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NERVOUS SYSTEM › PSYCHOANALEPTICS › ANTI-DEMENTIA DRUGS › Other anti-dementia drugs
Ginkgo folium
N06DX02
Forms & Strengths
- Standardized extract (EGb 761): 40 mg, 80 mg, 120 mg tablets or capsules
- Liquid extract: 40 mg/mL
- Dried leaf for herbal tea
Adult Dosing
- Cognitive impairment and dementia: 120 mg to 240 mg daily divided in 2-3 doses
- Peripheral arterial disease (intermittent claudication): 120 mg to 160 mg daily divided in 2-3 doses
- Tinnitus: 120 mg to 160 mg daily divided in 2-3 doses
Pediatric Dosing
- Safety and efficacy not established in pediatric patients under 18 years
- Not recommended for use in children
Indications
- Management of cognitive impairment and mild-to-moderate dementia (Alzheimer's and vascular)
- Improvement of pain-free walking distance in peripheral arterial disease (intermittent claudication)
- Adjuvant treatment of tinnitus and vertigo of presumed vascular origin
Mechanism of Action
- Antioxidant activity and scavenging of reactive oxygen species
- Inhibition of platelet-activating factor (PAF), reducing blood viscosity and platelet aggregation
- Improvement of microvascular perfusion and enhancement of cerebral blood flow
- Modulation of neurotransmitter systems (cholinergic, monoaminergic)
Contraindications
- Hypersensitivity to Ginkgo biloba preparations or excipients
- Pregnancy and lactation due to potential bleeding risks and lack of safety data
- Planned surgical or dental procedures due to increased bleeding risk
Adverse Reactions
- Gastrointestinal upset (nausea, diarrhea, abdominal pain)
- Headache, dizziness, and vertigo
- Allergic skin reactions (rash, pruritus, eczema)
- Increased bleeding tendency and spontaneous hemorrhages with chronic use
Drug Interactions
- Antiplatelet agents and anticoagulants (e.g., warfarin, aspirin, clopidogrel): increased risk of bleeding
- CYP3A4 inducers (e.g., carbamazepine, rifampin): may decrease ginkgo efficacy
- CYP3A4 inhibitors: potential alterations in ginkgo metabolism
- Monoamine oxidase inhibitors (MAOIs): potential additive pharmacodynamic interactions
Curated Content: Needs Vetting Before Put to Clinical Use