Peringatan Keamanan

Oral LD50 of standardized extract in mice is 7730 mg/kg, which corresponds to 2300 mg/kg of active ingredients, 1900 mg/kg of flavone glycosides, and 464 mg/kg of terpene lactones. Intravenous LD50 is 1100 mg/kg.L32779

No case of overdose has been reported so far.L10247 Cyanogenic glycosides found in raw ginkgo seeds are potentially toxic compounds; thus, contact or ingestion of ginkgo seeds can lead to serious reactions such as allergic skin reaction, including acute generalized exanthematous pustulosis, and convulsions. Ginkgo toxicity can manifest as bleeding, seizure, and serotonin syndrome. As there is no known antidote for ginkgo toxicity, treatment includes discontinuation of ginkgo and symptomatic and supportive care.A232379 Seizures may be attributed to ginkgotoxin, which can cause seizures at high doses.L32798

Ginkgo biloba

DB01381

biotech approved investigational nutraceutical

Deskripsi

Ginkgo biloba extract contains a group of terpene lactones (notably, ginkgolides and diterpenes) and ginkgo flavone glycosides (notably, ginkgetin, bilobetin, and sciadopitysin) that have antioxidant and vasoactive properties.A232389 Most of the studies that investigate the effect of ginkgo biloba use the standardized extract of Ginkgo biloba (EGb) 761 (EGb761), which was developed by a German pharmaceutical company in 1964.A232404 EGb761 contains 6% terpene lactones and 24% flavonoid glycosides.A232379 Flavonoids include quercetin, rutin, kaempferol, and isorhamnetin. Lactones include ginkgolide A, ginkgolide B, ginkgolide C, bilobalide, and ginkgotoxin, a lactone that is structurally related to pyridoxine.L32789 Ginkgo biloba is an herbal plant that is now cultivated worldwide. It is originally native to China, and ginkgo biloba extract has been used in traditional Chinese medicine for centuries.A232389

After its nootropic properties were discovered, ginkgo biloba has gained attention as a therapeutic ingredient for memory and concentration enhancement in cognitive impairment and neurogenerative diseases, such as dementia.A232384 Ginkgo biloba was investigated in preliminary studies for a variety of therapeutic purposes such as improving cardiovascular health, sexual dysfunction, psychiatric disorders, skin disorders, and glaucoma. Ginkgo biloba is found in a number of homeopathic and over-the-counter herbal products and dietary supplements, but it has no approved therapeutic indications by regulatory bodies, such as the FDA, EMA, and Health Canada.A232379 Ginkgo folium, the leaf extract of Ginkgo biloba, is considered an anti-dementia drug by the World Health Organization.A232389

Struktur Molekul 2D

Struktur tidak tersedia

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) Unpublished human data reports that after oral administration of 80 mg EGb 761, the half-life was four hours for ginkgolides A and six hours for ginkgolides B. The half-life of bilobalide was three hours after administration of 120 mg EGb 761 extract.[L32779]
Volume Distribusi No data available.
Klirens (Clearance) No data available.

Absorpsi

Studies assessed the pharmacokinetic parameters of terpene lactones, the main component of ginkgo biloba. Following oral administration of ginkgo biloba solution, the mean absolute bioavailability was 80% for ginkgolide A, 88% for ginkgolide B and 79% for biloalide.L10247 In an early rat study, about 60% of radiolabeled EGb 761 was absorbed with a Tmax of 1.5 hours. The highest amount of radioactivity was measured in the stomach and small intestine.L32779 In another study, after a single oral dose of 120 mg EGb 761 in healthy volunteers, Cmax was 22.22 ± 4.57 ng/mL for ginkgolide A, 8.27 ± 1.82 ng/mL for ginkgolide B, and 54.42 ± 13.62 ng/mL for biloalide. AUC0-? was 121.35 ± 22.92 ng × h/mL for ginkgolide A, 59.88 ± 11.39 ng × h/mL for ginkgolide B, and 217.24 ± 44.07 ng × h/mL for biloalide. Tmax ranged from 1.17 to 1.54 hours for those three compounds.L10247

Metabolisme

In earlier studies, detectable urinary metabolites in healthy volunteers who ingested EGb were various benzoic acids, such as 4-hydroxybenzoic acid conjugate, 4-hydroxyhippuric acid, 3-methoxy-4-hydroxyhippuric acid, 3,4-dihydroxybenzoic acid, 4-hydroxybenzoic acid, hippuric acid, and 3-methoxy-4-hydroxybenzoic acid (vanillic acid).L32789

Rute Eliminasi

At 72 hours following oral administration in rats, about 38% of the ginkgo biloba extract was excreted via expiration, 22% was excreted in urine, and 29% was excreted in feces. About 70% of ginkgolides A, 50% of ginkgolides B, and 30% of bilobalide were excreted unchanged in the urine.L32779

Interaksi Makanan

2 Data
  • 1. Avoid herbs and supplements with anticoagulant/antiplatelet activity. Additive anticoagulant/antiplatelet activity may increase the risk of bleeding. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.
  • 2. Take with or without food. Food insignificantly decreases the rate of absorption.

Interaksi Obat

733 Data
Lomitapide The metabolism of Lomitapide can be decreased when combined with Ginkgo biloba.
Aminosalicylic acid The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Aminosalicylic acid.
Mesalazine The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Mesalazine.
Sulfasalazine The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Sulfasalazine.
Diflunisal The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Diflunisal.
Salicylic acid The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Salicylic acid.
Balsalazide The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Balsalazide.
Olsalazine The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Olsalazine.
Bismuth subsalicylate The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Bismuth subsalicylate.
Dersalazine The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Dersalazine.
Phenyl aminosalicylate The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Phenyl aminosalicylate.
Methyl salicylate The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Methyl salicylate.
Nitroaspirin The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Nitroaspirin.
Aloxiprin The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Aloxiprin.
Guacetisal The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Guacetisal.
Carbaspirin calcium The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Carbaspirin calcium.
Choline salicylate The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Choline salicylate.
Thiosalicylic acid The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Thiosalicylic acid.
Acetylsalicylic acid The risk or severity of bleeding can be increased when Ginkgo biloba is combined with Acetylsalicylic acid.
Dipyridamole The therapeutic efficacy of Ginkgo biloba can be decreased when used in combination with Dipyridamole.
Ephedrine Ginkgo biloba may increase the neuromuscular blocking activities of Ephedrine.
Bambuterol Ginkgo biloba may increase the neuromuscular blocking activities of Bambuterol.
Clevidipine Ginkgo biloba may increase the neuromuscular blocking activities of Clevidipine.
Sar9, Met (O2)11-Substance P Ginkgo biloba may increase the neuromuscular blocking activities of Sar9, Met (O2)11-Substance P.
Mirabegron Ginkgo biloba may increase the neuromuscular blocking activities of Mirabegron.
Moxisylyte Ginkgo biloba may increase the neuromuscular blocking activities of Moxisylyte.
Procaine Ginkgo biloba may increase the neuromuscular blocking activities of Procaine.
Cocaine Ginkgo biloba may increase the neuromuscular blocking activities of Cocaine.
Trimethaphan Ginkgo biloba may increase the neuromuscular blocking activities of Trimethaphan.
Doxacurium Ginkgo biloba may increase the neuromuscular blocking activities of Doxacurium.
Chloroprocaine Ginkgo biloba may increase the neuromuscular blocking activities of Chloroprocaine.
Tubocurarine Ginkgo biloba may increase the neuromuscular blocking activities of Tubocurarine.
Aclidinium Ginkgo biloba may increase the neuromuscular blocking activities of Aclidinium.
Butyrylthiocholine Ginkgo biloba may increase the neuromuscular blocking activities of Butyrylthiocholine.
Oxybuprocaine Ginkgo biloba may increase the neuromuscular blocking activities of Oxybuprocaine.
Benzonatate Ginkgo biloba may increase the neuromuscular blocking activities of Benzonatate.
Efavirenz The serum concentration of Efavirenz can be decreased when it is combined with Ginkgo biloba.
Lepirudin Ginkgo biloba may increase the anticoagulant activities of Lepirudin.
Bivalirudin Ginkgo biloba may increase the anticoagulant activities of Bivalirudin.
Alteplase Ginkgo biloba may increase the anticoagulant activities of Alteplase.
Urokinase Ginkgo biloba may increase the anticoagulant activities of Urokinase.
Reteplase Ginkgo biloba may increase the anticoagulant activities of Reteplase.
Anistreplase Ginkgo biloba may increase the anticoagulant activities of Anistreplase.
Tenecteplase Ginkgo biloba may increase the anticoagulant activities of Tenecteplase.
Abciximab Ginkgo biloba may increase the anticoagulant activities of Abciximab.
Drotrecogin alfa Ginkgo biloba may increase the anticoagulant activities of Drotrecogin alfa.
Streptokinase Ginkgo biloba may increase the anticoagulant activities of Streptokinase.
Dicoumarol Ginkgo biloba may increase the anticoagulant activities of Dicoumarol.
Argatroban Ginkgo biloba may increase the anticoagulant activities of Argatroban.
Ardeparin Ginkgo biloba may increase the anticoagulant activities of Ardeparin.
Phenindione Ginkgo biloba may increase the anticoagulant activities of Phenindione.
Fondaparinux Ginkgo biloba may increase the anticoagulant activities of Fondaparinux.
Warfarin Ginkgo biloba may increase the anticoagulant activities of Warfarin.
Pentosan polysulfate Ginkgo biloba may increase the anticoagulant activities of Pentosan polysulfate.
Phenprocoumon Ginkgo biloba may increase the anticoagulant activities of Phenprocoumon.
Heparin Ginkgo biloba may increase the anticoagulant activities of Heparin.
Enoxaparin Ginkgo biloba may increase the anticoagulant activities of Enoxaparin.
Epoprostenol Ginkgo biloba may increase the anticoagulant activities of Epoprostenol.
Acenocoumarol Ginkgo biloba may increase the anticoagulant activities of Acenocoumarol.
4-hydroxycoumarin Ginkgo biloba may increase the anticoagulant activities of 4-hydroxycoumarin.
Coumarin Ginkgo biloba may increase the anticoagulant activities of Coumarin.
Ximelagatran Ginkgo biloba may increase the anticoagulant activities of Ximelagatran.
Desmoteplase Ginkgo biloba may increase the anticoagulant activities of Desmoteplase.
Defibrotide Ginkgo biloba may increase the anticoagulant activities of Defibrotide.
Ancrod Ginkgo biloba may increase the anticoagulant activities of Ancrod.
Beraprost Ginkgo biloba may increase the anticoagulant activities of Beraprost.
Prasugrel Ginkgo biloba may increase the anticoagulant activities of Prasugrel.
Rivaroxaban Ginkgo biloba may increase the anticoagulant activities of Rivaroxaban.
Sulodexide Ginkgo biloba may increase the anticoagulant activities of Sulodexide.
Semuloparin Ginkgo biloba may increase the anticoagulant activities of Semuloparin.
Idraparinux Ginkgo biloba may increase the anticoagulant activities of Idraparinux.
Cangrelor Ginkgo biloba may increase the anticoagulant activities of Cangrelor.
Astaxanthin Ginkgo biloba may increase the anticoagulant activities of Astaxanthin.
Apixaban Ginkgo biloba may increase the anticoagulant activities of Apixaban.
Otamixaban Ginkgo biloba may increase the anticoagulant activities of Otamixaban.
Amediplase Ginkgo biloba may increase the anticoagulant activities of Amediplase.
Dabigatran etexilate Ginkgo biloba may increase the anticoagulant activities of Dabigatran etexilate.
Danaparoid Ginkgo biloba may increase the anticoagulant activities of Danaparoid.
Dalteparin Ginkgo biloba may increase the anticoagulant activities of Dalteparin.
Tinzaparin Ginkgo biloba may increase the anticoagulant activities of Tinzaparin.
(R)-warfarin Ginkgo biloba may increase the anticoagulant activities of (R)-warfarin.
Ethyl biscoumacetate Ginkgo biloba may increase the anticoagulant activities of Ethyl biscoumacetate.
Nadroparin Ginkgo biloba may increase the anticoagulant activities of Nadroparin.
Triflusal Ginkgo biloba may increase the anticoagulant activities of Triflusal.
Ticagrelor Ginkgo biloba may increase the anticoagulant activities of Ticagrelor.
Ditazole Ginkgo biloba may increase the anticoagulant activities of Ditazole.
Vorapaxar Ginkgo biloba may increase the anticoagulant activities of Vorapaxar.
Edoxaban Ginkgo biloba may increase the anticoagulant activities of Edoxaban.
Sodium citrate Ginkgo biloba may increase the anticoagulant activities of Sodium citrate.
Dextran Ginkgo biloba may increase the anticoagulant activities of Dextran.
Bemiparin Ginkgo biloba may increase the anticoagulant activities of Bemiparin.
Parnaparin Ginkgo biloba may increase the anticoagulant activities of Parnaparin.
Desirudin Ginkgo biloba may increase the anticoagulant activities of Desirudin.
Antithrombin Alfa Ginkgo biloba may increase the anticoagulant activities of Antithrombin Alfa.
Protein C Ginkgo biloba may increase the anticoagulant activities of Protein C.
Antithrombin III human Ginkgo biloba may increase the anticoagulant activities of Antithrombin III human.
Letaxaban Ginkgo biloba may increase the anticoagulant activities of Letaxaban.
Darexaban Ginkgo biloba may increase the anticoagulant activities of Darexaban.
Betrixaban Ginkgo biloba may increase the anticoagulant activities of Betrixaban.
Nafamostat Ginkgo biloba may increase the anticoagulant activities of Nafamostat.

Target Protein

Sodium-dependent noradrenaline transporter SLC6A2
Phospholipase A2, membrane associated PLA2G2A
Glycine receptor subunit alpha-1 GLRA1
Gamma-aminobutyric acid receptor subunit alpha-1 GABRA1
Gamma-aminobutyric acid receptor subunit beta-2 GABRB2
Gamma-aminobutyric acid receptor subunit gamma-2 GABRG2
Amine oxidase [flavin-containing] A MAOA
Nitric oxide synthase, inducible NOS2

Referensi & Sumber

Synthesis reference: Klaus-Peter Schwabe, "Method of preparation of an extract from Ginkgo biloba leaves and pharmaceuticals containing the extract." U.S. Patent US5322688, issued July, 1989.
Artikel (PubMed)
  • PMID: 9611693
    Cohen AJ, Bartlik B: Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther. 1998 Apr-Jun;24(2):139-43.
  • PMID: 31082068
    Nguyen T, Alzahrani T: Ginkgo Biloba .
  • PMID: 23781271
    Brondino N, De Silvestri A, Re S, Lanati N, Thiemann P, Verna A, Emanuele E, Politi P: A Systematic Review and Meta-Analysis of Ginkgo biloba in Neuropsychiatric Disorders: From Ancient Tradition to Modern-Day Medicine. Evid Based Complement Alternat Med. 2013;2013:915691. doi: 10.1155/2013/915691. Epub 2013 May 28.
  • PMID: 21941584
    Silberstein RB, Pipingas A, Song J, Camfield DA, Nathan PJ, Stough C: Examining brain-cognition effects of ginkgo biloba extract: brain activation in the left temporal and left prefrontal cortex in an object working memory task. Evid Based Complement Alternat Med. 2011;2011:164139. doi: 10.1155/2011/164139. Epub 2011 Aug 18.
  • PMID: 23538078
    Diamond BJ, Bailey MR: Ginkgo biloba: indications, mechanisms, and safety. Psychiatr Clin North Am. 2013 Mar;36(1):73-83. doi: 10.1016/j.psc.2012.12.006.
  • PMID: 10807109
    Diamond BJ, Shiflett SC, Feiwel N, Matheis RJ, Noskin O, Richards JA, Schoenberger NE: Ginkgo biloba extract: mechanisms and clinical indications. Arch Phys Med Rehabil. 2000 May;81(5):668-78. doi: 10.1016/s0003-9993(00)90052-2.
  • PMID: 27414695
    Field BH, Vadnal R: Ginkgo biloba and Memory: An Overview. Nutr Neurosci. 1998;1(4):255-67. doi: 10.1080/1028415X.1998.11747236.

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