Ginkgo biloba

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Introduction

An ornamental tree & the oldest species of tree. Medicinal use has been traced back to the Chinese Materia Medica from 2800 BC. The German physician Engelbert Kaempfer was the 1st European to catalog Ginkgo in the late 17th century. It was brought to the US in 1784. Ginkgo is the most resistant of all trees to infection & pollution.

Uses

Current uses:

* of questionable benefit for cognitive impairment peripheral arterial disease (data conflicting)[16]

Contraindications

Caution:

  • discontinue use prior to surgery (1-2 weeks prior)
  • avoid in patients with bleeding disorder
  • avoid in patients with seizure disorder

Dosage

Pharmacokinetics

Adverse effects

Drug interactions

* discontinue 36 hours before surgery[12]

Mechanism of action

More general terms

References

  1. Victoria Rand, UCSF Fresno Lecture, 10/7/98
  2. Le Bara et al, JAMA October 1997
  3. Kleijnen et al, British J Clinical Pharmacology, 1992
  4. Kaiser Permanente, Northern California Regional Pharmacy & Therapeutics Committee
  5. Jump up to: 5.0 5.1 Prescriber's Letter 7(9):53 2000
  6. Jump up to: 6.0 6.1 Prescriber's Letter 9(2):9 2002
  7. Jump up to: 7.0 7.1 Journal Watch 22(18):140, 2002 Prescriber's Letter 9(9):53-54 2002 Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R. Ginkgo for memory enhancement: a randomized controlled trial. JAMA. 2002 Aug 21;288(7):835-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12186600
  8. Jump up to: 8.0 8.1 8.2 8.3 Prescriber's Letter 12(9): 2005 Drug Interactions with Ginkgo Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210910&pb=PRL (subscription needed) http://www.prescribersletter.com
  9. Jump up to: 9.0 9.1 DeKosky ST et al Ginkgo biloba for Prevention of Dementia JAMA. 2008;300(19):2253-2262 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19017911
  10. Jump up to: 10.0 10.1 Prescriber's Letter 16(1): 2009 Ginkgo for Prevention of Dementia Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=250103&pb=PRL (subscription needed) http://www.prescribersletter.com
  11. Jump up to: 11.0 11.1 Snitz BE et al Ginkgo biloba for Preventing Cognitive Decline in Older Adults. JAMA. 2009;302(24):2663-2670 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20040554 <Internet> http://jama.ama-assn.org/cgi/content/full/302/24/2663
  12. Jump up to: 12.0 12.1 12.2 12.3 12.4 12.5 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
  13. Jump up to: 13.0 13.1 Vellas B, Coley N, Ousset PJ et al Long-term use of standardised ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial Lancet Neurol. 2012 Oct;11(10):851-9. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22959217 <Internet> http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2812%2970206-5/abstract
  14. Jump up to: 14.0 14.1 14.2 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
    Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  15. Hirsch C. Ginkgo biloba extract did not reduce risk for Alzheimer disease in elderly patients with memory complaints. Ann Intern Med. 2013;158(2):JC7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23318341
  16. Jump up to: 16.0 16.1 16.2 16.3 Medical Knowledge Self Assessment Program (MKSAP) 17, 18 American College of Physicians, Philadelphia 2015, 2018.
  17. Jump up to: 17.0 17.1 17.2 Li S, Zhang X, Fang Q et al Ginkgo biloba extract improved cognitive and neurological functions of acute ischaemic stroke: a randomised controlled trial. Stroke Vasc Neurol. 2017 Dec 18;2(4):189-197 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29507779 Free PMC Article <Internet> http://svn.bmj.com/content/early/2017/11/08/svn-2017-000104