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What is ginkgo?
The use of ginkgo in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous. Ginkgo is also known as Ginkgo biloba, maidenhair tree, kew tree, fossil tree, ginkyo, and yinhsing.

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What are the possible side effects of ginkgo?

Although uncommon, serious side effects have been reported with the use of ginkgo. If you experience any of the following serious side effects, stop taking ginkgo and seek emergency medical attention or notify your doctor immediately:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• irregular heartbeats;

• muscle spasms or cramps;

• seizures; or

• loss of consciousness.

Other less serious side effects have also been reported to occur. Talk to your doctor or pharmacist if you experience

• headache;

• dizziness; or

• stomach upset.

Do not use ginkgo seeds or fruit pulp. These have been shown to be toxic. Also, do not handle the ginkgo fruit pulp. A severe reaction including skin redness, swelling, blistering, and itching lasting for 7 to 10 days has been reported.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take ginkgo?
The use of ginkgo in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous. If you choose to take ginkgo, use it as directed on the package or as directed by your doctor, pharmacist, or other health care provider.

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What is the most important information I should know about ginkgo?
Do not take ginkgo without first talking to your doctor if you have a bleeding or blood clotting disorder; if you are taking a medicine to prevent blood clots; or if you are taking other medications, herbs, antioxidants, or health supplements (these may also affect blood clotting). Ginkgo may affect the time it takes for the blood to clot. Ginkgo has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of ginkgo may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

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What happens if I miss a dose?
No information is available regarding a missed dose of ginkgo. Consult your doctor, pharmacist, or health care provider if you require further information.

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What other drugs will affect ginkgo?
Do not take ginkgo without first talking to your doctor if you are taking any of the following medicines: warfarin (Coumadin); aspirin; a nonsteroidal anti-inflammatory drug (NSAID) including ibuprofen (Advil, Motrin, Nuprin, others), naproxen (Aleve, Naprosyn, Naprelan, Anaprox, others), ketoprofen (Orudis KT, Orudis), indomethacin (Indocin), etodolac (Lodine), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), and others; ardeparin (Normiflo);

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Do not take ginkgo without first talking to your doctor if you are pregnant or could become pregnant. It is not known whether ginkgo will harm an unborn baby.

Do not take ginkgo without first talking to your doctor if you are breast-feeding a baby. It is also not known whether ginkgo will harm a nursing infant.

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What happens if I overdose?
Seek emergency medical attention. Symptoms of a ginkgo overdose may include seizures, a loss of consciousness, and possibly death.

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Who should not take ginkgo?
Do not take ginkgo without first talking to your doctor if you have a bleeding or blood clotting disorder; if you are taking a medicine to prevent blood clots; or if you are taking other medications, herbs, antioxidants, or health supplements (these may also affect blood clotting). Ginkgo may affect the time it takes for the blood to clot. Before taking ginkgo, talk to your doctor, pharmacist, or health care professional if you have any other medical conditions, allergies (especially to plants), or if you take other medicines or other herbal/health supplements. Ginkgo may not be recommended in some situations.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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