: Maxibiloba; Philipp.: Circulan; Nutrotal; Pol.: Bioginko; Cardiobonisol; Ginkgocard; Intelektan; Passibil; Venoforton; Rus.: Ginkor Fort (Гинкор Форт); Ginkor Gel (Гинкор Гель); Singapore: Ginkgo-PS; Memoloba†; Switz.: Allium Plus; Arterosan Plus; Capsules-vital; Gincosan; Triallin; Thai.: Ginkor Fort; UK: ProBrain; USA: Aphrofem; Cavigen; Dorofen; Gentaplex; Venez.: Sebium AKN; Sengobil.
Published May 08, 2019.