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Ginkgo biloba: to be avoided due to severe adverse effects

In practice, it is better to avoid this plant, which has no proven efficacy and exposes patients to serious adverse effects, including convulsions.

Products based on Ginkgo biloba are marketed for the treatment of some cognitive disorders in elderly patients. Ginkgo biloba has no proven efficacy, but it is known to expose patients to bleeding, intestinal or skin disorders, and hypersensitivity reactions.

The information on medicinal products containing Ginkgo biloba also mentions that in epileptic patients the occurrence of additional seizures caused by the ingestion of products containing ginkgo cannot be ruled out. Seizures attributed to medicinal products containing Ginkgo biloba or following ingestion of ginkgo fruits have been observed in treated and stabilised epileptic patients, as well as in adults and children with no history of epilepsy.

Ginkgo biloba contains at least one substance with a convulsive effect, ginkgotoxin, which is more concentrated in the seeds than the leaves. However, Ginkgo biloba leaves also contain it. Ginkgotoxin is present in smaller amounts in leaf-based food supplements and leaf infusions. Boiling seems to reduce its concentration.

Ginkgo biloba interacts with many substances, including some anti-epileptics, levothyroxine and antivitamin K. The clinical consequences are sometimes severe, with loss of efficacy or increased adverse reactions.

This combined evidence reinforces that it is better to avoid this plant, which has no proven efficacy beyond a placebo effect.

©Prescrire 1 June 2019

"Ginkgo biloba: seizures" Prescrire Int 2019; 28 (205): 155-156. (Pdf, subscribers only).

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See also:

Ginkgo and Alzheimer's
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Prescrire Int 2007:
16 (91): 205-207.
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