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Supplement · Grade B

Ginkgo Biloba and medications.

Every documented pair, every citation. Below: 6 documented pairs grouped by mechanism.

Ginkgo Biloba is in the Distil supplement database, evidence Grade B. The page below lists every medication we have explicitly assessed it against.

Ginkgo biloba, usually sold as the standardised EGb 761 extract, comes from the leaves of the maidenhair tree. Its flavone glycosides and terpene lactones support cerebral circulation, and the terpene lactones (ginkgolides) directly block platelet-activating factor. The Grade B evidence sits mainly in age-related cognitive decline and dementia: Le Bars 1997 and a 2015 meta-analysis found 240mg/day may support cognitive function, and there is reasonable evidence for anxiety. The honest limit is tinnitus, where recent reviews do not support a benefit, so it should not be recommended on that basis alone. The interaction angle is the main reason for care. Ginkgo is the most potent antiplatelet compound in the Distil database at standard doses, roughly 30 to 40 percent of low-dose aspirin at 240mg/day. It must be avoided or closely monitored with anticoagulants and antiplatelet drugs like aspirin and clopidogrel, and stopped at least six weeks before surgery. Worth checking with your GP if you take any blood thinner.

Below are the 6 documented pairs we have explicitly assessed for Ginkgo Biloba: 6 amber. The pairs cluster around 1 mechanism: Additive antiplatelet effect. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

Additive antiplatelet effect

Amber Aspirin

Both ginkgo and aspirin reduce platelet aggregation, so combining them increases bleeding risk additively. The combination is not catastrophic at typical doses but is worth stopping six weeks before any planned surgery or dental procedure.

PMID 29196903 · BNF: Aspirin
Amber Clopidogrel

Both ginkgo and clopidogrel reduce platelet aggregation, so combining them increases bleeding risk additively. The combination is worth stopping six weeks before any planned surgery or dental procedure.

BNF: Clopidogrel · PMID 29196903

Both ginkgo and diclofenac can slow blood clotting. Used together for short periods at standard doses, the combined effect is usually mild. Used at high doses for long periods, the combined effect can mean more bleeding and bruising. Stop ginkgo at least two weeks before any planned surgery.

PMID 22530457 · PMID 32478963 · PMID 29196903 · BNF: Diclofenac
Amber Ibuprofen

Both ginkgo and ibuprofen can slow blood clotting. Used together for short periods at standard doses, the combined effect is usually mild. Used at high doses for long periods, the combined effect can mean more bleeding and bruising. Stop ginkgo at least two weeks before any planned surgery.

PMID 22530457 · PMID 32478963 · PMID 29196903 · BNF: Ibuprofen
Amber Naproxen

Both ginkgo and naproxen can slow blood clotting. Used together for short periods at standard doses, the combined effect is usually mild. Used at high doses for long periods, the combined effect can mean more bleeding and bruising. Stop ginkgo at least two weeks before any planned surgery.

Ginkgo biloba has a mild antiplatelet effect of its own. The clinical data on whether it meaningfully shifts INR is mixed, but bleeding events have been reported, so combining with warfarin is best done with INR monitoring rather than freely.

PMID 32478963 · PMID 29196903 · BNF: Warfarin

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology
Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.