Contra-Indications | Not safe for use during pregnancy. Safety in breastfeeding has not been established. Warfarin and other anticoagulants: Ginkgo biloba has been shown to reduce platelet aggregation and blood clotting. The use with anticoagulants should be avoided or carefully monitored. Medicines that have anticoagulant effects include Aspirin, Clopidogrel, Dalteparin, Enoxaparin, Heparin, Indomethacin, Ticlopidine, Warfarin, and others. Ibuprofen: Concurrent use could lead to an increased risk of spontaneous bleeding. Alprazolam: Ginkgo biloba may decrease the effectiveness of Alprazolam. Anticonvulsants: Ginkgo biloba may reduce the effectiveness of anticonvulsants and increase the risk of seizures. Some anti-epileptic medicines include Phenobarbital, Primidone, Valproic Acid, Gabapentin, Carbamazepine, Phenytoin and others. Antidiabetic medicines: Ginkgo biloba seems to alter insulin secretion and metabolism, and might affect glucose levels in type 2 diabetics. Some antidiabetic medicines include Glimepiride, Glyburide, Insulin, Pioglitazone, Rosiglitazone and others. Seizure threshold lowering medicines: Concurrent use with seizure threshold lowering medicines could increase the changes of seizures. Some medicines that lower seizure threshold include: anesthetics, antiarrhythmics, antibiotics (Amphotericin, Penicillin, Cephalosporins, Imipenem), antidepressants (Bupropion, others), antihistamines (Cyproheptadine, others), immunosuppressants (Cyclosporine), narcotics (Fentanyl, others), stimulants (Methylphenidate), Theophylline. Trazodone: Concurrent use with Ginkgo biloba has been associated with coma. Efavirenz: Concurrent use may lead to decreased efavirenz concentrations and increased viral load. Fluoxetine, Buspirone, Melatonin and St Johns Wort: Ginkgo biloba used in combination with these medicines might cause hypomania in individuals with depression. |