From the Guidelines
Ginkgo biloba extract EGB 761 should be held for at least 2 weeks before surgery due to its potential to increase bleeding risk, especially when combined with anticoagulants or antiplatelet medications, as suggested by the most recent guidelines 1. The mechanism of action of Ginkgo biloba extract EGB 761 involves antioxidant effects, improvement of blood flow, and modulation of neurotransmitter systems. Its main active components, flavonoids and terpene lactones, protect cells from oxidative damage, enhance microcirculation, and may inhibit platelet aggregation. Some of the indications for Ginkgo biloba extract EGB 761 include:
- Cognitive impairment
- Dementia
- Peripheral vascular disease
- Tinnitus
- Vertigo However, the evidence for these uses varies in strength, with some studies suggesting a benefit, while others show no significant effect 1. The standard dosage of Ginkgo biloba extract EGB 761 is typically 120-240 mg daily of the standardized extract, divided into 2-3 doses. Common side effects of Ginkgo biloba extract EGB 761 include:
- Headache
- Gastrointestinal disturbances
- Dizziness
- Allergic skin reactions More serious concerns include increased bleeding risk, especially when combined with anticoagulants or antiplatelet medications. Ginkgo may also interact with certain medications, including antidepressants, seizure medications, and drugs metabolized by cytochrome P450 enzymes. While generally well-tolerated, Ginkgo biloba extract EGB 761 should be used cautiously in pregnant women, nursing mothers, children, and those with bleeding disorders or seizure conditions. The extract's effects may take 4-6 weeks to become noticeable, and the quality of commercial products varies significantly. It is essential to note that the use of Ginkgo biloba extract EGB 761 should be approached with caution, and patients should be closely monitored for potential side effects and interactions, as recommended by recent guidelines 1.
From the Research
Mechanism of Action
- The mechanisms of action of Ginkgo biloba (EGB 761) are thought to reflect the action of several components of the extract, including increasing blood supply by dilating blood vessels, reducing blood viscosity, modification of neurotransmitter systems, and reducing the density of oxygen free radicals 2.
- EGb 761 promotes vasodilation and improves blood flow through arteries, veins, and capillaries, and inhibits platelet aggregation and prolongs bleeding time 3.
- The psychological and physiological benefits of ginkgo are said to be based on its primary action of regulating neurotransmitters and exerting neuroprotective effects in the brain, protecting against or retarding nerve cell degeneration 3.
Indications
- Ginkgo biloba (EGB 761) is used for the treatment of a range of conditions, including memory and concentration problems, confusion, depression, anxiety, dizziness, tinnitus, and headache 2.
- EGb 761 is increasingly being used for the symptomatic treatment of cognitive disorders with or without cerebrovascular disease, due to its known neuroprotective effects and cerebrovascular benefits 4.
- EGb 761 is recommended in multiple guidelines for the symptomatic treatment of mild cognitive impairment (MCI) 4.
Side-Effects
- There are no significant differences between Ginkgo biloba (EGB 761) and placebo in the proportion of participants experiencing adverse events 2.
- No study assessed mood and function separately, but one study used the ADAS-Noncog, which assesses function over several domains, but not cognitive function, and there was no difference between Ginkgo and placebo 2.
- Safety data revealed no important safety concerns with EGb 761 5.
- A prospective study found no statistically significant prolongation in PFA-100 in vitro bleeding time or coagulation parameters in patients receiving EGb 761 after 7 days 6.