Nutritional Supplement

Ginkgo

  • Negative Interactions

    24
    • Ginkgo

      Aspirin

      Potential Negative Interaction

      There have been two case reports suggesting a possible interaction between ginkgo Ginkgo biloba and an anticoagulant drug or aspirin leading to increased bleeding. In the first, a 78-year-old woman taking warfarin developed bleeding within the brain following the concomitant use of ginkgo (the amount used is not given in the case report). In the second, a 70-year-old man developed slow bleeding behind the iris of the eye (spontaneous hyphema) following use of ginkgo (80 mg per day) together with aspirin (325 mg per day). While this interaction is unproven, anyone taking anticoagulant medications or aspirin should inform their physician before using ginkgo.

      Aspirin
      Ginkgo
      ×
      1. Matthews MK Jr. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1933-4 [letter].
      2. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108 [letter].
    • Ginkgo

      Bendroflumethiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Bendroflumethiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Chlorothiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Chlorothiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Chlorpropamide

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a preliminary trial, administration of Ginkgo biloba who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Chlorpropamide
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Chlorthalidone

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Chlorthalidone
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Glimepiride

      Potential Negative Interaction

      In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Glimepiride
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Glipizide

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a preliminary trial, administration of Ginkgo biloba who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Glipizide
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Glyburide

      Potential Negative Interaction

      In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Glyburide
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Glyburide Micronized

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a preliminary trial, administration of Ginkgo biloba who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Glyburide Micronized
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Heparin

      Potential Negative Interaction

      Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. People taking heparin should consult with a physician knowledgeable about botanical medicines if they are considering taking ginkgo.

      Heparin
      Ginkgo
      ×
      1. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136-9 [review].
      2. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108 [letter].
      3. Matthews MK Jr. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1933-4 [letter].
    • Ginkgo

      Hydrochlorothiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Hydrochlorothiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Hydroflumethiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Hydroflumethiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Ibuprofen

      Potential Negative Interaction
      It has been argued that ginkgo has a blood-thinning effect and might therefore further increase the risk of bleeing when taken in combination with drugs (including ibuprofen) that thin the blood. However, the bulk of the evidence suggests that ginkgo does not, in fact, have a blood-thinning effect.
      Ibuprofen
      Ginkgo
      ×
      1. Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized Ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy 2011;31:490-502.
    • Ginkgo

      Indapamide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Indapamide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Metformin

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Metformin
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Methyclothiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Methyclothiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Metolazone

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Metolazone
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Polythiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Polythiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Repaglinide

      Potential Negative Interaction

      In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Repaglinide
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600–11.
    • Ginkgo

      Ticlopidine

      Potential Negative Interaction

      Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. In a rat study, a high intake of ginkgo increased the action of ticlopidine in a way that could prove dangerous if the same effect occurred in people. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. People taking ticlopidine should use ginkgo extracts only under the supervision of a doctor.

      Ticlopidine
      Ginkgo
      ×
      1. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136-9 [review].
      2. Kim YS, Pyo MK, Park KM. Antiplatelet and antithrombotic effects of a combination of ticlopidine and Ginkgo biloba ext (EGb 761). Thromb Res 1998;91:33-8.
      3. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108 [letter].
      4. Rowin J, Lewis SL. Spontaneous bilateral subdural hematoma with chronic Ginkgo biloba ingestion. Neurology 1996;46:1775-6.
    • Ginkgo

      Tolbutamide

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a preliminary trial, administration of Ginkgo biloba who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

      Tolbutamide
      Ginkgo
      ×
      1. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600-11.
    • Ginkgo

      Trazodone

      Potential Negative Interaction

      There is one case report of an elderly patient with Alzheimer’s disease going into a coma while concurrently using trazodone and ginkgo. Until more is known, ginkgo should not be combined with trazodone except under supervision of a doctor.

      Trazodone
      Ginkgo
      ×
      1. Galluzzi S, Zanetti O, Binetti G, et al. Coma in a patient with Alzheimer's disease taking low dose trazodone and Ginkgo biloba. J Neurol Neurosurg Psychiatry 2000;68:679-80.
    • Ginkgo

      Trichlormethiazide

      Potential Negative Interaction

      One case was reported in which ginkgo use was associated with high blood pressure in a person treated with a thiazide diuretic. Ginkgo was not proven to be the cause of this reaction.

      Trichlormethiazide
      Ginkgo
      ×
      1. Shaw D et al. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Safety 1997;17:342-56.
    • Ginkgo

      Warfarin

      Potential Negative Interaction

      Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. There are two case reports of people taking warfarin in whom bleeding occurred after the addition of ginkgo. People taking warfarin should consult with a physician knowledgeable about botanical medicines if they are considering taking ginkgo.

      Warfarin
      Ginkgo
      ×
      1. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136-9 [review].
      2. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108 [letter].
      3. Rowin J, Lewis SL. Spontaneous bilateral subdural hematoma with chronic Ginkgo biloba ingestion. Neurology 1996;46:1775-6.
      4. Matthews MK Jr. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1933-4 [letter].
      5. Gilbert GJ. Ginkgo biloba. Lancet 1997;1137 [letter].
  • Supportive Interactions

    8
    • Ginkgo

      Clozapine

      Support Medicine
      In one study, treatment with 120 mg per day of Ginkgo biloba extract for 12 weeks enhanced the beneficial effect of clozapine on certain symptoms of schizophrenia in patients who had not responded adequately to clozapine by itself.
      Clozapine
      Ginkgo
      ×
      1. Doruk A, Uzun O, Ozsahin A. A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia. Int Clin Psychopharmacol 2008;23:223-7.
    • Ginkgo

      Citalopram

      Reduce Side Effects

      Ginkgo biloba extract may reduce the side effects experienced by some persons taking SSRIs such as fluoxetine or sertraline. An open-label study with elderly, depressed persons found that 200–240 mg of ginkgo per day was effective in alleviating sexual side effects in both men and women taking SSRIs. One case study reported that 180 to 240 mg of GBE daily reduced genital anesthesia and sexual side effects secondary to fluoxetine use in a 37-year-old woman.

      Citalopram
      Ginkgo
      ×
      1. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-45.
      2. Ellison JM, DeLuca P. Fluoxetine-induced genital anesthesia relieved by Ginkgo biloba extract. J Clin Psychiatry 1998;59:199-200.
    • Ginkgo

      Cyclosporine

      Reduce Side Effects

      Ginkgo was reported to protect liver cells from damage caused by cyclosporine in a test tube experiment. A Ginkgo biloba extract partially reversed cyclosporine-induced reduced kidney function in a study of isolated rat kidneys. Human trials have not studied the actions of ginkgo to prevent or reduce the side effects of cyclosporine.

      Cyclosporine
      Ginkgo
      ×
      1. Barth SA, Inselmann G, Engemann R, Heidemann HT. Influences of Ginkgo biloba on cyclosporine A included lipid peroxidation in human liver microsomes in comparison to vitamin E, glutathione and N-acetylcysteine. Biochem Pharmacol 1991;41:1521-6.
      2. Bagnis C, Deray G, Dubois M, et al. Prevention of cyclosporine nephrotoxicity with a platelet-activating factor (PAF) antagonist. Nephrol Dial Transplant 1996;11:507-13.
    • Ginkgo

      Fluoxetine

      Reduce Side Effects

      Ginkgo biloba extract (GBE) may reduce the side effects experienced by some persons taking SSRIs such as fluoxetine or sertraline. An open-label study with elderly, depressed persons found that 200–240 mg of GBE daily was effective in alleviating sexual side effects in both men and women taking SSRIs. One case study reported that 180–240 mg of GBE daily reduced genital anesthesia and sexual side effects secondary to fluoxetine use in a 37-year-old woman.

      Fluoxetine
      Ginkgo
      ×
      1. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-45.
      2. Ellison JM, DeLuca P. Fluoxetine-induced genital anesthesia relieved by Ginkgo biloba extract. J Clin Psychiatry 1998;59:199-200.
    • Ginkgo

      Fluvoxamine

      Reduce Side Effects

      Ginkgo biloba extract may reduce the side effects experienced by some persons taking SSRIs such as fluoxetine or sertraline. An open-label study with elderly, depressed persons found that 200 to 240 mg of ginkgo daily was effective in alleviating sexual side effects in both men and women taking SSRIs.

      One case study reported that 180–240 mg of GBE daily reduced genital anesthesia and sexual side effects secondary to fluoxetine use in a 37-year-old woman.

      Fluvoxamine
      Ginkgo
      ×
      1. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-45.
      2. Ellison JM, DeLuca P. Fluoxetine-induced genital anesthesia relieved by Ginkgo biloba extract. J Clin Psychiatry 1998;59:199-200.
    • Ginkgo

      Haloperidol

      Reduce Side Effects

      In a double-blind trial, supplementation of schizophrenic patients with Ginkgo biloba extract, in the amount of 250 mg per 2.2 pounds of body weight per day for 12 weeks, enhanced the effectiveness of haloperidol and also reduced the side effects of the drug.

      Haloperidol
      Ginkgo
      ×
      1. Zhang XY, Zhou DF, Zhang PY, et al. A double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophrenia. J Clin Psychiatry 2001;62:878-83.
    • Ginkgo

      Paroxetine

      Reduce Side Effects

      In three men and two women treated with fluoxetine or sertraline (SSRI drugs closely related to paroxetine) for depression who experienced sexual dysfunction, addition of Ginkgo biloba extract (GBE) in the amount of 240 mg per day effectively reversed the sexual dysfunction. This makes sense because ginkgo has been reported to help men with some forms of erectile dysfunction.

      Paroxetine
      Ginkgo
      ×
      1. Cohen AJ. Long term safety and efficacy of Ginkgo biloba extract in the treatment of anti-depressant-induced sexual dysfunction. Psychiatry On-Line http://www.priory.com/ginkgo.html.
      2. Sohn M, Sikora R. Ginkgo biloba extract in the therapy of erectile dysfunction. J Sex Educ Ther 1991;17:53-61.
    • Ginkgo

      Sertraline

      Reduce Side Effects

      In three men and two women treated with fluoxetine or sertraline (SSRI drugs closely related to paroxetine) for depression who experienced sexual dysfunction, addition of Ginkgo biloba extract (GBE) in the amount of 240 mg per day effectively reversed the sexual dysfunction. This makes sense because ginkgo has been reported to help men with some forms of erectile dysfunction.

      Sertraline
      Ginkgo
      ×
      1. Cohen AJ. Long term safety and efficacy of Ginkgo biloba extract in the treatment of anti-depressant-induced sexual dysfunction. Psychiatry On-Line http://www.priory.com/ginkgo.html.
      2. Sohn M, Sikora R. Ginkgo biloba extract in the therapy of erectile dysfunction. J Sex Educ Ther 1991;17:53-61.

References

1. Drieu K. Preparation and definition of Ginkgo biloba extract. In: Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic. Fünfgeld EW, ed. Berlin: Springer-Verlag, 32-6.

2. Ferrandini C, Droy-Lefaix MT, Christen Y, eds. Ginkgo biloba Extract (EGb 761) as a Free Radical Scavenger. Paris: Elsevier, 1993.

3. Lebuisson DA, Leroy L, Rigal G. Treatment of senile macular degeneration with Ginkgo biloba extract. A preliminary double-blind, drug versus placebo study. Presse Med 1986;15:1556-8 [in French].

4. Lanthony P, Cosson JP. The course of color vision in early diabetic retinopathy treated with Ginkgo biloba extract. A preliminary double-blind versus placebo study. J Fr Ophtalmol 1988;11:671-4 [in French].

5. Krieglstein J. Neuroprotective properties of Ginkgo biloba—constituents. Zeitschrift Phytother 1994;15:92-6.

6. Clostre F. From the body to the cell membranes: the different levels of pharmacological action of Ginkgo biloba extract. In: Rokan(Ginkgo biloba): Recent Results in Pharmacology and Clinic. Fünfgeld EW, ed. Berlin: Springer-Verlag, 1988, 180-98.

7. Jung F, Mrowietz C, Kiesewetter H, Wenzel E. Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung 1990;40:589-93.

8. Mix JA, Crews WD. An examination of the efficacy of Ginkgo biloba extract EGb761 on the neuropsychologic functioning of cognitively intact older adults. J Altern Complement Med 2000;6:219-29.

9. Quaranta L, Bettelli S, Uva MG, et al. Effect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma. Ophthalmology 2003;110:359-62.

10. Lebuisson DA, Leroy L, Reigal G. Treatment of senile macular degeneration with Ginkgo biloba extract: a preliminary double-blind study versus placebo. In Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic, Fünfgeld FW, ed. Berlin: Springer-Verlag, 1988, 231-6.

11. Lanthony P, Cosson JP. The course of color vision in early diabetic retinopathy treated with Ginkgo biloba extract. A preliminary double-blind versus placebo study. J Fr Ophtalmol 1988;11:671-4 [in French].

12. Allain H, Raoul P, Lieury A, et al. Effects of two doses of ginkgo biloba extract (EGb 761) on the dual-coding test in elderly subjects. Clin Ther 1993;15(3):549-58.

13. Rai GS, Shovlin C, Wesnes KA. A double-blind, placebo-controlled study of Ginkgo biloba extract (‘tanakan') in elderly patients with mild to moderate memory impairment. Curr Med Res Opin 1991;12(6):350-5.

14. Brautigam MRH, Blommaert FA, Verleye G, et al. Treatment of age-related memory complaints with Ginkgo biloba extract: a randomized double-blind placebo-controlled study. Phytomedicine 1998;5:425-34.

15. Wesnes K, Simmons D, Rook M. A double-blind, placebo-controlled trial of Tanakan in the treatment of idiopathic impairment in the elderly. Human Psychopharmacol 1987;2:159-69.

16. Israel L, Dell'Accio E, Martin G, Hugonot R. Ginkgo biloba extract and memory training programs—comparative assessment on elderly outpatients. Psychologie Médicale 1987;19:1431-9.

17. Gräbel E. The influence of Ginkgo biloba extract (EGb 761) on mental performance: A double-blind study under computerized measurement conditions in patients with cerebral insufficiency. Fortschr Med 1992;110:73-6.

18. Winther K, Randlov C, Rein E, Mehlsen J. Effects of Ginkgo biloba extract on cognitive function and blood pressure in elderly subjects. Curr Ther Res 1998;59:881-8.

19. Gavrilova SI, Preuss UW, Wong JW, et al. Efficacy and safety of Ginkgo biloba extract EGb 761 in mild cognitive impairment with neuropsychiatric symptoms: a randomized, placebo-controlled, double-blind, multi-center trial. Int J Geriatr Psychiatry 2014;29:1087–95.

20. van Dongen M, van Rossum E, Kessels A, et al. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial. J Am Geriatr Soc 2000;48:1183-94.

21. Ihl R, Bachinskaya N, Korczyn AD, et al. Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761 in dementia with neuropsychiatric features: a randomized controlled trial. Int J Geriatr Psychiatry 2011;26:1186-94.

22. Lebuisson DA, Leroy L, Reigal G. Treatment of senile macular degeneration with Ginkgo biloba extract: a preliminary double-blind study versus placebo. In Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic, Fünfgeld FW, ed. Berlin: Springer-Verlag, 1988, 231-6.

23. Le Bars PL, Katz MM, Berman N, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA 1997;278:1327-32.

24. Hofferberth B. The efficacy of EGb 761 in patients with senile dementia of the Alzheimer type, a double-blind, placebo-controlled study on different levels of investigation. Hum Psychopharmacol 1994;9:215-22.

25. Kanowski S, Herrmann W, Stephan K, et al. Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry 1996;29:47-56.

26. Maurer K, Ihl R, Dierks T, Frolich L. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer's type. J Psychiatr Res 1997;31:645-55.

27. Bachinskaya N, Hoerr R, Ihl R. Alleviating neuropsychiatric symptoms in dementia: the effects of Ginkgo biloba extract EGb 761. Findings from a randomized controlled trial. Neuropsychiatr Dis Treat 2011;7:209-15.

28. Mazza M, Capuano A, Bria P, Mazza S. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study. Eur J Neurol 2006;13:981-5.

29. van Dongen M, van Rossum E, Kessels A, et al. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial. J Am Geriatr Soc 2000;48:1183-94.

30. Wettstein A. Cholinesterase inhibitors and Ginkgo extracts-are they comparable in the treatment of dementia? Comparison of published placebo-controlled efficacy studies of at least six months' duration. Phytomedicine 2000;6:393-401.

31. DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA 2008;300:2253-62.

32. Schneider B. Ginkgo biloba extract in peripheral arterial disease. Meta-analysis of controlled clinical trials. Arzneimittelforschung 1992;42:428-36 [in German].

33. Peters H, Kieser M, Hölscher U. Demonstration of the efficacy of Ginkgo biloba special extract EGb 761® on intermittent claudication—a placebo-controlled, double-blind multicenter trial. VASA 1998;27:106-10.

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