What is the interaction between Ginkgo biloba (Katsura) and fluoxetine (Prozac)?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

There is no known significant interaction between Katsura (Cercidiphyllum japonicum) and Prozac (fluoxetine), but caution is advised when combining herbal supplements with prescription medications due to potential liver enzyme interactions 1. When considering the use of Katsura with Prozac, it's essential to consult with a healthcare provider to discuss potential risks and benefits. Prozac is primarily metabolized by the CYP2D6 enzyme system, and some plant compounds could potentially interfere with this process, either increasing or decreasing the medication's effectiveness or side effects. Some key points to consider when taking Prozac include:

  • Typical dosing ranges from 20-80mg daily
  • Potential for drug-drug interactions, particularly with monoamine oxidase inhibitors (MAOIs) and drugs that prolong the QT interval
  • Risk of discontinuation syndrome, characterized by symptoms such as dizziness, fatigue, and anxiety, when stopping or reducing the medication
  • Importance of medical supervision and monitoring for symptoms, especially when starting or stopping the medication It's crucial to prioritize medical supervision and monitoring when combining herbal supplements with prescription medications like Prozac to minimize potential risks and ensure optimal treatment outcomes 1. Key considerations for healthcare providers include:
  • Starting with a low dose and gradually increasing as tolerated
  • Monitoring for symptoms, especially in the first 24 to 48 hours after dosage changes
  • Being aware of potential drug-drug interactions and adjusting treatment plans accordingly
  • Providing personalized advice and guidance to patients based on their complete medical history, current medications, and health goals.

From the Research

Katsura and Prozac Interaction

  • There is no direct evidence of an interaction between Katsura and Prozac (fluoxetine) in the provided studies.
  • However, studies have investigated the potential for interactions between dietary supplements and prescription medications, including antidepressants like Prozac 2, 3.
  • Prozac is a selective serotonin reuptake inhibitor, and its interactions with other substances are often related to its effect on the serotonin system 4.
  • The potential for clinically significant drug-drug interactions involving the CYP 2D6 system has been studied, with effects observed with fluoxetine and paroxetine versus sertraline 5.
  • Pharmacokinetic and pharmacodynamic interactions between fluoxetine and other substances, such as moclobemide, have also been investigated 6.
  • To assess the potential interaction between Katsura and Prozac, it would be necessary to consult reliable dietary supplement resources or clinical pharmacists/pharmacologists, as suggested by 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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