Ginkgo biloba

SCIENTIFIC NAME:	FAMILY NAME: Ginkgoaceae
COMMON NAME: ginkgo

EVIDENCE FOR EFFICACY (HUMAN DATA)

Clinical Trials
	Ginkgo biloba standardized extract slowed down the cognitive deterioration of patients with vascular cognitive impairment in a 6-month, randomized, double-blind, placebo-controlled clinical trial.Demarin 2017
	In a randomized, double-blind, placebo-controlled exploratory study, Ginkgo biloba special extract LI 1370 improved dual-task walking in patients with mild cognitive impairment. Gschwind 2017
	Early treatment of extract of Ginkgo biloba (Ginaton) in delayed encephalopathy after acute carbon monoxide poisoning effectively improved lesion and signal on MRI and abnormal rate on EEG. [Article in Chinese] Xiao 2017
	In a prospective controlled randomized study, methylprednisolone had no additional benefits in patients with vestibular neuritis who underwent vestibular exercises and received Ginkgo biloba. Yoo 2017
	In a prospective, experimental pilot study, a recommended standard intake of 1260 mg Ω-3 polyunsaturated fatty acids (fish oil) daily - but not echinacea, ginkgo biloba, ginseng, St. John's wort, valeriana or garlic - decrease platelet aggregation and clot formation in healthy volunteers. Bagge 2016
	A randomized double blind placebo-controlled trial, on the effect of Ginkgo biloba EGb 761 on cognitive function in elderly adults with subjective memory impairment is presented. The conclusions show possible beneficial effect of EGb 761. Beck 2016
	The toxicities of the G. biloba extract (GBE) combined with sorafenib in patients with advanced HCC were similar with those observed in sorafenib monotherapy. GBE in combination with sorafenib slightly improved overall survival. Cai 2016
	A systematic review of 8 articles (n=563) on pharmacological treatments for postviral olfactory dysfunction cited that subjects did not show significant improvement when treatment with Ginkgo biloba.Harless 2016
	A prospective study evaluated data of patients with tinnitus. One group was treated with betahistine dihydrochloride. A second group, unimproved from Group 1, was treated with hyperbaric oxygen therapy with G. biloba extract. Both methods treatment of tinnitus are statistically significant. Holy 2016
	In a pilot study, patients with a Tinnitus Handicap Inventory (THI) score > 18 who listened to tailor-made notched music via smart phone for 30-60 min/day & took G. biloba for 3 months showed an improvement in their THI score. The effect was particularly marked for the emotional score of the THI. Kim 2016
	26 patients with tinnitus were treated with smartphone delivered notched music and prescribed Ginkgo biloba for three months. Testing after this period, showed improved scores on the Tinnitus Handicap Inventory, especially those with a higher initial THI score.Kim 2016
	A review of clinical studies using herbal therapies for clinical otorhinolaryngological problems found that per os ginkgo biloba has no indications in tinnitus, presbycusis or anosmia following viral rhinitis. However it did show superiority over placebo for selected vertigo. Laccourreye 2016
	A review of systemic reviews randomized controlled trials conducted in people with Alzheimer's disease or dementia measuring the impact on activities of daily living (ADL) was examined. 7 studies using Ginkgo biloba were included in this review. Laver 2016
	Among 22 randomized controlled trials, the evidence for antioxidants as add-on treatments to standard antipsychotic medication for improving acute psychotic episodes and core symptoms, and preventing relapse in people with schizophrenia is limited and mostly not relevant to clinicians or consumers. Magalhaes 2016
	In a double-blind, placebo-controlled, crossover study, G. biloba improved aspects of Stroop and Berg tasks in females but not in males. G. biloba reversed the intial (i.e., placebo) increase in cardiovascular reactivity (BP increased) to cognitive tasks in females.Ong 2016
	Review found various preclinical and clinical studies have shown a positive effect of Ginkgo biloba to improve cognitive abilities in impaired individuals and reducing anxiety under pathological conditions. Singh 2016
	In a randomized, double-blind, placebo-controlled crossover pilot study, treatment with Sailuotong, a formula of Panax ginseng, G. biloba & Crocus sativus resulted in small improvements in neurocognitive and cardiovascular function in healthy adults compared to placebo. Steiner 2016
	Bakuchiol, G. biloba extract and mannitol (BMG) complex regulated the sebum composition in acne patients by increasing the level of sapienic and linolenic acid and reducing the level of oleic acid. The reduced number of porphyrins on the skin surface showed it’s effectiveness against P. acnes. Trompezinski 2016
	Based on 12 systematic reviews of randomized controlled trials, G. biloba extract (200mg/day or more) taken for 22 wks or longer has potentially beneficial effects vs. placebo on cognitive performance, activities of daily living & clinical global impression in the treatment of dementia. Yuan 2016
	Using the GRADE (the Grading of Recommendations Assessment, Development and Evaluation) approach, an overview of systematic reviews concluded that G. biloba had tiny trends toward improvement in the neurological outcomes of patients with acute ischemic stroke.Zhang 2016
	Evaluation of all systematic reviews of G. biloba extract (GBE) for prevention of cognitive decline & intervention of mild cognitive impairment & dementia found that medication with GBE showed improvement in cognition, neuropsychiatric symptoms & daily activities; the effect was dose-dependent. Zhang 2016
	Meta-analysis of 3 randomized controlled trials from China suggested that adjunctive treatment with an extract of Ginkgo biloba appeared to be an effective and safe option for improving tardive dyskinesia in the treatment of schizophrenia patients. Zheng 2016
	A randomized controlled trial of an extract of Ginkgo biloba (EGb) for tardive dyskinesia (TD) showed that EGb was an effective and safe treatment for the improvement of TD. Zheng 2016
	Study of effects of Ginkgo biloba extract (GBE) on cognitive functions as well as oxidative stress and brain-derived neurotrophic factor (BDNF) levels in aged female rats showed GBE supplementation improved cognitive functions by decreasing oxidative damage and increasing BDNF level. Belviranlı 2015
	In a double-blinded, placebo-controlled, crossover trial of hypertensive subjects, a combination of extracts from grape seed & skin, green tea, resveratrol & a blend of quercetin, ginkgo biloba & bilberry reduced diastolic blood pressure by potentiating eNOS activation & nitric oxide production. Biesinger 2015
	Study of capsules containing n-3 polyunsaturated fatty acid, Ginkgo biloba leaf dry extracts, and lycopene taken daily for 3 years showed higher adherence to supplementation intervention was associated with lower Alzheimer's disease incidence and combination of supplements had significant effects. Bun 2015
	Review of efficacy and safety of extract of Gingko biloba (EGb) discusses 8 randomized, double-blind, placebo-controlled trials (RCTs) of 1033 patients in chronic schizophrenia treatment showing EGb had a significant difference in ameliorating total and negative symptoms. Chen 2015
	Administration of 15% solution of ginkgolide B treatment significantly decreases intracranial pressure and improves cerebral perfusion pressure in addition to decreases in lactate/pyruvate ratio in severely brain-injured comatose patients resistant to standard treatment. Chi 2015
	In a placebo-controlled trial, treatment of facial wrinkles in 21 female subjects with 2% formulated cream containing G. biloba, Punica granatum, Ficus carica and Morus alba fruits extract for 56 days significantly reduced the percentage of wrinkle depth, length, and area. Ghimeray 2015
	Meta-analyses of randomized, controlled clinical trials showed that silexan® (WS® 1265, lavender oil) in anxiety disorders, WS® 5570 (Hypericum extract) in major depression & EGb 761® (G. biloba extract) in dementia, were significantly superior to placebo in patients aged ≥ 60 years old. Kasper 2015
	Study of effects of Panax ginseng and Gingko biloba on driving performance showed no statistically significant difference between ginseng, Ginkgo or placebo on driving performance possibly due to the relatively small numbers in this study. LaSala 2015
	2 month study of using BGM (bakuchiol, Ginkgo biloba extract, and mannitol) complex to increase clinical efficacy of adapalene 0.1% gel in 111 patients with acne showed BGM improves the efficacy of adapalene by reducing lesions, seborrhea intensity and improving quality of life. Poláková 2015
	Reviewed treatment options in the management of chronic tinnitus, indicating nutritional supplements have a place in the treatment of mild-to-moderate tinnitus. Reviewers noted that Ginkgo biloba and B-complex vitamins may have an impact on selected patients. Seidman 2015
	Study of efficacy of Ginkgo biloba as a complementary therapy for attention-deficit/hyperactivity disorder (ADHD) showed more reduction was observed with G. biloba regarding ADHD-RS-IV parent rating inattention score, total score as well as teacher rating inattention score when compared to control. Shakibaei 2015
	Meta-analysis of effects on cognition in Alzheimer disease (AD) using drugs, Ginkgo biloba and exercise. Results show that drug treatments have a small but significant impact on cognitive functioning in AD.Ströhle 2015
	Pooled analyses of data from 4 randomized, placebo-controlled trials assessing the effects of Ginkgo biloba extract, EGb 761® in dementia patients with behavioural and psychological symptoms provides evidence of efficacy at a daily dose of 240 mg. von Gunten2015
	Study of western medicine therapy assisted by Ginkgo biloba tablets (GBT) in 80 patients with vascular cognitive impairment with no dementia showed scores of execution, attention, abstraction, delayed memory, and orientation were increased in combined treatment group compared with control. Wang 2015
	Study of Ginkgo biloba extract on cerebral oxygen and glucose metabolism in elderly patients with pre-existing cerebral ischemia showed the extract improves cerebral oxygen supply, decreases cerebral oxygen extraction rate and consumption, and helps balance cerebral oxygen supply and consumption. Xu 2015
	A systematic review and meta-analysis of RC trials exploring the effectiveness and safety of Ginkgo biloba in treating mild cognitive impairment and Alzheimer's disease found potentially beneficial results limited sample size and inconsistent findings. Yang 2015
	Study of cosmetic formulations containing green tea and/or Ginkgo biloba extraction on improvement of skin barrier function and elasticity showed the extracts effectively improved skin conditions and skin elasticity was more pronounced. Campos 2014
	Study of effects of Gingko biloba (Gb) supplementation in Alzheimer's disease patients receiving cholinesterase inhibitors showed Gb may provide some added cognitive benefits in AD patients already under ChEIs treatment. Canevelli 2014
	Study of of Ginkgo biloba extract gel (EGB) and minocycline hydrochloride on periodontitis and their inhibition on putative periodontal pathogens showed inhibition effects of EGB and minocycline hydrochloride were comparable for major periodontal pathogens within short term. [Article in Chinese] Cheng 2014
	Study of effects of Ginkgo biloba extract (EGB) on major periodontal pathogens in subgingival plaque shows EGB significantly inhibited major periodontal pathogens and can be used as an adjuvant for periodontitis treatment. Cheng 2014
	Dual-dose, acute crossover intervention using G. biloba supplements in healthy participants showed intact ginkgolide J in urine following oral consumption of ginkgo supplements and is also the first to account for excreted terpene lactones as a proportion of dose. Dew 2014
	Study of Ginkgo biloba extract EGb 761 on neuropsychiatric symptoms (NPS) and cognition in patients with mild cognitive impairment (MCI) showed EGb 761 improved NPS and cognitive performance in patients with MCI and the drug was safe and well tolerated. Gavrilova 2014
	Randomized, crossover clinical trial of ginkgo biloba extract on visual field defect and contrast sensitivity showed ginkgo biloba extract treatment had no effect on mean defect or contrast sensitivity in this group of normal tension glaucoma patients. Guo 2014
	Study of efficacy of Ginkgo biloba (EGb 761) on cognitive impairment in patients with diabetes mellitus type 2 showed standardized extract of Ginkgo biloba (EGb 761) used in dose 240 mg per day during one month had a positive effect on cognitive function. [Article in Russian]Khaĭrullin 2014
	Study of G. biloba extracts on pharmacokinetics and pharmacodynamics of cilostazol and its active metabolites in healthy Korean subjects shows co-administration of GBE had no statistically significant effects on pharmacokinetics with noticable but insignificant pharmacodynamic effect. Kim 2014
	Study to evaluate changes in glycemic control and psychological state of patients with type 2 diabetes mellitus (T2DM) showed antioxidant G. biloba leaf extract exhibited a mild effect on psychological state and a trend of improving glycemic control. Lasaite 2014
	Study of Standard Process products, Ginkgo Synergy(®), Choline and OPC Synergy(®) plus Catalyn(®, in d/b, randomized trial on cognitive and immune functioning in healthy older adults showed isolated and modest effects of a Ginkgo biloba plus choline-based formula on cognitive & immune functioning. Lewis 2014
	The effects of Ginkgo biloba extract (GBE) on sexual desire in postmenopausal women showed sexual desire was significantly improved in the GBE group compared to the placebo group (P = 0.02). Pebdani 2014
	Study of Ginkgo biloba leaves (EGb) on cerebral blood oxygenation in prefrontal cortex and on performance during working memory task, using near-infrared spectrometry showed EGb might improve memory function in middle-aged individuals by counteracting occurrence of hemispheric asymmetry reduction. Sakatani 2014
	Study of 11 metabolic syndrome patients after a 2-month treatment with Ginkgo biloba showed a decrease in hs-CRP and and HOMA-IR, and a beneficial change of arteriosclerotic, inflammatory and oxidative stress biomarkers were found. IL-6 and nanoplaque formation was reduced. Siegel 2014
	Study of efficacy and safety of Ginkgo biloba extract EGb 761 and betahistine at recommended doses in patients with vertigo showed the 2 drugs were similarly effective in the treatment of vertigo, but EGb 761 was better tolerated. Sokolova 2014
	Review of effects of standardized Ginkgo biloba extract EGb761 for cognitive impairment and dementia showed EGb761 at 240 mg/day is able to stabilize or slow decline in cognition, function, behavior, and global change at 22-26 weeks in cognitive impairment and dementia with no adverse effects. Tan 2014
	Study of EGb761 on Heat-shock proteins expression in paired tumors and normal lung tissues of 64 patients with non-small cell lung cancer (NSCLC) showed EGb761 can decrease the migration ability of A549/H441 by inhibiting HSP27 expression most likely through AKT and p38 MAPK pathways activation. Tsai 2014
	Study of clinical efficacy of Ginkgo biloba special extract (EGb 761®) and correlation with brain electrical activity in children with ADHD showed possible improvements in quality of life and ADHD core symptoms. Uebel-von Sandersleben 2014
	Study of Ginkgolide B in treatment of patients suffering from migraine with aura showed a marked amelioration of features of neurological symptoms in treated attack. In 4 patients (18.1 %) suffering from typical aura with migraine, the pain phase disappeared with no adverse events. Allais 2013
	Study of 34 outpatients with moderate cognitive impairment treated with a standard extract of Ginkgo Biloba - EGb761 (memoplant) revealed a significant improvement in attention, memory, orientation and visual-spatial/ executive functions as well as in anxiety and depression. [Article in Russian] Boĭko 2013
	Review and a meta-analysis of 3 randomized controlled trials in schizophrenia patients and 8 randomized controlled trials in dementia patients showed G. biloba treatment reduced symptoms in schizophrenia and improved cognitive function and activities of daily living of those with dementia. Brondino 2013
	A randomized controlled pilot trial: the effects of EGb 761 on information processing and executive function in multiple sclerosis. [No abstract] Diamond 2013
	Study of ticlopidine with Ginkgo Biloba extract in patients with acute cerebral ischemia showed ticlopidine plus Gingko Biloba extract has sufficient anti-platelet abilities with an acceptable profile of adverse events and CYP2C19 *2 alleles are associated with clopidogrel responsiveness. Hong 2013
	Review of 4 randomized, controlled trials investigating efficacy of G. biloba extract EGb 761(®) in elderly patients with Alzheimer or vascular dementia showed efficacy of EGb 761(®) in age-related dementia with neuropsychiatric features. The drug was safe and well-tolerated. Ihl 2013
	Meta-analysis of studies about effect of ginkgo biloba extract (GbE) on cognition and daily functioning in persons with dementia highlights serious weaknesses in available studies. GbE may be effective in persons under 75 years of age with dementia but long term more studies are suggested. Jiang 2013
	Study of amyloid-β deposition and cognition, apolipoprotein E (APOE) status, brain volume, and Ginkgo biloba (Gb) treatment in nondemented very elderly subjects showed no relationship between Gb treatment and Aβ deposition as determined. Mathis 2013
	Study of trimetazidine, betahistine and G. biloba extract in treatment of tinnitus showed After 3 month treatment, a decrease of 19.7±15.5 units in trimetazidine group, 12.2±12.7 units in betahistine group, and 3.80±5.9 units in ginkgo biloba compared to control. Orhan 2013
	Double-blind, placebo-controlled, randomized clinical trial of effect of Ginkgo biloba on functional outcome of 52 patients with acute ischemic stroke suggests that G biloba may have protective effects.Oskouei 2013
	Evaluation of placebo-controlled, double-blind, randomized trial of 120 persons given Ginkgo biloba, α-lipoic acid plus vitamin C, papaverine chlorhydrate plus vitamin E, or placebo showed the various treatments had no effect on any evaluated measures of hearing, either between groups or over time. Polanski 2013
	Study of pharmacoeconomic implications of treating noninstitutionalized Austrian dementia patients with a drug based on EGb 761R, a standardized extract from Gingkgo biloba showed treatment with EGb 761R (240 mg/day) slowed deterioration by 22.3 months compared to placebo. Rainer 2013
	Study of g. biloba co-administration on pharmacokinetics of tamoxifen, anastrozole and letrozole in women with early breast cancer showed G. biloba was well tolerated, with no difference in toxicity and does not significantly affect pharmacokinetics of tamoxifen, anastrozole or letrozole. Vardy 2013
	Study of Memo®, with royal jelly, G. biloba and P. ginseng on Mini-Mental State Examination (MMSE) scores in patients with mild cognitive impairment showed formula may be helpful in treating cognitive decline and early phases of pathologic cognitive impairment of dementia and Alzheimer's. Yakoot 2013
	Review of studies of Ginkgo biloba extract for patients with early diabetic nephropathy showed Gingko biloba extract is a valuable drug which has prospect in treating early diabetic nephropathy, especially with high urinary albumin excretion rate baseline level. Zhang 2013
	Irradiated brain tumor survivors who participated in a phase II study showed improvement in quality of life and cognitive function when given Ginkgo biloba at a dose of 120 mg/day (40 mg t.i.d.) for 24 weeks. Attia 2012
	In a placebo-controlled, double-blind, pilot study, 41 patients with Raynaud disease given Ginkgo biloba extract, EGb 761, did not show a significant reduction in clinically relevant symptoms compared with placebo. Bredie 2012
	In a study of 23 patients with with differentiated thyroid cancer Ginkgo biloba extract was found to protect from possible oxidative and genotoxic damage associated with (131)I treatment in patients requiring (131)I therapy for thyroid cancer, without affecting the clinical outcome. Dardano 2012
	A Ginkgo biloba tablet given 3 times/d for 12 mos. to patients in China with mild cognitive impairment showed significant cognitive function improvement. [Article in Chinese] Dong 2012
	Study of effects of Ginkgo Biloba tablet (GBT) in treating mild cognitive impairment (MCI) in 113 patients showed one-year treatment with GBT could significantly improve cognitive function and could also lower the dementia conversion rate. [Article in Chinese]Dong 2012
	Ginkgo biloba was not found effective in reducing tinnitus in a randomized crossover study of 27 men and 11 women. Han 2012
	47 outpatients with a DSM-IV-TR diagnosis of autism ages between 4 and 12 participated in a d/b clinical trial. Those given Ginkgo biloba extract as an adjunctive treatment with risperidone did not produce significant outcomes. Hasanzadeh 2012
	In a d/b randomised, placebo-controlled, 24-week trial with 410 outpatients, w/mild to moderate Alzheimer's disease or vascular dementia, given 240 mg/daily of Ginkgo biloba extract EGb 761(®), showed significant and clinically relevant improvement in cognition, psychopathology, functional measures. Herrschaft 2012
	Ginkgo biloba extract, EGb761, improved neuropsychiatric symptoms and cognitive and functional abilities in a 24-wk randomised controlled trial assessing the efficacy of a 240 mg daily dose of EGb761 in 404 outpatients ≥ 50 with mild to moderate dementia, Alzheimer's disease, or vascular dementia. Ihl 2012
	Ginkgo biloba extract slowed the progression of visual field defects in 42 patients with normal tension glaucoma. Lee 2012
	A clinical trial found that treatment with ginkgo 120 mg 2/d for 12 weeks did not improve cognitive performance in persons with MS.Lovera 2012
	Comparison of G. biloba with rivastigmine in patients with Alzheimer dementia in slowing down degenerative progression and cognitive impairment showed differences in efficacy of G. biloba and rivastigmine and suggested use of cholinesterase inhibitors instead of G. biloba in mild to moderate cases. Nasab 2012
	Acute stroke is associated with oxidative stress and inflammatory response in the early period. G. biloba plays a potential role in reducing oxidative damage and inflammatory response as found in a study of 31 cerebrovascular accident patients and 30 healthy controls. Thanoon 2012
	A randomised, parallel-group, double-blind, placebo-controlled GuidAge clinical trial, enrolled 2854 adults aged 70+ reporting of memory issues to their physicians. Study concluded that participants taking Ginkgo biloba extract did not show a reduction the progression of Alzheimer's disease. Vellas 2012
	Ginkgo biloba tablets were found to improve therapeutic efficacy, cognitive ability and cerebral blood flow supply of patients with vascular cognitive impairment. Zhang 2012
	Ginkgo biloba extract (EGb-761) given to Chinese schizophrenic patients improved symptoms of Tardive dyskinesia and increased brain-derived neurotrophic factor levels compared with placebo treatment in a double-blind, randomized, placebo-control 12-week treatment with 240 mg per day of EGb-761. Zhang 2012
	Patients with mild cognitive impairment took Ginkgo biloba leaf tablets 3 times a day, 19.2 mg each dose for 6 months. Results showed scores of the logical memory test and nonsense picture recognition were increased significantly in this treatment group.[Article in Chinese] Zhao 2012
	A randomized, controlled, double-blind, multicenter clinical trial involving 410 outpatients with mild to moderate dementia given EGb 761(®), 240 mg 1 times daily was found effective in alleviating behavioral and neuropsychiatric symptoms in patients with mild to moderate dementia. Bachinskaya 2011
	A 24wk randomized, placebo-controlled, double-blind clinical trial was performed on 410 outpatients with mild to moderate Alzheimers disease. Patients given Ginkgo biloba, EGb 761®, (240 mg once daily) showed slower deterioration as compared with the placebo group. Ihl 2011
	Ginkgo biloba extract, EGb 761, (240 mg once daily) improved free recall of appointments in a randomized study of 188 healthy middle-aged healthy volunteers. Kaschel 2011
	A randomised controlled crossover trial was conducted on 14 young healthy men, who received Ginkgo biloba extract or placebo had minimal impact on vascular function and blood pressure. Keheyan 2011
	A study of 30 patients with normal tension glaucoma found that the group receiving Ginkgo biloba extract of 80mg/twice daily for 4 weeks had increased blood flow and volume in all areas, having a positive effect on ocular blood flow. Park 2011
	Study confirmed the positive effects of Ginkgo biloba extract on steady state visually evoked potential topography in nineteen healthy middle-aged (50-61 year old) male participants whilst completing an object working memory task. Silberstein 2011
	In a monocentric, controlled clinical trial with 32 elderly patients, 16 patients received three 90 mg ginkgo extract tablets twice daily for 30 days. Ginkgo increased the microcirculation significantly, and improved the radical scavenging capacity in elderly patients. Suter 2011
	In a clinical trial ingestion of 60 mg of Ginkgo biloba twice daily was associated with a significant improvement of vitiligo vulgaris over a 12 week period. Szczurko 2011
	A study of Ginkgo biloba special extract EGb 761® on human cytochrome P450 activity in healthy volunteers found EGb 761® had no relevant effect on the in vivo activity of the major CYP enzymes in humans and therefore has no relevant potential to cause respective metabolic drug-drug interactions. Zadoyan 2011
	Results of a randomized, double-blind, placebo-controlled trial, shows Ginkgo biloba (EGb-761) to be an effective treatment for reducing the symptoms of tardive dyskinesia in schizophrenia patients suggesting improvement may be mediated through the well-known antioxidant activity of this extract. Zhang 2011
	In a randomized, double-blinded, placebo-controlled, two-way cross-over trial of 12 healthy humans, Ginkgo biloba extract had limited effects on the pharmacokinetics but no effects on the pharmacodynamics of single dose warfain in health subjects and showed no effect on the clotting process. Zhou 2011
	[Ginko may not slow mental decline in older adults.] [No authors listed] 2010
	Cancer was analyzed as a secondary endpoint in the Ginkgo Evaluation of Memory (GEM) Study, the largest randomized, double-blind, placebo-controlled clinical trial of Ginkgo supplementation to date with a total of 3069 GEM participants 75+ years of age. Biggs 2010
	The erythrocyte protective effects of Ginaton, a ginkgo biloba extract were investigated in sixty patients undergoing hypothermic cardiopulmonary bypass. [Article in Chinese] Deng 2010
	The effectiveness and safety of association of Ginkgolide B/Coenzyme Q10/Riboflavin/Magnesium complex was verified for brief prophylaxis in a population of school-aged children with migraine. Esposito 2010
	A review of controlled clinical studies on medicinal plants for treatment of generalized anxiety disorder indicates isolated studies with Ginkgo, Galphimia glauca, Matricaria recutita, Passiflora incarnata & Valeriana officinalis showed potential use for anxiety diseases. [Article in Portuguese] Faustino 2010
	Compared to no-drug treatment and ginkgo biloba, galantamine therapy provides clinical benefits and achieves savings in health care costs associated with patients with mild-to-moderate Alzheimer's disease in Germany. Guo 2010
	A 24-week randomized, placebo-controlled, double-blind clinical trial of EGb 761® was performed to find out whether treatment effects correlate with neuropsychiatric symptom burden at baseline, retrospective analyses of data in 410 outpatients with AD with cerebrovascular disease. Ihl 2010
	The coadministration of Ginkgo biloba extract with ticlopidine was not associated with any significant changes in the pharmacokinetic profile of ticlopidine compared with ticlopidine administered alone in the small group of healthy Korean men. Kim 2010
	A double-blind trial that randomly assigned 3069 participants over 75 years of age to 120 mg of Ginkgo biloba EGb 761 twice daily or placebo shows there was no evidence that G. biloba reduced total or cardiovascular disease (CVD) mortality or CVD events. Kuller 2010
	Determination of the effects of Ginkgo biloba extract (240 mg/day) on BP & incident hypertension in 3,069 participants (mean age, 79 years; 46% female; 96% white) from Ginkgo Evaluation of Memory study shows G. biloba does not reduce BP or the incidence of hypertension in elderly men & women. Nahin 2010
	Eleven trials involving 477 participants compared Ginkgo biloba with placebo and assessed the absolute claudication distance (maximal walking distance) & found no evidence that Ginkgo biloba has a clinically significant benefit for patients with intermittent claudication.Nicolaï 2010
	It is hypothesized that Ginkgo biloba would be beneficial for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD), and evaluated in a double blind, randomized, parallel group comparison of G.biloba and methylphenidate. Salehi 2010
	Ginkgo as an add-on therapy to antipsychotic medication produced statistically significant moderate improvement in total and negative symptoms of chronic schizophrenia. Ginkgo as add-on therapy ameliorates the symptoms of chronic schizophrenia. Singh 2010
	It is shown that Ginkgolide B, an herbal constituent extract from ginkgo biloba tree leaves, seems to be effective as preventive treatment in reducing migraine attack frequency and in attenuating the use of symptomatic medication in a small series of children with primary headache. Usai 2010
	A study of gender and mitochondrial toxicity of amyloid-beta peptide concluded that clinical trials with Ginkgo biloba and other estrogenic therapies have not proved successful in treating Alzheimer's disease in women. Viña 2010
	The effectiveness of standardized Ginkgo biloba extract (GbE) on cognitive symptoms of dementia with a treatment period of approximately 6 months was evaluated which revealed that GbE was found to be effective for cognitive functions in dementia with the treatment of 6 months. Wang 2010
	Assessment of the effects of Ginkgo biloba in Alzheimer's disease as well as vascular and mixed dementia covering a variety of outcome domains with 2372 patients in the meta-analysis, shows Ginkgo biloba appears more effective than placebo. Weinmann 2010
	Extract of Ginkgo biloba, EGb-761 appears to be an effective treatment for reducing the symptoms of tardive dyskinesia in schizophrenia patients, and improvement may be mediated through the well-known antioxidant activity of this extract. Zhang 2010
	Ginkgo biloba extract(GBE) when taken in normally recommended doses over a 4-week time period, may not affect the pharmacokinetics of diazepam via CYP2C19 and the excretion of N-desmethyldiazepam in healthy volunteers. No drug-drug interaction was observed between GBE and diazepam. Zuo 2010
	The antiproliferative effects of a Gingko biloba leaf extract to cells from tissues of the human oral cavity were studied. Toxicity to carcinoma HSC-2 cells was correlated with the prooxidative nature of the extract. Babich 2009
	The newly developed, holistic fresh leaf extract of Ginkgo biloba is a safe, effective, and, at least, adjuvant treatment option for 59 elderly patients with mild cognitive impairments. Bäurle 2009
	EGb 761, a Ginkgo biloba extract used in chronic age-dependent neurological disorders, may represent a novel treatment for sarcopenia, both more manageable and less cumbersome than exercise and caloric restriction. Bidon 2009
	Randomized, double-blind studies, in which extracts of Ginkgo biloba at any strength and over any period were compared with placebo for their effects on people with acquired cognitive impairment, including dementia, of any degree of severity. Birks 2009
	A retrospective study of 94 patients carried out with Simvastatin and Ginkgo biloba for the treatment of subacute tinnitus over 4 months showed no significant efficacy in treatment of subacute tinnitus. Canis 2009
	After administration of simvastatin over 4 months, using Ginkgo biloba as a control, the retrospective study has shown no significant efficacy in treatment of subacute tinnitus. Canis 2009
	Examination of efficacy & safety of nifedipine sustained release (SR) compared with Ginkgo biloba extract as treatment for primary Raynaud's phenomenon (RP) in Korea showed nifedipine SR was more effective than Ginkgo biloba extract for treatment of primary RP in Korean patients. Choi 2009
	A multicentric, open, preliminary trial on use of ginkgolide B, a herbal constituent extract from Ginkgo biloba tree leaves, to evaluate prophylactic treatment of migraine with aura (MA) in fifty women, found ginkgolide B to be effective in reducing MA frequency and duration. D'Andrea 2009
	Investigation into the effect and clinical value of ginkgo biloba extract (Ginaton) on the plasma vascular endothelial growth factor (VEGF) in 20 patients during peri-operative period of cardiac surgery showed that Ginaton could induce production of VEGF. [Article in Chinese]Deng 2009
	Determination of the preventive effect of Ginkgo biloba extract GBE, in the formation of myringosclerosis using prospective, randomized clinical study shows formation of experimental myringosclerosis was reduced or inhibited & tympanic membranes were thinner after systemic GBE administration. Emir 2009
	[A comment on Ginkgo biloba for mild to moderate dementia in a community setting by McCarney et al.] Ernst 2009
	Seven Chinese herbs and six randomized controlled clinical trials were identified in the treatment of Alzheimer's disease. Ginkgo biloba, Lycopodium serratum and Ginseng have been assessed for their clinical efficacy with limited favorable evidence. No serious adverse events were reported. Fu 2009
	[An example for an underpowered study: a comment on Ginkgo biloba for mild to moderate dementia in a community setting by McCarney et al.] Gaus 2009
	[A comment on Ginkgo biloba for mild to moderate dementia in a community setting by McCarney et al.] Hindmarch 2009
	[Ginkgo biloba does not reduce incidence of dementia in elderly people.] Hoerr 2009
	The article summarizes neuropsychological effects of chronic administration of ginkgo in healthy and cognitively impaired subjects of any age. Kaschel 2009
	The efficacy of Ginkgo biloba extract EGb 761 in the treatment of dementia (Alzheimer's disease and vascular dementia) was studied in 10 randomized, controlled, double-blind clinical trials. The results show EGb 761 has its place in the treatment of dementia. [Article in German] Kasper 2009
	[Ginkgo biloba prevention trials: more than an ounce of prevention learned.] Kaye 2009
	The study found no significant relationship between Ginkgo biloba extract use over the past 12 months among patients with glaucoma, though this finding requires replication in a prospective study. Khoury 2009
	In study of 24 healthy Korean male volunteers, a single dose of a combined fixed-dose formulation of ticlopidine 250 mg/ginkgo extract 80-mg tablets & concomitant admin. of ticlopidine & ginkgo extract tablets produced no statistically significant differences in pharmacokinetics of ticlopidine. Kim 2009
	Two randomized, double-blind, placebo-controlled cohort studies were conducted to determine the efficacy of 2 different sources of Ginkgo biloba extract in reducing the incidence and severity of acute mountain sickness following rapid ascent to high altitude. Leadbetter 2009
	Ginkgo leaf extract could decrease the plasma level of von Willebrand factor, raise the plasma nitric oxide level and improve the endothelium dependent vascular dilating function as shown in a study of 64 patients with early stage diabetic nephropathy. Li 2009
	A literature review and meta-analysis of 20 randomized controlled trials including acupuncture (n = 2 trials), anti-oxidants (n = 2), biofeedback (n = 5), Ginkgo biloba (n = 1) were carried out to study the efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon. Malenfant 2009
	[Fundamentals of therapeutic application of EGb 761][Article in German] Müller 2009
	Secondary analyses of a randomized controlled trial were performed with 395 patients aged 50 years or above, with dementia with neuropsychiatric features to find out whether treatment effects of Ginkgo biloba extract EGb 761 differed by type of dementia.Napryeyenko 2009
	Assessment of the effect of Ginkgo biloba on walking distance in people with intermittent claudication shows no evidence that Ginkgo biloba has a clinically significant benefit for patients with peripheral arterial disease. Nicolaï 2009
	6 psychiatric outpatients diagnosed with attention-deficit disorder (ADD) were rated at baseline and while taking Ginkgo biloba to determine its efficacy as a treatment for ADD. During treatment, the patients' mean scores improved significantly & in hyperactivity, inattention, & immaturity factors. Niederhofer 2009
	A single-blind, randomized, placebo-controlled trial carried out to determine the effect of Ginkgo biloba L. on the symptoms of premenstrual syndrome(PMS), using eighty-five students with PMS shows G. biloba L. can reduce the severity of PMS symptoms. Ozgoli 2009
	[Ginkgo biloba did not prevent dementia or Alzheimer disease in elderly people.] Parsons 2009
	Patients treated with a Ginkgo biloba extract associated with hyaluronic acid ophthalmic solution (GB-HA), compared to patients treated with HA alone, showed a significant decrease in the appearance of conjunctival hyperemia, conjunctival discharge, and chemosis. Russo 2009
	A survey of the clinical development of pharmacotherapy for Alzheimer's disease indicates that Phase III trials of Ginkgo biloba, NSAIDs, phenserine, statins, tarenflurbil, tramiprosate, and xaliproden have been completed, none of them demonstrating adequate efficacy. Sabbagh 2009
	The efficacy of treating postviral olfactory loss(POL) with glucocorticoids, Ginkgo biloba(Gb)& mometasone furoate nasal spray, was analyzed in 71 patients which showed that the addition of Gb showed a tendency of greater efficacy in the treatment of POL.Seo 2009
	The Ginkgo Evaluation of Memory (GEM) study, a randomized, double-blind, placebo-controlled clinical trial of 3069 community-dwelling participants aged 72 to 96 years, was carried out to determine whether G. biloba slows the rates of global or domain-specific cognitive decline in older adults. Snitz 2009
	Ginkgo biloba has been shown both to provide benefit and no benefit on cognition in both healthy elderly and patients with Alzheimer's disease. Solomon 2009
	The randomized, double-blind exploratory trial was undertaken to compare treatment effects and tolerability of EGb 761(R), donepezil and combined treatment in patients with AD and neuropsychiatric features and generated 3 hypotheses. Yancheva 2009
	A combined herbal supplement of Rhodiola and Gingko in sixty-seven healthy male volunteers (34 in the Rhodiola-Gingko Capsule group and 33 in the placebo group) could improve the endurance performance by increasing oxygen consumption and protecting against fatigue. Zhang 2009
	A 5-year double blind, randomized trial of EGb 761 for the prevention of Alzheimer's disease(AD) in elderly subjects with memory complaints has been initiated to evaluate its efficacy in prevention of AD and assess usefulness of various baseline characteristics as predictors of conversion to AD. Andrieu 2008
	21 trials for treatment of dementia showed significant results in favor of ginkgo application in over 50% of investigated outcome parameters, 8 were significant for less than 50% of parameters, 4 showed trend in favor of ginkgo, only 2 studies found no advantage for ginkgo. [Article in German] Bornhöft 2008
	The study was carried out to estimate the extent and utilization patterns of combined prescriptions of aspirin and Ginkgo biloba extract in Taiwan based on an analysis of a nationwide database.Chang 2008
	Randomized, double-blind, placebo-controlled clinical trial of Ginkgo biloba at 120 mg twice a day was not effective in reducing either the overall incidence rate of dementia or Alzheimer disease incidence in elderly individuals with normal cognition or those with mild cognitive impairment. DeKosky 2008
	Randomized, placebo-controlled, double-blind, 42-month pilot study was carried out to assess the feasibility, safety, and efficacy of Ginkgo biloba extract (GBE) on delaying the progression to cognitive impairment in normal elderly aged 85 and older. Dodge 2008
	An evaluation of the effects of the extract of G. biloba(EGb) as an adjunct to antipsychotic clozapine for refractory schizophrenia was carried out in 42 patients & preliminary data suggested that EGb was useful for enhancing the effect of clozapine on negative symptoms in resistant schizophrenia. Doruk 2008
	In older adults with PAD, Ginkgo biloba produced modest but insignificant increase in maximal treadmill walking time & flow-mediated vasodilation. These data do not support use of G. biloba as an effective therapy for PAD, although a longer duration of use should be considered in any future trials. Gardner 2008
	A retrospective study of patients suffering from chronic unilateral or bilateral tinnitus that was previously ineffectively treated by oral drugs [betahistine (Betaserc), extract of Ginkgo biloba (EGb 761), tanakan, and cinnarizine-dimenhydrinate, singly or in combination] was performed. Hahn 2008
	Micro-inflammation reaction exists popularly in patients undergoing maintenance hemodialysis, and the combined therapy with hypha cordyceps and ginkgo leaf tablet could effectively improve this kind of micro-inflammation reaction. [Article in Chinese] Huang 2008
	Some herbal formulations, such as St. John's wort, have been analyzed in clinical trials to estimate their real value & the use of other herbal medicines, such as Kava-kava, valerian, and Ginkgo biloba was also discussed. Jarema 2008
	Review on the effects of systemic medications and some native vasoactive molecules on ocular blood flow shows some evidence exists for a positive effect of centrally acting calcium-channel blockers, nitric oxide precursors, adenosine, histamine, estrogens, and ginkgo biloba extract. Lesk 2008
	Determination of the effectiveness and the safety profile of Ginkgo biloba for treating early stage dementia in 176 participants in a community setting showed no evidence that a standard dose of high purity Ginkgo biloba confers benefit in mild-moderate dementia over 6 months. McCarney 2008
	The present study provided an empirical examination of the effects of both short- and long-term GBE administration on subjective and physiological (vaginal photoplethysmography) measures of sexual function in women with Sexual Arousal Disorder. Meston 2008
	Reports investigating the efficacy of NHPs for vitiligo exist, but are of poor methodological quality and contain significant reporting flaws. L-phenylalanine used with phototherapy, and oral Ginkgo biloba as monotherapy show promise and warrants further investigation.Szczurko 2008
	Study carried out to identify numbers of control participants required in a pragmatic randomized trial of Ginkgo biloba for dementia treatment; to assess characteristics associated with capacity & to describe a legally acceptable consent process for research. Warner 2008
	The GEM (Ginkgo Evaluation of Memory) & GuidAge studies are ongoing randomized double-blind, placebo-controlled trials of Ginkgo biloba (GE), to test whether GE is effective in prevention of dementia (especially Alzheimer's disease) in normal elderly or those with early cognitive impairment. Williamson 2008
	It is suggested that Ginkgo biloba extract treatment in coronary artery disease patients led to an increase of distal left anterior descending coronary artery blood flow, which might at least be related partly to the restoration of the delicate equilibrium between nitric oxide and endothelin-1. Wu 2008
	The study was designed to test the effects of Ginkgo biloba extract on distal left anterior descending coronary artery blood flow and endothelium-dependent brachial artery flow-mediated dilation in sixty healthy elderly adults. Wu 2008
	Extract of Ginkgo biloba Egb761 is an ideal drug for preventing and reducing the acute doxorbincin-induced cardiotoxicity in 60 patients with breast cancer; & it could also be helpful for alleviating the chronic cardiotoxicity. [Article in Chinese] Yi 2008
	Pineal hormone melatonin (melaxen preparation) and a typical cognitive enhancer Ginkgo biloba (bilobil preparation) decreased the retinal light sensitivity thresholds after two-week administration in young (aged 19-23) patients with cerebral trauma anamnesis. [Article in Russian] Arushanian 2007
	The effect of the Ginos, a derivative of extract Ginkgo Biloba, administered to 100 patients, aged from 45 to 80 years, in addition to somatic therapy, was less pronounced for affective disorders - depression and anxiety. The drug was well-tolerated by patients. [Article in Russian] Batysheva 2007
	In vivo platelet function was not affected by the administration of any commercially available herbal agents investigated, including Ginkgo biloba, and was markedly inhibited with the administration of aspirin.Beckert 2007
	Update of 2002 Cochrane evidence-based review of Ginkgo biloba for cognitive impairment and dementia found that while safe with no excess adverse effects compared to placebo, overall the evidence for predictable and clinically significant benefit is inconsistent and unconvincing. Birks 2007
	An updated systematic review was carried out for randomized, placebo-controlled, double-blind clinical trials of the effects of standardized Ginkgo biloba (G. biloba) extracts on cognitive function in healthy subjects under the age of 60 years. Canter 2007
	[Methodological matters on an Alzheimer's dementia trial: is a double-blind randomized controlled study design sufficient to draw strong conclusions on treatment? Reply to Dr Mazza and colleagues].Corrao 2007
	EGb 761 supplementation neutralized genotoxic damage induced by radioiodine treatment, without affecting the clinical outcome & it is suggested that Gingko biloba extracts may prevent genetic effects of radioiodine therapy for hyperthyroid Graves' disease. Dardano 2007
	It is suggested that EGb 761 standardized plant extract of Ginkgo biloba has acceptable acute tolerability at single doses up to 80 mg/day in school-aged children and is possibly efficacious in decreasing dyslexia difficulties. Donfrancesco 2007
	Associations between cognitive function, gait speed, and self-reported measures of physical function in 3035 healthy mobile participants of the Ginkgo Evaluation of Memory Study evaluated in 2000-2001 were determined. Fitzpatrick 2007
	[The protective effects of Ginkgo biloba extract in decreasing hemolysis of RBC in Glucose-6-phosphate dehydrogenase-deficient patients.] Foroughinia 2007
	In relation to the use of the two substances, Ginkgo biloba and Allium sativum, dry extract of G. biloba proved to be more effective in reducing blood viscosity in normal volunteers. Galduróz 2007
	Drug therapies which include betahistine, cinnarizine, clonazepam flunarizine or Ginkgo biloba, were more effective than no medication in the integrated balance therapy for patients with Ménières disease or other peripheral vestibular disorders. Ganança 2007
	In older adults with peripheral artery disease or cardiovascular disease risk, a relatively high dose of Ginkgo biloba combined with 325 mg/day daily aspirin did not have a clinically detectable impact on indices of coagulation examined over 4 weeks, compared with the effect of aspirin alone. Gardner 2007
	The study presents a proposal for the methodological approach for postmarketing safety profile assessment based on sales data and information for adverse drug reactions of newly introduced herbal medicinal products (Ginkgo biloba example in Bulgaria) in the market.Getov 2007
	[Statement to the preliminary report of the IQWiG A05-19B ginkgo-containing preparation at Alzheimers dementia] [Article in German]Gogol 2007
	It is possible that the therapeutic effect of Ginkgo biloba extract does not originate from direct interactions between terpene trilactones and the Abeta(25-35) peptide and is more complex. He 2007
	Improved memory performance following 120 mg of Ginkgo biloba extract was confirmed in healthy young volunteers but suggests that acute administration of this daily has a detrimental effect on speed of attention task performance which is opposite to that seen previously following higher doses. Kennedy 2007
	[Comments on the article by Mazza et al. concerning Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study]. Korczyn 2007
	Although theophylline, diuretics, terbutaline, steroids, calcium antagonist, Ginkgo biloba extracts and plasmapheresis have been suggested as medication for Systemic capillary leak syndrome, none of them have been proven to be effective. Lee 2007
	The effect of extract of Gingko biloba (EGb) on soluble intercellular cell adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with early diabetic nephropathy was investigated. [Article in Chinese] Li 2007
	It is found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. McCarney 2007
	24 hours of pretreatment with Ginkgo biloba and subsequent maintenance during exposure to high altitude are sufficient to reduce the incidence of acute mountain sickness in participants with no previous high-altitude experience. Moraga 2007
	EGb 761, the focus of phase-III clinical trials, GEM and GuidAge studies, evaluate its efficacy on the prevention of Alzheimer's disease in subjects over 70 years old. Ramassamy 2007
	The effects of Ginkgo biloba extract EGb 761 on neuropsychiatric symptoms of dementia was evaluated in a randomised controlled 22-week trial using 400 patients with dementia associated with neuropsychiatric features which showed the largest drug-placebo differences in favor of EGb 761 were found. Scripnikov 2007
	In a pilot study the effect of Ginkgo biloba (EGb 761: Rökan novo), the free oxygen radical scavenging properties of which are well-documented, was investigated on the atherosclerotic nanoplaque formation in cardiovascular high-risk patients. Siegel 2007
	Ginkgo Biloba Extract (GBE) significantly decreases infiltration of inflammatory cells such as eosinophils & lymphocytes in asthmatic airway & relieves airway inflammation. GBE may decrease activation of the PKCalpha in the inflammatory cells & decrease the IL-5 level in induced sputum. Tang 2007
	The effect of Liuwei Dihuang Soft Capsule and Ginkgo Leaf Tablet on serum regulated upon activation, normal T cell expressed and secreted (RANTES) in the patients with diabetes mellitus type 2 (DM2) was investigated. [Article in Chinese] Wang 2007
	A 24-week double-blind, placebo-controlled ginkgo biloba trial was carried out to evaluate whether a combination of supervised exercise training and ginkgo biloba treatment is a better treatment than exercise training alone for patients with peripheral arterial disease.Wang 2007
	A study designed to test the effects of Ginkgo biloba extract (GBE) on distal left anterior descending coronary artery blood flow & endothelium dependent brachial artery flow-mediated dilation in patients with coronary artery disease showed that GBE improves coronary blood flow. Wu 2007
	Ginkgo biloba leaf extract can lower blood lipid levels & urinary protein in children with primary nephrotic syndrome and improve their clinical syptoms & renal function, so has clinical value as an adjuvant treatment of steroid therapy in such children. [Article in Chinese]Zhong 2007
	Among 80 patients with vestibular symptoms, 13 patients (16%) had tried some form of complementary therapy for their vestibular symptoms. Ginkgo biloba and acupuncture were the two most popular treatments. Six of the 13 patients reported that their choice of treatment(s) helped them. Baguley 2006
	[Letter to the Editor: The effect of the ingestion of Ginkgo biloba extract (EGb 761) on the pharmacokinetics of metformin in non-diabetic and type 2 diabetic subjects-A double blind placebo-controlled, crossover study.] Blumenthal 2006
	A 12-week, double-blind, study assessed effects of ginkgo (120 mg per day) on cognitive abilities, attention and mood in 93 healthy older adults (55-79 years) & in 104 young adults. For older adult sample, longer-term memory assessed by associational learning tasks showed improvement with ginkgo. Burns 2006
	Ginkgo Evaluation of Memory study of Ginkgo biloba was carried out by administering 120 mg twice per day as Ginkgo biloba extract, as a 5-year, randomized double-blind, placebo-controlled trial in prevention of dementia (and especially Alzheimer's disease) in normal elderly.DeKosky 2006
	Review on pharmacological strategies that have been clinically studied for the primary or secondary prevention of Alzheimer's disease shows that at least 4 large prevention trials of conjugated oestrogen, selenium and vitamin E, Ginkgo biloba and statins are currently underway. Doraiswamy 2006
	The Ginkgo Evaluation of Memory Study, a double-blind, placebo-controlled randomized clinical trial evaluating Ginkgo biloba to prevent dementia, successfully recruited 3072 participants age 75 years and older at four U.S. sites through Mass mailings. Fitzpatrick 2006
	This exploratory pilot study 22 individuals with multiple sclerosis (MS) showed that no adverse events or side effects were reported and that ginkgo exerted modest beneficial effects on select functional measures (eg, fatigue) among some individuals with MS. Johnson 2006
	The ingestion of 120 mg of Ginkgo biloba Extract as a single for 3 months did not produce insulin resistance in the non-diabetic or pre-diabetic subjects or exacerbate the disease in the T2DM subjects.Kudolo 2006
	[Effect of ginkgo biloba extract on lipid peroxidation injury in the elderly patients with chronic corpulmonale.] [Article in Chinese] Luo 2006
	The clinical efficacy of Ginkgo biloba E.S. (Flavogin) in the dementia of the Alzheimer type, was confirmed in patients aged 50-80 years and comparable with donepezil clinical efficacy. Mazza 2006
	This is based on the reports that in the past, several studies suggest that Ginkgo biloba could have a potential benefit effect on cognitive function and prevention of Alzheimer disease. Vellas 2006
	Update of 2001 Cochrane evidence-based review of G. biloba for vitiligo found some evidence of short term benefit with steroids, light therapies and other treatments for vitiligo, but long term benefits and harms of treating have not yet been established. Whitton 2006
	Ginkgo biloba special extract EGb 761, an anti-dementia drug, enhances cognitive functioning and stabilizes mood in 107 cognitively impaired elderly subjects. Woelk 2006
	Co-administration of acetylsalicylic acid and Ginkgo biloba special extract EGb 761 does not constitute a safety risk, including in an elderly patient population undergoing treatment with EGb 761. Wolf 2006
	Investigation of the effects of Ginko biloba extract on T lymphocyte subsets and superoxide dismutase levels in 109 schizophrenia patients shows that it may improve the decreased peripheral immune functions in schizophrenia. Zhang 2006
	It has been suggested that extract of gingko biloba might enhance the efficiency of antipsychotic in patients with schizophrenia, particularly on positive symptoms of the disorder. Atmaca 2005
	A preliminary open-label study was undertaken to assess the efficacy and tolerability of ginkgo biloba during a 6-month period in Alzheimer type dementia, vascular and mix dementia. [Article in Polish] Bidzan 2005
	A randomized, placebo-controlled trial of acetazolamide vs Ginkgo biloba for acute mountain sickness prophylaxis was performed and found no evidence of similar efficacy for Ginkgo biloba. Chow 2005
	After acute administration ginkgo improved performance in tests of attention and memory. However, there were no effects after 6 weeks, suggesting that tolerance develops to the effects in young, healthy participants. Elsabagh 2005
	A study to determine whether cognitive benefits, of Gingko biloba in post-menopausal women, would persist even after 6 weeks & those with poorer cognitive performance would benefit more revealed that beneficial effects were limited to test of mental flexibility & to those with poorer performance. Elsabagh 2005a
	The rate of bleeding complications is low in patients when taking any of the widely used antidementia drugs, glutamate modulators, cholinesterase inhibitors, calcium antagonists or the phytomedicine Ginkgo biloba. Gaus 2005
	Single timepoint, phenotypic metabolic ratios were used to determine whether long-term supplementation of St John's wort, garlic oil, Panax ginseng, and Ginkgo biloba affected CYP1A2, CYP2D6, CYP2E1 or CYP3A4 activity in 12 healthy elderly subjects. Gurley 2005
	The effects of Ginkgo biloba special extract, EGb 761, on PFA-100 in vitro bleeding time in elderly patients with mild cognitive impairment.Halil 2005
	The effect of ginkgo extract was observed on 45 patients pulmonary interstitial fibrosis showed that occurrence of pulmonary infection was less in ginkgo treated group than that in the control group Ginkgo is effective in treating pulmonary interstitial fibrosis. [Article in Chinese]He 2005
	The benefit and structure of Ginkgo biloba-extract EGb 761 in treatment of patients with dementia was examined which showed that Gingko produced to a higher quality of life & the progression of disease is slowed down & treatment costs are lower. [Article in German] Heinen-Kammerer 2005
	The comparitive study of the effects of Ginkgo biloba treatment with the homeopathic remedy Vertigoheel in 170 patients with atherosclerosis-related vertigo shows that Vertigoheel is an appealing alternative to established G. biloba therapy for atherosclerosis-related vertigo. Issing 2005
	The effect of ginkgo & ginger, on pharmacokinetics & pharmaco-dynamics(PD&PK) of warfarin & independent effect of these herbs on clotting status was investigated in 12 healthy subjects which showed that Ginkgo & ginger at recommended doses do not affect clotting status, (PD&PK) of warfarin. Jiang 2005
	Ginkgo biloba extract was effective in partially reversing the thrombogenic coagulation profile without increasing the risk of bleeding in chronic peritoneal dialysis patients. Kim 2005
	Ginkgo biloba extract injection is effective in treating early diabetic nephropathy through decreasing urinary albumin excretion rate, regulating blood lipids, improving renal function and hemorheology. [Article in Chinese] Lu 2005
	A 14-day oral administration of a widely used, standardized ginkgo extract at a generally advocated dosage of 240 mg/day did not significantly alter concentrations of major circulating steroids in men and women. Markowitz 2005
	The reviewed RCTs, systematic reviews and meta-analyses which based their findings on the results of RCTs suggest that Ginkgo biloba is effective compared with placebo for patients with intermittent claudication. Pittler 2005
	The determination of the clinical efficacy of Ginkgo biloba extract (GbE) in mild to moderate dementia of the Alzheimer type did not show efficacy of GbE. Schneider 2005
	The results of a meta-analysis of four recent clinical trials evaluating the homeopathic preparation Vertigoheel (VH) compared with usual therapies (betahistine, Ginkgo biloba extract, dimenhydrinate) for vertigo in a total of 1388 patients shows good efficacy and tolerability of VH. Schneider 2005
	Two systematic clinical trials, both double-blind and placebo controlled, have yielded negative results and suggest that Ginkgo biloba extracts are of little more use in the treatment of tinnitus than a placebo. Smith 2005
	Update of 2002 Cochrane evidence-based review of Ginkgo biloba for acute ischaemic stroke found that there was no convincing evidence from trials of sufficient methodological quality to support the routine use of Ginkgo biloba extract to promote recovery after stroke. Zeng 2005
	[Ginkgo biloba and acetazolamide for acute mountain sickness: exclusion of high risk, low status groups perpetuates discrimination and inequalities.] Adams 2004
	A most recent large trial with Ginkgo biloba clearly showed that this drug does not prevent acute mountain sickness in a low-risk setting in which acetazolamide in a low dose of 2 x 125 mg was effective.Bartsch 2004
	Anatomical & functional changes in visual organ in children & adolescents, age between 11 & 19 years, with long lasting diabetes mellitus (DM)type 1 & taking Egb 761 as an adjuvant was evaluated which showed that Egb 761 seems to be good adjuvant in patient with long lasting DM. [Article in Polish] Bernardczyk-Meller 2004
	The effect of the Gingko biloba extract EGb 761 on skin blood flow in 27 healthy middle-aged volunteers and accompanying changes in urinary metabolites was investigated. Boelsma 2004
	[Ginkgo biloba and acetazolamide for acute mountain sickness: bias in participants may underestimate effectiveness of agents.] Elphick 2004
	Evaluation of the efficacy of ginkgo biloba, acetazolamide, and their combination as prophylaxis against acute mountain sickness with 614 healthy western trekkers showed that when compared with placebo, ginkgo is not effective at preventing acute mountain sickness.Gertsch 2004
	It is shown that by treatment of dementia patients with Ginkgo special extract EGb 761, the progression of dependency and need of care can be slowed down, which may have an impact on costs for care, e.g. by delaying nursing home placement. [Article in German] Haan 2004
	There were no significant effects of Gincosan (120mg Ginkgo biloba & 200mg Panax ginseng) treatment on ratings of mood, bodily symptoms of somatic anxiety, menopausal symptoms or sleepiness or on any of cognitive measures of attention, memory or frontal lobe function in post-menopausal women. Hartley 2004
	Update of 2002 Cochrane evidence-based review of G. biloba for tinnitus found that the limited evidence did not demonstrate effectiveness for tinnitus as a primary complaint. There was no reliable evidence to determine if it is effective for tinnitus associated with cerebral insufficiency. Hilton 2004
	3 months of oral administration of Ginkgo biloba (GBE 761) reduced malondialdehyde levels of erythrocytes membranes, fibrinogen levels, promoted erythrocytes deformability, & improved blood viscosity & viscoelasticity, which may facilitate perfusion in diabetic mellitus patients with retinopathy. Huang 2004
	Ginkgo biloba increases exhaled nasal nitric oxide (NO) output during normoxia and enhances reduced exhaled nasal NO output during normobaric hypoxia in humans. Jowers 2004
	Flavonoid antioxidants (dikvertin and ginkgo biloba) reduced the content of lipid peroxidation products, and induced the antioxidant activity in tear and blood plasma in patients with peripheral vitreochoreoretinal dystrophies and retinal detachment. [Article in Russian] Karazhaeva 2004
	A clinical trial was conducted to investigate the influence of Ginkgo biloba special extract EGb 761 on hemostasiological parameters in 50 healthy, male volunteers which showed no evidence of any inhibition of blood coagulation and platelet aggregation through EGb 761. Kohler 2004
	Trial data for cholinesterase inhibitors were more consistent than those for ginkgo, particularly regarding patient populations and outcome measures. Kurz 2004
	[Clinical effect of acute cerebral infarction treated by ginkgo damo injection and it's influence on SOD, MDA and NO] [Article in Chinese]Liu 2004
	A double-blind placebo-controlled study conducted with 19 healthy males & 20 females with a mean age of 23.6 +/- 5.4 years and mean weight of 70.0 +/- 1.9 kg showed that supplement of Ginkgo biloba was ineffective at alleviating symptoms of post-lunch dip or at enhancing taste and smell function. Mattes 2004
	[Clinical observation on treatment of diabetic peripheral neuphropathy by ginkgo leaf extract combined with active vitamin B12] [Article in Chinese] Meng 2004
	A randomized, double-blind, placebo-controlled study with 85 healthy subjects shows that the combined Ginkgo biloba and Bacopa monniera extract had no cognitive enhancing effects in healthy subjects. Nathan 2004
	It is indicated that use of Ginkgo biloba or Ginseng does not provide any quantifiable beneficial effects on memory performance in the long-term in healthy adult volunteers. Persson 2004
	A randomized placebo controlled double blind trials of Ginkgo biloba (Gb) & meta-analysis of randomized trials with 66 adult patients with tinnitus showed that Gb does not benefit patients. Rejali 2004
	A double blind randomized placebo controlled trial with 60 participants, aged 21- 60 years, showed that the combination of Gingko biloba (GB) & Codonopsis pilosula seemed to be better than GB alone in improving the cognitive function and overall health. Singh 2004
	In the short-term, Ginko biloba--Troxerutin-Heptaminol Hce is effective, acceptable and safe in the treatment of 22 patients with acute hemorrhoidal attacks. Sumboonnanonda 2004
	Effects of continuing treatment with Ginkgo biloba extract 120 mg/day on activities of daily living & mood in healthy older volunteers who had immediately previously participated in a survey of effects of a 4 month treatment with drugs showed improvement in mood & self-assessed performance of tasks. Trick 2004
	Both modified Wuzi Yanzong Granule and Ginkgo leaf capsule can effectively improve the memorial function of patients with mild cognitive impairment. [Article in Chinese] Wang 2004
	A triple-blind, randomized, placebo-controlled, trial of Ginkgo biloba 240 mg daily was carried out in 24 patients with sexual impairment due to antidepressant drugs showed spectacular individual responses but no statistically significant differences. Wheatley 2004
	The potential association between use of C4A treatments, in particular EGb 761 (standardized Ginkgo biloba extracts), and dementia of Alzheimer type was investigated in elderly women & results suggest that C4A treatment may reduce the risk of developing Alzheimer's dementia in elderly women. Andrieu 2003
	A prospective, double-blind, randomized, placebo-controlled study was carried out in 32 healthy volunteers to evaluate the effect of 3 doses of Ginkgo extract (120, 240 & 480 mg/day for 14 days) on hemostasis, coagulation & fibrinolysis showed no alteration of platelet function or coagulation. Bal Dit Sollier 2003
	A pilot study to assess multiple crossover n = 1 trials with verum/placebo discrimination as the outcome measure as a means of identifying responders and non-responders to the acute nootropic effect of Ginkgo biloba among healthy volunteers was carried out.Canter 2003
	Ginkgo biloba exocarp polysaccharides capsule preparation has some definite therapeutic effects on upper digestive tract malignant tumors of middle and late stage in 86 patients. [Article in Chinese]Chen 2003
	A randomized double-blind, monocenter study with 66 healthy elderly subjects was carried out to investigate the short-term effect of special ginkgo extract EGb 761 & the results suggest a positive effect of EGb 761 on subjective emotional well-being of healthy elderly persons. [Article in German] Cieza 2003
	The relatively short-term (i.e., 4 weeks) effects of Ginkgo biloba extract EGb 761 on mental functioning and quality of life in healthy volunteers was evaluated which showed that self-estimated mental health as well as self-estimated quality of life were significant in favor of EGb 761. Cieza 2003
	[Ginkgo biloba works in healthy persons, too. Older people feel more mentally fit] [Article in German] Cieza 2003
	A randomized, double-blind, placebo-controlled cross-over trial indicated that Coenzyme Q10 and Ginkgo biloba do not influence the clinical effect of warfarin. [Article in Danish] Engelsen 2003
	The benefits of Ginkgo on memory and frontal lobe function found in the double-blind, placebo-controlled study, postmenopausal women are modest but are unlikely to be secondary to major mood changes.Hartley 2003
	Commonly used doses of Ginkgo biloba do not have any immediate or short-term effects on blood pressure, heart rate, or electrocardiographic variables in young, healthy volunteers. Kalus 2003
	Neither piracetam nor Ginkgo biloba appears to be a promising medication for the treatment of cocaine dependence. Kampman 2003
	Both ginseng and ginkgo also led to significant reductions in frontal 'eyes closed' theta and beta activity, with additional reduction for ginseng in the alpha waveband in 15 healthy volunteers. Kennedy 2003
	Gingko biloba extract was a potent antioxidant for both normocholesterolemic and hypercholemic subjects, It acts by reducing thiobarbituric acid reacting substances possibly by inhibiting platelet COX-1 isoform activity. Kudolo 2003
	An exploratory analysis of the influence of baseline neuropsychological profiles on the effect of Gingko biloba extract EGb 761 in Alzheimer's disease was conducted in patients with Alzheimer's Disease. Le Bars 2003
	It is found that standardized extracts of Ginkgo biloba at recommended doses are unlikely to significantly alter the disposition of co-administered medications primarily dependent on the CYP2D6 or CYP3A4 pathways for elimination in normal volunteers. Markowitz 2003
	Ginkgo biloba extract seems to be a simple, safe and fairly effective therapy for arresting the progression of the slow-spreading vitiligo disease. Parsad 2003
	Ginkgo biloba extract administration appears to improve preexisting visual field damage in some patients with normal tension glaucoma.Quaranta 2003
	A double-blind study with placebo and Ginkgo biloba in 48 men aged 60 -70 showed a reduction in blood viscosity, improved cerebral perfusion in specific areas and improved global cognitive functioning.Santos 2003
	It has been found that a single dose of 180 g of Ginkgo biloba does not affect soleus motoneuron pool excitability in 20 healthy volunteers. Stone 2003
	Agents including the antioxidants vitamin E, selegiline, and Ginkgo biloba extracts have shown some benefit in clinical trials for treatment of Alzheimer disease. Tariot 2003
	A 24-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter trial in elderly patients with dementia do not support the view that Ginkgo is beneficial for patients with dementia or age-associated memory impairment. van Dongen 2003
	The effect of Ginkgo biloba exocarp polysaccharides on human gastric cancer was studied in 30 patients and its therapeutic mechanism may relates to its effects on the expression of c-myc, bcl-2 and c-fos genes, which can inhibit proliferation and induce apoptosis and differentiation of tumor cells. Xu 2003
	The efficacy of Tianlong Xifeng granule in the treatment of ceroarterosclerosis with Gan-yang-hua-feng Zheng was investigated in 122 patients & 60 patients in the control group were treated with Ginkgo Biloba capsule. [Article in Chinese] Yi 2003
	[Use of tanakan in disturbances of memory and attention in the elderly].[Article in Russian] Zakharov 2003
	Clinical trials in healthy subjects shows no marked or consistent positive effects of Ginkgo biloba on any particular objective measure of cognitive function. A positive subjective effect was reported only in the longest trial. Canter 2002
	The bioavailability of the main active ingredient in Ginkgo biloba extract, ginkgolid B, was higher in volunteers treated with 40mg twice daily as compared to the single 80mg dose. Drago 2002
	Pretreatment with Ginkgo biloba extract, one day prior to rapid ascent, appeared to reduce the severity of acute mountain sickness.Gertsch 2002
	A randomized placebo-controlled, double-blind study did not replicate a prior positive finding supporting the use of Ginkgo biloba for antidepressant, especially SSRI, induced sexual dysfunction. Kang 2002
	The relative bioavailability of ginkgolide A, ginkgolide B and bilobalide was investigated after single oral administration of 120 mg Ginkgo biloba extract as tablets or capsules in humans. Kressmann 2002
	The effect of ingesting Ginkgo biloba extract on platelet aggregation in platelet-rich plasma and prostanoid urinary excretion in healthy volunteers and subjects with Type 2 diabetes mellitus was compared.Kudolo 2002
	[Ginkgo is not a smart pill.] Lazar 2002
	The improvement seen in Alzheimer patients treated with Ginkgo biloba extract EGb 761 was found to be dependent on the severity of the dementia. Le Bars 2002
	Under clinical conditions, bilobil increases the cerebral blood flow, normalizes the metal ligand homeostasis, and improves the antioxidant status in children with early forms of cerebrovascular disease (neurocirculate distonia) and attention deficit hyperactivity syndrome. [Article in Russian] Limanova 2002
	[The acute effects of combined administration of Ginkgo biloba and Bacopa monniera on cognitive function in humans.] Maher 2002
	A clinically oriented overview of the efficacy and safety of Ginkgo biloba, St. John's wort, ginseng, Echinacea, saw palmetto and kava based on American experiences was given. [Article in Swedish]Mattsson 2002
	Oral treatment with a Ginkgo biloba extract (Gibidyl Forte(R)) is able to dilate forearm blood vessels causing increments in regional blood flow without changing blood pressure levels in healthy subjects.Mehlsen 2002
	A large-scaled clinical trial was conducted with 262 community-dwelling volunteers (both male and female) 60 years of age and older, to study the efficacy of Ginkgo biloba extract on the neuropsychological functioning of cognitively intact older adults. Mix 2002
	Ginkgo biloba phytosome may be effective in reducing the number of Raynaud's attacks per week in patients suffering from Raynaud's disease. Muir 2002
	The acute effects of Ginkgo biloba (GB 120 mg) on memory functioning was examined in healthy older volunteers using cognitive drug research battery of memory tests & Rey auditory verbal learning task & findings suggest that 120 mg of GB has no acute nootropic effects in healthy older individuals. Nathan2002
	Patients with vestibular lesion symptoms, treated with Ginkgo biloba extract, gained full vestibular compensation sooner than untreated patients. [Article in Polish] Orendorz-Fraczkowska 2002
	The acute effects of single doses of Ginkgo biloba (GK501), Ginseng (G115) and their combination (Ginkoba M/E, Pharmaton SA) on the performance of healthy young adults (mean age 21 years) during serial arithmetic tasks with differing cognitive load was examined.Scholey 2002
	Ginkgo biloba extract, an over-the-counter agent marketed as enhancing memory, did not improve any cognitive function in volunteers 60 years or older when treated with a dose of 40mg three times daily. Solomon 2002
	Folium Ginkgo extract could suppress the free radical production, -scavenge free radicals, antagonize the lipid peroxidation injury of cell membrane and up-regulate erythrocyte immunity in 30 asphyxia neonates. [Article in Chinese] Wang 2002
	Large trial found 50 mg Ginkgo biloba extract LI 1370 given 3 times daily for 12 weeks is no more effective than placebo in treating tinnitus. Drew 2001
	Patients treated with antidepressants and Ginkgo biloba extract (GBE Li 1370) showed improvement on cognitive performance and sleep regulation than those not on Ginkgo biloba extract. Hemmeter 2001
	Trial of healthy volunteers found dose-dependent improvement in performance on the "quality of memory" factor, targeted at the secondary memory rather than the working memory component. There was a dose dependent decrease in "speed of attention".Kennedy 2001
	Increase in hepatic metabolic clearance rate of insulin and hypoglycemic agents found in 3-month study of Ginkgo biloba extract (EGb 761)of individuals with non-insulin-dependent diabetes mellitus.Kudolo 2001
	Study of 36 ADHD children treated with Panax quinquefolium and Ginkgo biloba extract found symptoms improved. Lyon 2001
	Study of 30 healthy males found Ginkgo biloba extract to be safe but largely ineffective in enhancing memory. Moulton 2001
	Trial with healthy volunteers found no differences in sleep paramaters (including REM)where Ginkgo biloba extract Li1370 was administered. Sleep efficiency and subjective sleep quality improved and showed Li1370 was well tolerated. Murray 2001
	Trial of Alzheimer patients found significant improvements in speed of information processing working memory and executive processing attributable to EGb. Stough 2001
	Trial of schizophrenic patients found Ginkgo biloba treatment may enhance the effectiveness of antipsychotic drugs and reduce their extrapyramidal side effects. Zhang 2001
	The impact of 4 months supplementation with 120 mg/day of Ginkgo biloba special extract (LI 1370) on activities of daily living & various aspects of mood & sleep in a population of older volunteers revealed that GBE supplementation has beneficial effects on quality of life in an older population. Cockle 2000
	Ginkgo biloba administration did not significantly change brain MAO A or B suggesting that mechanisms other than MAO inhibition may be mediating some of its CNS effects. Fowler 2000
	Study on the efficacy of Ginkgo biloba therapy in 72 patients (44 male and 28 female) with chronic cochleovestibular disorders shows it has a very good effect on both postural and oculovestibular reflexes. Also, hearing was improved, and patients' comfort was heightened by the therapy. Hahn 2000
	Acute administration of Ginkgo biloba to healthy young volunteers significantly improved "speed of attention". Effects were dose dependent. Kennedy 2000
	Lowered blood pressure and increased fasting plasma insulin and C-peptide found in 3-month study of ingestion of Ginkgo biloba extract on pancreatic beta-cell function in response to glucose loading in normal glucose tolerant individuals. Kudolo 2000
	Study of mildly to severely impaired Alzheimer's patients found improvements in group taking Ginkgo biloba extract. Le Bars 2000
	Short-term utilization of Ginkgo biloba extract EGb 761 found to enhance neurocognitive functions/processes of cognitively intact older adults. Mix 2000
	Systematic review of 8 RCTS suggests Ginkgo biloba extract is moderately superior to placebo in the symptomatic treatment of intermittent claudication. Pittler 2000
	Combination of Muira puama and Ginkgo biloba found effective in the treatment of sexual dysfunction in healthy women with low sex drive, based on self-reporting. Waynberg 2000
	Trial of 256 healthy middle-aged volunteers found Ginkgo/ginseng combination significantly improved working and long-term memory.Wesnes 2000
	Ginkgo extract EGb 761 found as effective as second-generation cholinesterase inhibitors (donepezil, rivastigmine, metrifonate) in the treatment of mild to moderate Alzheimer's dementia. Wettstein 2000
	Ginkgo biloba extract significantly improved symptoms of glaucoma in particular ocular blood flow velocity. Chung 1999
	Patients taking Ginkgo experienced reduced symptoms of mental decline. A more objective system of assessment is needed to provide firm proof. Curtis-Prior 1999
	Cochrane evidence-based review of Ginkgo biloba for age-related macular degeneration found that the question as to whether people with AMD should take Ginkgo Biloba extract to prevent progression of the disease has not been answered by research to date. Evans 1999
	Ginkgo biloba did not prevent the development of the symptoms of winter depression. Lingaerde 1999
	Indeterminate results from a tinnitus treatment program that included Gingko biloba. Oliveira 1999
	Acute doses of standardized Ginkgo biloba extract enhanced memory, particularly working memory in asymptomatic volunteers.Rigney 1999
	Improvement in pain-free walking distance in patients with peripheral arterial occlusive disease were found using two different dosage levels of ginkgo biloba extract EGb 761. Schweizer 1999
	Ginkgo biloba extract EGb may enhance treatment with antipsychotic haloperidol on schizophrenia, especially positive symptoms. Mechanism may be an antioxidant effect. Zhou 1999
	Ginkgo biloba extract with carboxymethyl-beta-1,3-glucan applied to skin for 2 weeks reduced dermatitis from various allergens for 22 women in double blind study Castelli 1998
	Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders can considerably improve oculomotor and visuovestibular function.Cesarani 1998
	Ginkgo leaf extract, avg 209 mg/day, offset sexual dysfunction caused by serotonin reuptake inhibitors, 91% for 33 women and 76% for 30 men Cohen 1998
	Alzheimer's therapy study ought to include ginkgo, antioxidants, hormones, etc.; a review Doraiswamy 1998
	Literature review indicates ginkgo biloba provides statistically significant but clinically modest improvement in cognitive function for early dementia Flint 1998
	Ginkgo biloba special extract EGb 761--an anti-dementia drug [Article in German] Horr 1998
	Patients with circulatory encephalopathy improved when they received different forms of Ginkgo biloba extract (EGb 761) in combined treatment. Ivaniv 1998
	Patients with peripheral arterial occlusive diseases experience improvement when treated with Ginkgo biloba extract GbE. Li 1998
	Systematic review of reported trials of Ginkgo biloba on cognitive function in Alzheimer disease show positive effects but more research needed on dosage. Oken 1998
	111 patients with peripheral occlusive arterial disease and claudication given 3 pills/day of EGb 761 for 24 wk had walking distance increase to 153m vs 127 for placebo Peters 1998
	Preliminary lab and clinical data support use of herbals such as ginseng, ginkgo biloba and garlic, and nutritional supplements to slow aging Rattan 1998
	Analysis (by GC/MS) and characterization of quercetin and kaempferol in urine following ingestion of Ginkgo biloba tabletsWatson 1998
	Review indicates good evidence for the efficacy of St John's wort for depression and for ginkgo in the treatment of memory impairment caused by dementia Wong 1998
	After six-weeks treatment, increase in ECG first degree AV-blocks and abnormalities of repolarization for imipramine but a significant reduction for hypericum in double blind study with 209 depression patients Czekalla 1997
	Modest improvements in cognitive tests by 202 mild to severely demented patients taking EGb 761 for a year Le Bars 1997
	240 mg/day of Ginkgo extract EGb 761 (Tebonin forte) to 20 Alzheimer's patients improved SKT score by 3 points while placebo group deteriorated by 0.8. Maurer 1997
	320 mg/day EGb 761 (n = 8) compared to placebo (n = 7) for 5 days before cardiopulmonary bypass reduced thiobarbituric acid-reactive species, decrease of DMSO/ascorbyl radicals, myoglobin leakage and ventricular myosin leakage. Final outcome comparable Pietri 1997
	Urine collected for 3 days after Ginkgo biloba leaves taken contains metabolites that account for less than 30% of the flavonoids ingestedPietta 1997
	64 healthy adults given Ginkgo biloba/ginseng combination at 80, 160, or 320 mg bid for 90 days had improved heart rate and cognitionWesnes 1997
	24 week, randomized, placebo-controlled double-blind study with parallel-group comparison of 60 patients with peripheral arterial occlusive disease using EGb 761 at 120 mg/d found longer walking distances in the treatment group [Article in German] Blume 1996
	18 claudication patients randomized in a double blind cross-over study with GB-8 at 120 mg/day for 3 months showed improved concentration and memory but unchanged walking distance, peripheral blood pressure, and leg pain [Article in Danish] Drabaek 1996
	Review of 10 clinical trials with Ginkgo for claudication found all lacking in methodological quality so further study is necessary [Article in German] Ernst 1996
	Placebo-controlled, randomized, double-blind trial with 40 moderate dementia patients found that Ginkgo EGb 4 days per week for 4 weeks improved condition (p <0.05)[Article in German] Haase 1996
	216 Alzheimer's and multi-infarct dementia patients in a randomized, double-blind, placebo-controlled study of 240 mg EGb 761 for 24 weeks found benefit with the 156 patients who completed the studyKanowski 1996
	New Clinical Drug Eval. Unit (NCDEU) review of natural psychotropics, highlighting Hypericum, Valerian, Ginkgo and GinsengCott 1995
	55 ischaemic stroke patients in placebo controlled trial found no benefit for Ginkgo extract at 160 mg/day although 40 trials by others have shown usefulness for chronic cerebral ischaemia Garg 1995
	Meta analysis of 11 placebo controlled randomized double blind trials in patients with cerebrovascular insufficiency indicates Ginkgo benefit [Article in German] Hopfenmuller 1994
	900 mg of hypericum per day for 4 weeks benefited seasonal affective disorder (SAD) Martinez 1994
	43 patients with high cholersterol (230-390) had modest lowering by garlic-ginkgo combination compared with placebo Kenzelmann 1993
	72 outpatients with cerebral insufficiency in a double-blind, randomized placebo-controlled study for 24 weeks with EGb 761 found improved short-term memory [Article in German] Grassel 1992
	Meta-analysis of 5 placebo controlled trials with EGb 761 for patients with peripheral arterial disease found improved walking distances [Article in German] Schneider 1992
	31 memory impaired patients in a 6-month double-blind, placebo controlled trial with 120 mg/d Ginkgo extract (tanakan) showed benefit for cognitive function Rai 1991
	60 inpatients with cerebral insufficiency in a double-blind study for 6 weeks with 160 mg/d Ginkgo extract had small progressive improvements after 4 weeks [Article in German] Eckmann 1990
	For 70 patients with vertiginous syndrome of undetermined origin, in a 3-month double blind trial, 47% of the treatment group had symptoms eliminated vs. 18% of the placebo group [Article in French]Haguenauer 1986
	103 tinnitus patients in a 13 month trial found benefit with Ginkgo vs. placebo [Article in French] Meyer 1986
	166 patients with cerebral disorders due to ageing in a double-blind, placebo controlled trial had benefit after 3 or more months [Article in French] Taillandier 1986
	A 6-month double-blind randomised clinical trial with 79 patients with peripheral arteriopathy showed benefit for Ginkgo extract (rokan)Bauer 1984

Observational Studies/Case Reports
	242 medical students in King Abdulaziz University in Saudi Arabia were given a validated and reliable self-administered questionnaire on their knowledge and attitudes of complimentary and alternative medicine. Knowledge of Ginkgo biloba uses was limited. Alzahrani 2016
	Among 1,788 subjects from 53 different countries who responded to a questionnaire posted on a website, Ginkgo biloba was reported to help hearing and concentration. Coelho 2016
	Case of diffuse alveolar hemorrhage in woman consuming Ginkgo biloba extract and ginseng. Extensive evaluation revealed no etiology. Patient has had no further bleeding since discontinuing Ginkgo biloba extract and ginseng. Carlile 2015
	Case report of authors grandfather, who had a known history of Parkinson's, had dramatic improvement after supplementation with ginkgo and a multivitamin-multimineral supplement. Conrad 2014
	A comprehensive review on promoting successful cognitive aging indicates there is presently no clear evidence for antioxidants or Ginkgo biloba. Daffner 2010
	In European medicine, G. biloba medications are used to improve memory, to treat neuronal disorders such as tinnitus or intermittent claudication, and to improve brain metabolism and peripheral blood flow. Leistner 2010
	Review discusses possible mechanisms underlying neuroprotective actions of standardized extract from the leaves of the G.biloba tree, labeled EGb761, & the problem of studying this herb clinically to verify its efficacy in the treatment and prevention of Alzheimer's disease. Shi 2010b
	[Forget about ginkgo supplements to aid memory.] [No authors listed] 2009
	It is suggested that kaempferol and quercetin, essential ingredients in Ginkgo biloba extract (GBE), may overcome the dose problem of GBE and play a valuable role, clinically, in controlling mucin hypersecretion in airway inflammation. Kwon 2009
	In an observational study, three patients received 2 x 100 mg Ginkgo Biloba EGb 761 for 4 weeks, showed some improvement on the Aberrant Behavior and Symptom Checklist and the results suggest that Ginkgo Biloba might be effective at least as an add-on therapy.Niederhofer 2009
	The possible benefits and risks of commonly used herbal medications such as arnica montana, St. John's wort, bromelain, echinacea, ginkgo biloba, ephedra, valerian & others, focusing on their potentially positive or negative impact during the perioperative period of aesthetic surgery were reviewed. Rowe 2009
	The review presents published evidence on supplementation of single ingredients e.g., minerals, vitamins, amino acids & essential fatty acids, botanicals including Ginkgo biloba & ginseng & multi-ingredient formulas in the treatment of Attention-deficit/hyperactivity disorder symptoms. Rucklidge 2009
	An 11-year-old Chinese boy admitted to the hospital because of dyskinesia in his right upper and lower extremities, had been treated with ginkgo biloba leaf extract from 2001 to 2007 and the symptom improved gradually during that period. Zhao 2009
	[Electrical storm caused by complementary medication with Ginkgo biloba extract.] Pfister 2008
	[Ginkgo biloba extract and preventing Alzheimer disease.] Schneider 2008
	The patient treated with amlodipine until 7 weeks of gestation, was also exposed to levosulpiride, aluminum hydroxide gel, magnesium carbonate, and Ginkgo biloba. At 38(+3) weeks of pregnancy, she delivered a 3750 g healthy female baby. Ahn 2007
	[Visual improvement in a patient taking ginkgo biloba extract: a case study.] Dorairaj 2007
	Apart from agents like Pentoxifyline, Nimodipine which are useful in Vascular dementia some other agents like ginkgo biloba, acetylocholinesterase inhibitors, are also have shown mild benefit or at least were associated with some stabilization of dementia. [Article in Polish] Bidzan 2006
	Ginkgo biloba leaf extract could improve cerebral oxygen supply, promote superoxide dismutase activity to inhibit production of free radicals in patients undergoing hypothermic cardiopulmonary bypass, and thus shows an evident protective effect in the brain. [Article in Chinese] Deng 2006
	Perfusion with Ginkgo biloba leaf extract during cardiopulmonary bypass (CPB) could significantly decrease the release of myocardial injury markers and improve post-CPB cardiac function recovery, exerting favorable myocardium-protective effects. [Article in Chinese]Deng 2006
	[Ginkgo biloba, may significantly reduce gastrointestinal pain: it may also reduce the risk of stomach cancer that is associated with the wide-spread use of proton pump inhibitors.] Eli 2006
	Among all 68,403 nursing home residents with an herb order, ginkgo was prescribed for 61.9% of residents with an Epi/Sz diagnosis and 58.0% (p = 0.820) of residents without an Epi/Sz diagnosis. Harms 2006
	A case of persistent postoperative bleeding following total hip arthroplasty was described and the patient was taking ginkgo biloba extract, an unlicensed herbal medicine taken to improve mental alertness. Bebbington 2005
	15 published case reports described a temporal association between using ginkgo and a bleeding event. Most cases involved serious medical conditions, including 8 episodes of intracranial bleeding. Bent 2005
	[Bilateral haematoma after rhytidoplasty and blepharoplasty following chronic use of Ginkgo biloba.] Destro 2005
	The case of a 55-year-old male who self-medicated with Ginkgo biloba & suffered a fatal breakthrough seizure, with no evidence of non-compliance with his anticonvulsant medications was presented.Kupiec 2005
	Although several recent studies found that both Sophora Japonica and Ginkgo biloba have the same components of quercetin and rutin, only Ginkgo biloba has been widely used to treat cerebrovascular disorders and dementia in humans. Lao 2005
	[Clinical observation on treatment of senile insomnia with application therapy on Shenque acupoint with gingkgo leaf preparation: a report of 25 cases] [Article in Chinese] Li 2005
	[Vitreous haemorrhage associated with Gingko biloba use in a patient with age related macular disease.] MacVie 2005
	[Ginkgo biloba in Down Syndrome.] Donfrancesco 2004
	The review gives an overview and evaluation of clinical studies proving the efficacy of Ginkgo biloba extract EGb 761 in patients with peripheral arterial occlusive disease. Horsch 2004
	Ginkgo biloba, available as an over-the-counter extract, provides symptom relief of intermittent claudication which is comparable to pentoxifylline. Jacoby 2004
	Review on current antidementive therapy indicates that Ginkgo biloba or piracetam are alternatives for patients with mild-to-moderate dementia, in whom acetylcholinesterase inhibitors cannot be used. [Article in German] Perneczky 2004
	[Anti-dementia agent helps mentally fit seniors, too. Compensated and errorless with Gingko] [Article in German] [No authors listed] 2003
	[Ginkgo and memory.] Arnold 2003
	[Scientific reporting of unscientific data--a case of Ginkgo biloba being miscredited.] Bruhn 2003
	[Gingko: smart pill or not?] Caspi 2003
	[Ginkgo and memory.] Cheuvront 2003
	[Ginkgo ineffective for tinnitus.] DeBisschop 2003
	[Ginkgo and memory.] Doraiswamy 2003
	[Are there any studies showing whether ginkgo biloba is effective for tinnitus (ringing in the ears)?] Feinberg 2003
	A case is reported of a woman who developed retrobulbar haemorrhage and was subsequently found to have been taking Gingko biloba extract tablets which may have predisposed her to developing the haemorrhage. Fong 2003
	It is indicated that Gingko biloba extract is of particular interest to patients with dementia and with behavioural and psychological symptoms (BPSD) since it improves both the patient's cognitive ability and behavioural and psychological symptoms. Hoerr 2003
	In healthy adults as well as in individuals categorized as having mild cognitive impairment, Ginkgo biloba EGb 761 improved cognition in some but not all neuropsychological tests. Ihl 2003
	Among the limited therapeutic options for dementia of Alzheimer's type, treatment with Ginkgo biloba extract appears to be the method of choice compared to the cholinesterase inhibitors. Schulz 2003
	[Ginkgo and memory.] Wheatley 2003
	[Use of Tanakan (EGb 761) in ophthalmology] [Article in Slovak]Cernak 2002
	A case of frequent ventricular arrhythmias probably due to Ginkgo biloba is presented. The patient complained of palpitations twice in a month and on both occasions symptoms and electrocardiographic evidence of ventricular arrhythmias resolved with discontinuation of Ginkgo biloba. Cianfrocca 2002
	This reports a liver transplant recipient with potentially life-threatening toxicity resulting from Gingko biloba use. The patient had been consuming Gingko biloba throughout the postoperative period. No further bleeding episodes occurred after the cessation of use. Hauser 2002
	This is the first English-language case report measuring 4-metoxypyridoxine concentration during ginkgo seed poisoning: a 2-year-old girl presented with vomiting and diarrhea 7 hours after eating a large quantity of ginkgo seeds. Kajiyama 2002
	Standardized leaf extracts of Ginkgo biloba reduce the symptoms of age-associated memory impairment and dementia, including Alzheimer's disease, and may be of benefit in treating intermittent claudication & useful in preventing and treating cardiovascular disease. Mahady 2002
	The first case of a patient in whom Ginkgo biloba extract proved to be the unique cause of spontaneous hyphema was reported.[Article in French] Schneider 2002
	The case of a female patient with a history of mild traumatic brain injury and resulting depression is presented. She experienced hypomania after adding St John's wort and Ginkgo biloba to her regimen of fluoxetine and buspirone, which remitted after discontinuation of the herbal medicines. Spinella 2002
	This study discusses a 56 year old man who suffered an intracerebral haemorrhage after regularly taking Ginkgo biloba leaf extract.Benjamin 2001
	A case of post-laparoscopic cholecystectomy bleeding in a patient taking Gingko biloba is reported. This preparation has been reported to cause spontaneous bleeding and may interact with anticoagulants and antiplatelet agents. Fessenden 2001
	Two patients with well-controlled epilepsy presented with recurrent seizures within 2 weeks of commencing extract of Ginkgo biloba. The herbal remedy was discontinued and both patients are seizure-free several months later. Granger 2001
	Future of the therapy of dementia--current data on Ginkgo-Special Extract EGB 761 [Article in German] anon 1998
	Ginkgo biloba for dementia anon 1998
	Fluoxetine-induced genital anesthesia relieved by Ginkgo biloba extract Ellison 1998
	Garlic, ginseng, and Ginkgo biloba were the herbs most frequently used by customers shopping at two health food stores Eliason 1997
	For 42 diabetic patients followed for 3 yr: Ginkgo and aspirin improved platelet reactivity but not erythrocyte aggregation Husstedt 1997
	Ginkgo extract (tanakan) helped some early stage circulatory encephalopathy patients but not those with advanced disease [Article in Ukrainian] Kupnovyts'ka 1997
	The effect of tanakan on central nervous system function in patients with the residual manifestations of stroke [Article in Russian]Kuznetsova 1997
	Ginkgo benefited 71% of 32 patients treated for varicose veins [Article in Romanian] Palade 1997
	Hyphema (bleeding into the anterior chamber of the eye) associated with ingestion of Ginkgo biloba extract Rosenblatt 1997
	The clinical efficacy of tanakan in patients with stage-I atherosclerotic circulatory encephalopathy [Article in Russian] Rudenko 1997
	Research review on G. biloba extract printed in Alternative Medicine Review. Gaby 1996
	Survey of 159 doctors in Goettingen about treatment for Alzheimer's indicates drugs of choice are piracetam 31%, Ginkgo 28%, nimodipine 26%, aspirin 17% Stoppe 1996
	76 lymphedema patients given Coumarin 60 mg/daily + Gingko Biloba 40 mg/daily + Melilotus 40 mg/daily for 6-8 months had improvement with pain, edema and infections [Article in Italian] Vettorello 1996
	Unilateral vestibular deafferentation (UVD), which causes ocular motor and postural disorders, apears to benefit from Ginkgo Smith 1994
	160 mg/day of EGb 761 improved retinal sensitivity for elderly ischemic patients while 80 mg/d failed [Article in German] Raabe 1991
	Psychomotor and memory test sessions 1 hour before and after a single 600 mg dose of Ginkgo extract in 12 healthy women showed no significant differences [Article in French] Warot 1991

Traditional and Folk Use
	The review concerns a number of substances including Ginkgo biloba, and the B vitamins folate and cobalamin, which have been receiving much attention, particularly in the media, for their potential to protect against age-related cognitive decline. Brown 2010
	Review on the role of natural products in the discovery of new drug candidates for the treatment of Neurodegenative Disorders II: Alzheimer's Disease shows more than sixteen plant species, including Ginkgo biloba and Picrorhiza kurvoa, are discussed as potential sources of active extracts. Campos 2010
	There is insufficient evidence to establish or refute a beneficial effect on dementia for exercise, treatment of type 2 diabetes, omega-3 fatty acids, folic acid with/without vitamin B12, antioxidant vitamins, or ginkgo biloba. Ebmeier 2010
	[Ginkgo biloba and cognitive decline.] Feng 2010
	Evaluation of three selected claimed health effects for Ginkgo biloba (improvement of blood circulation, improvement of symptoms of old age, and improvement of memory) was achieved through review of publicly available scientific data. A total of 35 human intervention studies were evaluated. Fransen 2010
	Therapies for the treatment of Alzheimer's disease discussed in the article include Ginkgo biloba, a nonprescription natural supplement, and Axona((R)), designated by the FDA as a medical food. Howland 2010
	Identification and description of the popular and clinical uses of medicinal plants for female sexual dysfunction treatment in climacteric women indicates that Ferula hermonis, Angelica sinensis, and Gingko biloba may be suggested for arousal disorder studies.Mazaro-Costa 2010
	Review on alternative medicine shows garlic is known to reduce blood lipids; hawthorn may be useful at early stages of cardiac insufficiency, ginkgo biloba in arterial and cerebral disorders, horse chestnut for the treatment of peripheral vascular pathology. [Article in Russian] Baksheev 2009
	There is presently no clear evidence that antioxidants or Ginkgo biloba promote successful cognitive aging. The impact of resveratrol, fish oil, and a long list of other proposed agents needs to be determined. Daffner 2009
	[Ginkgo extract in people with declining mental performance][Article in German] Kaschel 2009
	[Significance of Ginkgo biloba extract in dementia] [Article in German]Kasper 2009
	Investigation of the usage patterns of complementary and alternative medicines, as well as dietary interventions, by South Australian people with multiple sclerosis shows that the commonly used herbal products included Ginkgo biloba (18.2%) and valerian (16.4%). Leong 2009
	Vitamin E, folic acid, alpha lipoic acid, lyophilized redwine, coenzyme Q10, epigallocatechin gallate, Ginkgo biloba, melatonin, Cu chelators, regular low & moderate intensity exercise and treatments with catalase & l-carnitine hold promise to mitigating the effects of amyotrophic lateral sclerosis. Patel 2009
	Four of the most commonly used herbs today in North America namely garlic, gingko, ginseng, and ginger were discussed & the pharmacology, benefits, and possible side effects of these herbs were also presented. Shankland 2009
	The current literature regarding the prophylactic use of Ginkgo biloba extract (GBE) in acute mountain sickness (AMS) was reviewed & studies with regard to GBE dose, composition, study design, altitude reached, ascent rate, exercise, and risk of AMS was compared. van Patot 2009
	[Ginkgo (Ginkgo biloba).] [No authors listed] 2008
	Various potential risk or preventive factors were suggested by epidemiologic research, including modifiable lifestyle factors like physical exercise & diet, as well as some preventive pharmacologic strategies such as hormone replacement therapy, nonsteroidal antiinflammatory drugs & Ginkgo. Coley 2008
	[Turning over a new leaf: Ginkgo biloba in prevention of dementia?]DeKosky 2008
	Alternative therapies such as nonsteroidal anti-inflammatory drugs, vitamin E, selegiline, Ginkgo biloba extracts, estrogens, and statins, as well as behavioral and lifestyle changes, have been explored as therapeutic options for the treatment of Alzheimer's disease. Farlow 2008
	Review on bibliometric study of the scientific literature from the last 20 years shows the plants most widely mentioned in the psychiatric literature were St. John's wort (Hypericum perforatum L.; n=937) and ginkgo (Ginkgo biloba L.; n=694). García-García 2008
	It is indicated that plants such as Equisetum, Araucaria, Ginkgo and Angiopteris would have formed a major part of sauropod diets, while cycads, tree ferns and podocarp conifers would have been poor sources of energy. Hummel 2008
	A number of different alternative medicines such as Ginkgo biloba, curcumin, and huperzine A, are used by patients having Alzheimer disease. It is both desirable & expected for clinicians to be acquainted with these medications. Kelley 2008
	Review on phytochemicals and age-related eye diseases shows that additional phytochemicals of emerging interest, like green tea catechins, anthocyanins, resveratrol, and Ginkgo biloba, shown to ameliorate ocular oxidative stress, deserve more attention in future clinical trials. Rhone 2008
	The main bioactive constituents of Ginkgo biloba are terpene trilactones and flavonoid glycosides which are considered responsible for the pharmacological activities of its standardized leaf extract.Singh 2008
	Ginkgo biloba has been widely used for many years by people with symptoms attributed to "cerebrovascular insufficiency", despite the lack of evidence of a causal role. [No authors listed] 2007
	Review on botanical ingredients in cosmeceuticals indicates, a select group of botanical compounds, many of which have long traditions in Asian medicine, with potential or exhibited dermatologic applications, including curcumin, Ginkgo biloba, ginseng, silymarin, soy, and tea tree oil. Baumann 2007
	Review on Ginkgo biloba in glaucoma shows the two principal directions in the therapy of the primary open angle glaucoma are lowering intraocular pressure medication and the surgical way. [Article in Romanian] Dumitricã 2007
	[Integrative care--can ginkgo improve cognitive function?] Eliopoulos 2007
	The agents being studied for the treatment of Alzheimer's disease include dietary supplements (eg, vitamin E), herbal preparations (eg, Ginkgo biloba), medications approved for other indications (eg, HMG-CoA reductase enzyme inhibitors) and research drugs. Hogan 2007
	[Association between priapism and concurrent use of risperidone and Ginkgo biloba.] Lin 2007
	[Application regarding ginkgo biloba.] Strain 2007
	In recent years some natural substances and standardized plant extracts (Ginkgo biloba L., Centella asiatica L.) Urban, Bacopa monniera L., Evolvulus alsinoides L.) are often used in Alzheimer's disease and other types of dementia. [Article in Czech] Cervenka 2006
	Assessment of the evidence surrounding the use of certain complementary supplements in otolaryngology shows that there is overwhelming evidence that Ginkgo biloba may play no role in tinnitus. Karkos 2006
	The most important medicinal plants, including Ginkgo biloba, St John's wort, Kava-kava, Valerian, Bacopa monniera and Convolvulus pluricaulis, are reviewed which are widely used for their reputed effectiveness in CNS disorders. Kumar 2006
	Emerging role of polyphenolic compounds from green tea, the Ginkgo biloba extract EGb 761, blueberries extracts, wine components and curcumin in the treatment of neurodegenerative diseases are reviewed. Ramassamy 2006
	The 15 herbs traditionally used for anti-cancer treatment & are anti-angiogenic through multiple interdependent processes (including effects on gene expression, signal processing & enzyme activities) include Artemisia annua, green tea, Ginkgo biloba, quercetin and Chinese destagnation herbs. Sagar 2006
	Among 620 mildly cognitively impaired patients and their caregivers, a total of 51.8% of subjects were current natural health product users, with vitamin E, ginkgo biloba, and glucosamine being the most commonly used products. Sharma 2006
	Review on herbal medicine shows that enough data are available on three herbs (ginkgo (Ginkgo biloba), St John's wort (Hypericum perforatum) and saw palmetto (Serenoa repens)) for meta-analyses to have been undertaken. Walker 2006
	Traditional Chinese medicine such as Salvia miltiorrhiza, Acanthopanax senticosus, Ginkgo biloba, Pueraria lobata, Liguisticum chuanxiong, cow bezoar, etc., have been proven beneficial in CVS prevention & treatment, while S. miltiorrhiza & TCM soup have unique effects on bleeding absorption. Wang 2006
	15 herbs including Camellia sinensis (green tea), Ginkgo biloba, quercetin, & ginger are are traditionally used for anticancer treatment and are antiangiogenic through multiple interdependent processes that include effects on gene expression, signal processing, and enzyme activities. Yance 2006
	Among 10,572 respondents with cardiovascular disease, 36% had used complementary and alternative medicine and the most commonly used therapies were herbal products (18%) which includes echinacea, garlic, ginseng and ginkgo biloba. Yeh 2006
	The agents that show promise in helping prevent Alzheimer's disease include: 1) aged garlic extract, 2) curcumin, 3) melatonin, 4) resveratrol, 5) Ginkgo biloba extract, 6) green tea, 7) vitamin C and 8) vitamin E. Frank 2005
	The available data on the pathophysiologic background of Alzheimer's disease was reviewed and thus the most commonly used therapeutic agents, specifically rivastigmine, Ginkgo biloba, piracetam and selegiline. [Article in Polish] Gabryelewicz 2005
	Plant extracts including ginkgo biloba, echinacea, ginseng, grape seed, green tea, lemon, etc. have been widely used as topical applications for wound-healing, anti-aging, and disease treatments.Hsu 2005
	Review on recent trends in use of herbal and other natural products shows that use of Ginkgo biloba and Panax ginseng declined during the study, while lutein use increased dramatically, because of its addition to multivitamin products. Kelly 2005
	Flavonoids, in the new formulation of micronised purified flavonoid fraction (MPFF) or as part of the ancient traditional medicine derivative of the Ginkgo tree, are used for relief of acute symptoms (for control of bleeding and re-bleeding in all grades of haemorrhoids). Misra 2005
	Its multiple beneficial actions, including increased ocular blood flow, antioxidant activity, platelet activating factor inhibitory activity, nitric oxide inhibition & neuroprotective activity, combinedly suggest that Ginkgo biloba extract could have major therapeutic value in glaucoma treatment. Ritch 2005
	Review on increasing trends in elderly persons' use of nonvitamin, nonmineral dietary supplements and concurrent use of medications shows that by 1999, glucosamine emerged as the most frequently used nonvitamin, nonmineral supplement followed by ginkgo biloba, chondroitin, and garlic. Wold 2005
	The studies on the preventing effects of natural antioxidants, such as vitamins E and C, flavonoids, and polyphenols on neurodegenerative diseases, especially summarizing the results on the protective effect of ginkgo biloba extract on neuron cells were reviewed. Zhao 2005
	[Also true for healthy persons! Longer mental fitness with ginkgo] [Article in German] [No authors listed] 2004
	Study on prevalence & predictors of herbal medicine use in surgical patient shows that among 2,186 patients 57% of respondents used herbal medicine at some point in their life, 38% in the past 2 years (eg, echinacea [48%], aloe vera [30%], ginseng [28%], garlic [27%], & ginkgo biloba [22%]). Adusumilli 2004
	Herbs with a high concentration of flavonoids which have been proposed to be effective cytoprotectors such as Achyrocline satureioides, Ginkgo biloba and Epilobium parviflorum are of special interest. Arredondo 2004
	Antioxidants for inclusion as ideal ocular nutritional supplements, suitable for those with a family history of glaucoma, cataract, or age-related macular disease, were vitamins A, B, C and E, carotenoids beta-carotene, lutein, and zeaxanthin, minerals selenium and zinc, & Ginkgo biloba. Bartlett 2004
	The Gingko biloba extract EGb 761 has been the subject of many studies which confirm its usefulness for the prevention and treatment of neurodegenerative pathologies. Christen 2004
	A range of many pharmacological treatments have been tested, including selegiline, piracetam, vitamin E, Ginkgo biloba, anti-inflammatory drugs & hormone replacement therapy, but, so far, Cochrane reviews have not established efficacy of these interventions for Alzheimer's. Evans 2004
	Soy, St. John's Wort, Silybum marianum, Ginkgo biloba, Citrus species, Vaccinum mirtillus, Hawthorn and tea are medicinal plants containing flavonoids whose efficacy in the treatment of a variety of diseases has been demonstrated in numerous clinical studies. [Article in Italian] Firenzuoli 2004
	A review about the older people with Alzheimer's dementia or vascular dementia or age-associated memory impairment treated with Ginkgo biloba extract (EGb), reveals that EGb has reproducible effects on cognitive functions in Alzheimer's disease. Gertz 2004
	Review on chinese herbs as immunomodulators and potential disease-modifying antirheumatic drugs in autoimmune disorders shows that Ginkgo biloba is another potential Chinese herb for this consideration. Ho 2004
	Arginine, yohimbine, Panax ginseng, Maca, and Ginkgo biloba all have some degree of evidence that they may be helpful for erectile dysfunction. McKay 2004
	A survey conducted on dietary supplement use in 458 veteran outpatients currently taking prescription medications shows that most common products included are vitamins and minerals, garlic, Ginkgo biloba, saw palmetto, and ginseng. Peng 2004
	One of the most popular herbal supplements Ginkgo biloba extract, is taken for its perceived "memory enhancing" properties. Smith 2004
	The most common of the relevant medicines to cure various symptoms of senescence are nootropic piracetam, gamma-aminobutyric acid, selegiline, Ginkgo biloba, pentoxifylline, cerebrolysin, solcoseryl, ergoloid, vinpocetin, sertraline, and estrogens, among others. Ukraintseva 2004
	A phase II study of EGb 761 in combination with fluorouracil is in progress in Germany in patients with pancreatic cancer & German researchers are investigating the potential of EGb 761 for the treatment of sudden deafness and tinnitus in clinical studies. [No authors listed] 2003
	Herbal medicines were given most frequently for a behavioral condition, with ginkgo biloba, echinacea, and St. John's wort most prevalent. Almost 83% of caregivers gave herbal medicines alone, whereas 13% gave herbal medicines with prescription drugs. Cala 2003
	[Gin(kgo) and tonic--with a twist!] Cooper 2003
	Primary care patients experiencing common menopausal symptoms are likely to use herbal products (phytoestrogens, St. John's wort, Ginkgo biloba, and ginseng) that are purported to provide menopause symptom relief, and many believe that these products improve their menopausal symptoms. Dailey 2003
	[A brief history of EGb 761 and its therapeutic uses.] DeFeudis 2003
	Among hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" constituents with potential human health benefits, soy, garlic, and ginkgo biloba play potential role in cardiovascular disease prevention and treatment. Gardner 2003
	[The lowdown on Ginkgo biloba.] Gold 2003
	Gingko biloba extract is prescribed for a range of neurological and vascular disorders including dementia, arterial occlusive disease, retinal deficit, and tinnitus. Le Bars 2003
	[Ginkgo and memory.] Nathan 2003
	A study was undertaken to investigate registered nurses' knowledge about and use of five common herbal products including ginkgo, St. John's wort, ginseng, & garlic. Sand-Jecklin 2003
	Ginkgo biloba is commonly used in the treatment of early-stage Alzheimer's disease, vascular dementia, peripheral claudication, and tinnitus of vascular origin. Sierpina 2003
	Review on herbs commonly used by women indicates that Gingko biloba seems to slow the progression of dementia but increases the risk of bleeding. Tesch 2003
	[Ginkgo on your mind? It may ease dementia, but nothing's definite.]Carmichael 2002
	Review on importance of biologically active components and plants in the prevention of complications of diabetes mellitus shows that the mostly used plants includes Ginkgo biloba, Allium sativum, Silybum marianum, Panax Ginseng, Carica papaya, etc.,. [Article in Lithuanian] Savickiene 2002
	Long before the current biologically-based hypothesis of cholinergic derangement in Alzheimer' s disease emerged, plants now known to contain cholinergic antagonists were recorded for their amnesia- and dementia-inducing properties. Perry 1999
	[Herbal remedies. Ginkgo biloba may slow dementia.] [No authors listed] 1997
	Platelet activating factor antagonists in Ginkgo helps explain the pharmacological basis of several traditional medicines Braquet 1991
	Search for ethnobotanical uses of Ginkgo in Dr. Duke's Phytochem and Ethnobot DB

SAFETY DATA

Adverse Effects & Toxicity
	Explored the toxicity of ginkgolic acid(15:1) from Ginkgo biloba (EGb) using nuclear magnetic resonance based metabolomics with biochemistry assays. This integrated metabolomics testing described the mechanism of ginkgolic acid (15:1)-induced liver damage in mice.Jiang 2017
	Review presented information on the toxicological effects from experimental studies both in vitro and in vivo to human case reports (caused by G. biloba seeds or leaves), and also summarizes the negative results from relatively large clinical trials. Mei 2017
	Airborne contact dermatitis caused by the sarcotesta of Ginkgo biloba. [No abstract] Ji 2016
	Using NHANES 2001-2012 data (N = 29,684), there was no difference in levels of markers of liver function in 616 ginkgo consumers (65.1 ± 4.4 mg/day intake) compared to non-consumers.Lieberman 2016
	At moderate to high concentrations, selected herbal constituents, including Ginkgolide A and B from G. biloba, showed alterations in contractility, cell viability, and cell protein content of chick embryonic heart micromass and Mouse D3 embryonic stem cells. Mohammed 2016
	Flavonoids quercetin and kaempferol, both from the Gingko biloba plant, demonstrated significant ototoxicity, killing up to 30 % of zebrafish lateral line hair cells. A third Ginkgo flavonoid, isorhamnetin exhibited similar levels of ototoxicity. Neveux 2016
	Among 87 adverse effects to Plant Food Supplements self-reported by 2,359 consumers during the European PlantLIBRA PFS Consumer Survey 2011-2012, 52 cases were defined as possible. Of those 52, six cases were due to G. biloba. Restani 2016
	Study of cytotoxicity and mutagenicity of 3 major Ginkgolic acids (GAs) from G. biloba with different alkyl or alkenyl groups (13:0, 15:1, 17:1) in male Chinese hamster lung fibroblasts (V79 cells) using the resazurin reduction assay showed evidence of some cytotoxic potency but not mutagenicity. Berg 2015
	Ginkgo biloba extract-induced hepatocarcinogenesis in mice is mainly constitutive androstane receptor-mediated. This mode of action is considered to be qualitatively implausible for humans. Maeda 2015
	Ginkgo biloba may cause asymptomatic ventricular premature contractions! [No abstract] Dube 2013
	Study of of B6C3F1 mice treated with G. biloba extract for 2 years shows dose-dependent increase in hepatocellular tumors and the mechanism involves alterations in H-ras and Ctnnb1 mutation spectra, WNT pathway dysregulation and significantly altered gene expression. Hoenerhoff 2013
	Allergic contact dermatitis due to ginkgo tree fruit and leaf. [No abstract] Hotta 2013
	Patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency who developed acute hemolytic anemia after having received an injection of Ginkgo biloba for dementia prophylaxis without medical advice. Lai 2013
	Toxicology and carcinogenesis studies of Ginkgo biloba extract (CAS No. 90045-36-6) in F344/N rats and B6C3F1/N mice showed increased liver weight, hepatocyte hypertrophy, thyroid gland follicular cell hypertrophy, pigmentation in nose epithelium and hyaline droplet accumulation in nose epithelium. National Toxicology Program 2013
	Study of toxicity and carcinogenicity of G. biloba extract (GBE) in B6C3F1/N mice and F344/N rats showed high incidence of hepatoblastomas in mice and carcinogenic potential in thyroid gland of both mice and rats with nonneoplastic lesions in liver, thyroid gland, and nose of mice and rats. Rider 2013
	Study of lifestyle and dietary influences on nosebleed severity in hereditary hemorrhagic telangiectasia shows most frequently reported foods that exacerbate epistaxis included G. biloba. Silva 2013
	Reported is a potential interaction between Efavirenz and Ginkgo biloba. Naccarato 2012
	Ginkgo was found to have no excess side effects compared with placebo in a human study, however a few minor side effects are listed with some concern of the risk of bruising and bleeding, and interactions with anticoagulants/antiplatelet drugs. [Article in Norwegian] Roland 2012
	Allergen of the month - ginkgo. No abstract. Weber 2012
	Ginkgo biloba was reported to have arrhythmic effects in a 35 year old woman. Russo 2011
	Systematic review was carried out to assess the clinical evidence on interactions between Ginkgo biloba and drugs. Abad 2010
	Determination of the gross structural malformations to the mice fetuses of mothers given Ginkgo biloba during pregnancy substantiate the early finding that Ginkgo biloba can be teratogenic when given to pregnant mothers. Zehra 2010
	From a total of 64 493 reports, 778 reports concerned 967 suspected adverse reactions related to 175 different CAM products. The most reported CAM substances were purple coneflower (8.1%), purple coneflower + siberian ginseng + Adhatoda vasica (7.3%) and ginkgo leaf (Ginkgo biloba) (6.7%). Jacobsson 2009
	[Bleeding caused by Ginkgo biloba extract?] [Article in German] Kloft 2009
	Besides the beneficial attributes, ginkgotoxin, a B(6) antivitamin which may cause epileptic convulsions, other severe neuronal disorders and even death, is also found in Ginkgo leaves and leaf-derived remedies.Salamon 2009
	Long-term Ginkgo biloba extract (GBE) feeding impairs peripheral circulation due to bradycardia and hepatic function in aged spontaneously hypertensive rats. Thus, in an elderly population with hypertension, use of GBE may need to be assessed for effects on heart rate and liver function. Tada 2008
	CAERS data from 1999 to 2003 involving adverse effects associated with the 6 most frequently used dietary botanical supplements: Echinacea, ginseng, garlic, Ginkgo biloba, St. John's wort, and peppermint was obtained. Wallace 2008
	Examination of the toxicity of diesel exhaust particles (DEPs) using the Ah immunoassay (Ah-I) to study the inhibitory effects of various foods and polyphenols on DEP-induced AhR activation shows Ginkgo biloba extract had the strongest inhibitory effect on DEP-induced AhR activation. Izawa 2007
	Low-level evidence based on expert opinion shows that ginkgo leaf may be an emmenagogue and have hormonal properties. Dugoua 2006
	Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba, was reported for the first time. Pennisi 2006
	[Ginko biloba and cerebral hemorrhage] [Article in Spanish] Castellote Varona 2005
	Twenty seizures were judged as probably related, 13 possibly related, and 10 as unrelated to dietary supplements (DS) use. Creatine, St. John's wort, and ginkgo biloba were other DS implicated in possibly related seizure events. Haller 2005
	During recent years, several cases of hemorrhage have been reported to occur in coincidence with the use of Ginkgo products.Koch 2005
	[Ginkgo seed food poisoning] [Article in Japanese] Wada 2005
	[Bleeding complication under Gingko biloba medication.] Yagmur 2005
	The case of a 75-year-old male who suffered from Stevens-Johnson syndrome which evolved into toxic epidermal necrolysis, probably because of the ingestion of ginkgo biloba extract was described. [Article in Spanish] Yuste 2005
	Canthaxanthine, chamomile, Datura, Echinacea purpurea, Ginkgo biloba, licorice, niacin, and vitamin A are all associated with clinically significant ocular side effects. Fraunfelder 2004
	[Adverse interactions between low-dose aspirin/warfarin and garlic/ginseng/Ginkgo biloba.] Rai 2004
	The potential risks of commonly used herbal medications in dental patients such as Ginkgo Biloba, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, Garlic, Kava and Ephedra was reviewed. [Article in Hebrew] Zlotogorski Hurvitz 2004
	The relative risks for an adverse reaction in persons using ephedra compared with other herbs were extremely high, ranging from 100 (95% CI, 83 to 140) for kava to 720 (CI, 520 to 1100) for Ginkgo biloba. Bent 2003
	It is suggested that Levodopa had neurotoxic effect and Ginkgo biloba Extract (EGb) may decrease the toxicity of levodopa. The combined use of EGb with Levodopa may be a workable method to treat PD and may be better than using Levodopa alone. Cao 2003
	[Fatal intracerebral mass bleeding associated with Ginkgo biloba and ibuprofen.] Meisel 2003
	[Toxic seizures in children: case scenarios and treatment strategies.]Shannon 2003
	Ginkgo extract EGb 761, (< 5 ppm gingkolic acids ,GA), was incubated and neutral red uptake was half-maximally inhibited at concentrations of 900 mg/l (HaCaT) and 1480 mg/ml (LLC-MK(2)). The corresponding IC(50)-values for the mixture of GA ranged between 22 mg/l (HaCaT) and 4.6 mg/l (LLC-MK(2)). Hecker 2002
	[Spontaneous cerebellar haemorrhage associated with Ginkgo biloba ingestion]. [Article in Spanish] Purroy Garcia 2002
	Review on herbs commonly used by women indicates that Gingko biloba seems to slow the progression of dementia but increases the risk of bleeding. Tesch 2002
	During production of the standardized Ginkgo extract EGb 761, alkylphenols are largely eliminated as water insoluble compounds (decanter sludge). A sludge fraction enriched for ginkgolic acids and biflavones was found to induce death of 50% of the chick embryos at 1.8 mg/egg in a hen's egg test. Baron-Ruppert 2001
	No evidence for the presence of type I allergens in Ginkgo biloba extracts was found. The authors recommend serological and/or skin testing to exclude sensitisation to components of Ginkgo biloba extracts. Mossabeb 2001
	[A Ginkgo biloba-Associated Paranoid Reaction.] Berigan 2000
	Side effects seen in 33 women and 30 men treated with serotonin reuptake inhibitors plus Ginkgo include gastrointestinal disturbances, headache, and general central nervous system activation Cohen 1998
	Ginkgo fruits can cause allergic contact dermatitis but leaf extract, containing 1000 ppm ginkgolic acids, does not Hausen 1998
	Bleeding time was prolonged by 150% and ADP-induced platelet aggregation was decreased by a small dose of ticlopidine (50 mg/kg/day) combined with EGb 761 (40 mg/kg/day) or a larger dose of only ticlopidine (200 mg/kg/day) Kim 1998
	Extracts of Ginkgo biloba and bleeding or haemorrhage. Skogh 1998
	Subarachnoid haemorrhage associated with Ginkgo biloba. Vale 1998
	Ginkgo biloba extract is possibly effective for cerebrovascular insufficiency and dementia but herbs generally need more rigorous study about adverse interactions Zink 1998
	Ginkgolic acid and related alkylphenols: review of the literature on chemical and biological aspects with special reference to their allergic and other undesired properties and removal for medicinal extractsJaggy 1997
	Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Rowin 1996
	Overdose with Ginkgo preparations? [Article in German] Oberpichler-Schwenk 1995

Interactions
	A case report of a 58-year-old man with phalangeal fractures who suffered from acute kidney injury that was most likely induced by the drug interaction between sodium aescinate and ginkgo biloba extract due to the protein-binding and metabolic characteristics of these drugs. Ji 2017
	A systematic review to assess the influence of CYP450 inducers on the pharmacokinetic parameters of voriconazole found that Ginkgo biloba had no significant influence. Li 2017
	Compared to rats without pretreatment, administration of Ginkgo biloba extract significantly decreased the Cmax and the AUC0-∞ of clopidogrel in a dose-dependent manner. As expected, pretreatment of high dose GBE significantly increased the Cmax and AUC0-∞ of the clopidogrel active metabolite. Deng 2016
	Study of hydrolyzed ginkgolides and possible drug-drug interactions (DDI) during clinical use via inhibition or induction of major human cytochrome P450s (CYPs) showed hydrolyzed ginkgolides are not likely to cause DDI via inhibition but CYP3A4 induction might be clinically relevant. Zhou 2014
	Study of influence of Ginkgo biloba extract (GBE) on pharmacokinetics (PK) and pharmacodynamics of simvastatin in 14 healthy volunteers showed GBE consumption decreased simvastatin system exposure, but did not affect simvastatin acid pharmacokinetics. Dai 2013
	Review of pharmacokinetic drug interactions involving standardized Ginkgo biloba extracts (GLEs), EGb 761, together with synthetic drugs appears to be safe as long as daily doses up to 240 mg are consumed and potential for drug interactions cannot be excluded for poorly standardized GLEs. Unger 2013
	Based on meta-analysis of hemostasis outcomes, comparison of mean difference or baseline change between treatment and placebo groups did not indicate a higher bleeding risk associated with standardized Ginkgo biloba extract. Kellermann 2011
	Ginkgo biloba-related drug metabolizing enzymes may cause herb-drug interactions and contribute to hepatotoxicity. In addition, the outcomes of pathway and network analysis may be used to elucidate the toxic mechanisms of Ginkgo biloba. Guo 2010
	In vitro evaluation of the dose-dependent induction potential of six commonly used trade herbal products including St John's wort, Gingko biloba and common sage, on CYP2C19 and CYP2E1 metabolic activities in cultured human hepatocytes was carried out.Hellum 2009
	Literature review to determine possible interactions between seven popular herbal medicines (ginkgo, St John's wort, ginseng, garlic, echinacea, saw palmetto and kava) and conventional drugs indicates Ginkgo biloba decreases the plasma concentrations of omeprazole, ritonavir and tolbutamide. Izzo 2009
	High dose of gingko extract can induce the activity of CYP3A, and promote the metabolism of simvastatin & the medical interaction should be focused when gingko extract is coadministered with simvastatin and other substracts of CYP3A. [Article in Chinese] Liu 2009
	A literature search performed on species of plants that can interact with anesthetic & surgical processes included Allium sativum, Ephedra sinica, Echinacea purpurea, Ginkgo biloba, Panax ginseng, Hypericum perforatum, Glycyrrhiza glabra and Valeriana officinalis. [Article in Spanish] Muedra 2009
	The study was carried out to investigate if Ginkgo biloba extract (GB) can potentiate the antiplatelet effects of cilostazol to explore the utility of combination therapy of cilostazol and GB against peripheral occlusive vascular diseases. Ryu 2009
	[Interaction of Ginkgo biloba with efavirenz.] Wiegman 2009
	There is scant information from case reports or controlled trials to support the suggestion that Ginkgo potentiates the effects of anticoagulant or antiplatelet drugs. Bone 2008
	Coadministration of Ginko biloba either with cilostazol or clopidogrel in 10 healthy male volunteers did not enhance antiplatelet activity compared with individual agents. Aruna 2006
	The effect of Ginkgo biloba on the activity of CYP2C9, the isoform responsible for S-warfarin clearance, was assessed in 11 healthy volunteers who received single 100-mg doses of flurbiprofen, a probe substrate for CYP2C9 which showed no effect of ginkgo on the kinetics or dynamics of warfarin. Greenblatt 2006
	The investigation of herb-drug interactions with warfarin in healthy subjects by using a population pharmacokinetic-pharmacodynamic modeling approach reveals that Ginkgo and ginger did not affect the pharmacokinetics of warfarin in healthy subjects. Jiang 2006
	In vitro & in vivo inhibition studies were done to ascertain influence of ginkgo on CYP2C9, the P-450 isozyme responsible for metabolism of most potent warfarin enantiomer, (S)-warfarin which showed no interactions between Ginkgo biloba extract & CYP2C9 probe substrates when observed in vivo. Mohutsky 2006
	The review summarize the current literature regarding,interactions of flavonoids which are present in many dietary supplements or herbal remedies including Ginkgo Biloba, Soy Isoflavones & Milk Thistle with ATP-binding cassette (ABC) efflux transporters, mainly P-glycoprotein, MRP1, MRP2 and BCRP. Morris 2006
	Ginkgo biloba pretreatment potentiated acetaminophen toxicity in cultured rat hepatocytes and ginkgolide A contributed to this novel effect of the extract by inducing cytochrome P450 3A. Rajaraman 2006
	It is suggested that the combination of Ginkgo biloba extract and drugs like tolbutamide & midazolam should be cautious in terms of the potential interactions, especially in elderly patients or patients treated with drugs exerting relatively narrow therapeutic windows.Uchida 2006
	Identification of potential drug-drug interactions between drugs used by patients recently discharged from hospital & subsequent estimation of clinical implications of these interactions reveals that 11 of potential class 2 interactions involved over-the-counter products (aspirin & Ginkgo biloba). Glintborg 2005
	Ginkgo biloba (ginkgo) caused bleeding when combined with warfarin or aspirin (acetylsalicylic acid), raised blood pressure when combined with a thiazide diuretic and even caused coma when combined with trazodone in patients. Hu 2005
	It is found that the components of ginseng and ginkgo biloba are capable of inhibiting CYP2C9- and CYP3A4-mediated metabolic reactions and quercetin & ginsenoside Rd have the potential to interact with conventional medicines that are metabolized by CYP2C9 and CYP3A4 in vivo. He 2004
	It is indicated that Ginkgo biloba extract (GBE) reduces the therapeutic potency of phenobarbital via enhancement of cytochrome P450 expression in rats, and raises the possibility that GBE and drug interactions may occur clinically. Kubota 2004
	Herbs with the potential to significantly modulate the activity of drug-metabolizing enzymes (notably cytochrome p450 isozymes) and/or the drug transporter P-glycoprotein include garlic, ginkgo (Ginkgo biloba), echinacea, ginseng, St John' s wort and kava. Sparreboom 2004
	Ginkgo biloba extract (GBE)-induced hepatic drug metabolizing enzymes in rats, especially CYPs, were rapidly recovered by discontinuation of GBE in rats even after excess treatment, and interactions of GBE with drugs could be avoided by discontinuation of GBE. Sugiyama 2004
	It is shown that Ginkgo biloba can induce omeprazole hydroxylation in a CYP2C19 genotype-dependent manner and concurrently reduce the renal clearance of 5-hydroxyomeprazole. Yin 2004
	The concomitant oral use of Ginkgo biloba leaf extract appeared to reduce the first-pass metabolism of orally administered nifedipine, by inhibiting CYP3A, possibly but not P-glycoprotein, in rats. Yoshioka 2004a
	Ginkgo biloba leaf extract (GBE) and nifedipine (NFP) should not be simultaneously ingested as much as possible, and careful monitoring is needed when administering NFP concomitantly with GBE to humans. Yoshioka 2004b
	Review on potential interactions between herbal medicines and conventional drug therapies used by older adults attending a memory clinic showed that the most common potential herb-drug interaction was between ginkgo and aspirin. Dergal 2002
	A 78-year-old man who was on lisinopril 20 mg daily & ginkgo biloba 50 mg t.i.d, developed headache, confusion & progressive right-sided weakness after a fall & a subdural hematoma was diagnosed by CT scan & it was suggested that Ginkgo biloba either caused or predisposed to subdural hematoma. Miller 2002
	This review briefly summarizes important adverse interactions of commonly used herbal remedies with prescription cardiovascular medications. Aggarwal 2001
	Review of literature describing possible interactions between herbal therapies, including Ginkgo biloba, and conventional drug therapy to treat dementia. Gold 2001
	Literature search of herb-drug interaction was performed using Medline, Cochrane Library, Embase and phytobase. Ginkgo biloba interactions include bleeding when combined with warfarin, raised blood pressure when combined with a thiazide diuretic and coma when combined with trazodone. Izzo 2001
	This review discusses potential interactions between warfarin and Ginkgo biloba. Evans 2000
	Gingko biloba, among others, if taken with warfarin, may eliminate its therapeutic effect or may be toxic to the organism. [Article in Czech]Tumova 2000
	Literature review of potential interactions between warfarin and ginkgo, among others, resulting in intracerebral hemorrhage. Vaes 2000
	Reports of Ginkgo biloba extract causing spontaneous bleeding, and having drug interactions with anticoagulants and antiplatelet agents, are reviewed. Cupp 1999
	Literature review of dietary supplement and drug interactions, including bleeding complications with Ginkgo biloba, with or without concomitant drug therapy. Smolinske 1999
	Social interaction among rats was decreased by Ginkgo EGb 761 (injected or oral), increased by diazepam, and increased further when both administered. Chermat 1997
	Pilot study with 23 depressed patients on whether Ginkgo helps or harms amitriptyline treatment [Article in French] Loas 1996

Contraindications
	Reported here is a case of a young woman who made chronic use of Ginkgo biloba and suffered from cerebral bleeding without any structural abnormalities. Pedroso 2011
	In practice, patients with risk factors for bleeding (anticoagulant or antiplatelet treatment, surgery, etc.) should avoid using Gingko biloba extracts. [No authors listed] 2008
	Contraindications of other plants, often represented by interactions with drugs include Ginkgo biloba and drugs acting on blood coagulation. Calapai 2007
	Vitamin E and Ginkgo biloba have anticoagulant and anti-platelet effects respectively, and high doses are contraindicated in those being treated for vascular disorders. Bartlett 2005

EVIDENCE OF ACTIVITY

Animal Studies
	In a randomized controlled trial, Ginkgo biloba extract had a protective effect on lead-induced morphometric changes in the kidneys of albino rats. Amjad 2017
	Ginkgo biloba exocarp extracts (GBEE) inhibited the growth of LLC transplanted tumors in mice with a dose-effect relationship. GBEE induced apoptosis in LLC cells via mitochondrial-mediated intrinsic pathway and death receptor-mediated extrinsic pathway. Cao 2017
	A standardized G. biloba leaf extract counteracted the effects of carbon tetrachloride on the concentration of total proteins in urine, the concentration of renal malondialdehyde (MDA), and the renal histological changes in male Wistar rats. Chávez-Morales 2017
	Ginkgo biloba ameliorated high dose Bisphenol A (BPA)-induced hippocampal neuronal damage and subsequent cognitive deficits through mechanisms involving its ability to enhance the release of biogenic amines as well as its antioxidant and adiponectin pro-secretory effects in male rats. El Tabaa 2017
	Ginkgolide A from G. biloba was nontoxic to hepatocytes, inhibited cellular lipogenesis and lipid accumulation by causing mitochondrial oxidative stress and exhibited hepatoprotective efficacy by inducing cellular lipoapoptosis and by inhibiting cellular inflammation in mice fed a high fat diet. Jeong 2017
	Ginkgo biloba extract alleviated oxidative stress and some neurotransmitters changes induced by aluminum chloride in rats.Mohamed 2017
	An extract of Ginkgo biloba (EGb76) ameliorated neuronal apoptosis and promoted angiogenesis in experimental intracerebral hemorrhage via RSK1/GSK3β pathway in C57BL/6 mice injected with collagenase. Pan 2017
	Both Ginkgo biloba and Trifolium pretense minimized sodium arsenite-induced neurotoxicity and dementia in different regions of brain and spinal cord of rats. Ginkgo biloba and Trifolium pretense in combination was more effective as a protective agent compared to either one used alone. Abdou 2016
	Ginkgo biloba leaf extract showed some anticancer activity on chemically induced hepatocellular carcinoma in rats via its apoptotic and antiproliferative actions. Ahmed 2016
	Ginkgo biloba ameliorated subfertility induced by testicular ischemia/reperfusion injury in adult Wistar rats. Ahmed 2016
	Ginkgo biloba leaf extract, EGb761, and alpha-tocopherol treatment reversed the increase in vacuous chewing movements, decreased Bax expression, increased Bcl-2 expression, and decreased the Bax/Bcl-2 ratio in haloperidol-induced tardive dyskinesia in rats. An 2016
	Ginkgo biloba extract (EGb 761) treatment reversed the effects of cisplatin on nitric oxide and glutathione levels, but did not affect the decreased malondialdehyde levels in rats. Aydin 2016
	Exposure of high, sustained positive GZ, interfered with leaning and memory of rats. An extract of Ginkgo biloba was shown to improve and prevent the learning and memory impairment of the sustained exposure to high GZ effects. Chen 2016
	Wistar rats were divided into four groups: one control; one given titanium dioxide nanoparticles (TiO2-NPs); the Ginkgo biloba (GbE) group; and the Ginkgo biloba group with the titanium dioxide nanoparticles. GbE was found to protect the renal cells from the adverse effects of the TiO2-NPs. Escarcega-Gonzalez 2016
	Ginkgo biloba exocarp extracts (GBEE) suppressed the growth of Lewis lung cancer (LLC) cells in a dose-dependent way in vitro. GBEE retarded the growth of LLC transplanted tumor in a dose-dependent way, suppressing tumor lung metastasis in mice. Han 2016
	Treatment with Ginkgo biloba exocarp extract (GBEE) effectively reversed drug-resistance of S180 MDR cells to cisplatin, extending the survival time of mice with ascite tumors and inhibited tumor growth in solid tumor mice. It also improved cytokine expression levels in blood serum of treated mice. Hu 2016
	Treatment with a standard G. biloba extract, EGb 761, (100 mg/kg intraperitoneal injection per day) relieved the motor deficiencies of Spinocerebellar ataxia type 17 transgenic mice. Huang 2016
	Treatment with Bilobalide, a constituent of G. biloba, markedly decreased the levels of interleukin-6 (IL-6), IL-1β and tumor necrosis factor-α (TNF-α) in mice. Additionally, it exerted a gastro-protective effect. Hui 2016
	Fermentation increased the protective effect of Ginkgo biloba leaf extract in the rat brain on the neuroinflammation, release of the stress hormones, apoptosis and oxidative damage induced by γ-irradiation.Ismail 2016
	Ginkgo biloba extract modulated inflammatory cytokines and cholinergic dysfunction and exhibited neuroprotective action in chronic cerebral hypoperfusion in a rat model of bilateral common carotid artery occlusion. Kim 2016
	Mongolian gerbils with Noise Induced Hearing Loss (NIHL) treated with standardized G biloba extract (EGb761) had hearing thresholds restored back to pre-trauma conditions and improved subjective tinnitus symptoms. Krauss 2016
	Diterpene ginkgolides (DG), a class of constituents in G. biloba extract, and venlafaxine administration significantly increased hedonic behavior in mice in the sucrose preference test. DG treatment also shortened immobility time in the tail suspension test, suggesting antidepressant-like effects. Liang 2016
	Ginkgo biloba aqueous ethanolic extract significantly increased the cutaneous dermal absorption of C-salicylic acid two fold showing the effect of natural plant extracts on hydrophobic (salicylic acid) dermal penetration. Muhammad 2016
	Behavioural data showed that rats treated with a standardized extract of Ginkgo biloba treatment had improved short-term memory. Neither an anti-anxiety effect nor a change in locomotor activity was observed. Ribeiro 2016
	The protective effects of two formulations of Gingko biloba on motor changes induced by cassava juice in male Wistar rats showed that G. biloba prevented motor changes. Rivadeneyra-Dominguez 2016
	In a rat tardive dyskinesia model, haloperidol-induced vacuous chewing movements (VCM) & BDNF expression in 4 areas of the brain were evaluated. Both standardized G. biloba extract (EGb761) & Vitamin E treatment exerted positive effect in all 4 areas, reducing VCMs & increasing BDNF. Shi 2016
	Therapeutic efficacy of Ginkgo biloba for early-period noise-induced hearing loss: An experimental animal study. [No abstract]. Sjostrand 2016
	Chronic treatment with standardized Gingko biloba extract (EGb761) improved cognitive function and the reduced amyloid plaque formation in 2-month-old APP/PS1 mice. EGb761 treatment inhibited pro-inflammatory effects of microglia and induced of anti-inflammatory effects. Wan 2016
	Ginkgo biloba (GBE) achieved cardioprotective action and prevention of myocardial ischemia in rats from multiple metabolic pathway regulation. Wang 2016
	In LPS-induced pulmonary injury in rats, Ginkgolide B and ginkgolides mixture at the equivalent dosages have equal efficiency in attenuating the accumulation of inflammatory cells, including neutrophils, lymphocytes, and macrophages, and in improving the histological damage of lungs. Wu 2016
	Chronic administration of bilobalide (BB), a unique constituent of Ginkgo biloba, effectively reversed the alterations in behavior (depression-like) and cognitive deficit induced by chronic unpredictable mild stress in mice. Wu 2016
	Ginkgo biloba extract reversed the pathological process of +Gz exposure by partially regulating the perturbed fatty acid β-oxidation pathway, glycerophospholipid metabolism, purine metabolism and lysine metabolism in a rat model. Yang 2016
	Gingkgolide A, a primary component of Gingko biloba extract, activates the pregnane X receptor (PXR) and enhances the PXR and PXR expression, providing a therapeutic and protective effect on tetrachloromethane (CCl4)-induced hepatitis in mice. Ye 2016
	a standardized extract of Ginkgo biloba differentially modulated short- and long-term memory, as well as anxiety-like behavior, in adult rats.Zamberlam 2016
	Ginkgo biloba leaf extract, EGb-761, dose dependently decreased thermal hyperalgesia and mechanical allodynia on chronic constriction injury - induced neuropathic pain in mice. EGb-761 also decreased the inflammatory cytokines and increased the mu opioid receptor expression. Zhu 2016
	Atherosclerotic rats treated with Ginkgo biloba tablets (GbT) showed that inflammatory factors were reduced and the level of scavenger receptor A could be inhibited. Zhu 2016
	A standardized G. biloba extract intraperitoneally injected in chronic constriction injury mice attenuated thermal hyperalgesia and mechanical allodynia dose-dependently. It also significantly decreased pro-inflammatory cytokines and enhanced mu opioid receptor expression in the sciatic nerve. Zhu 2016