Ginkgo biloba does not the risk of bleeding.
Article Type: Brief article
Subject: Ginkgo (Health aspects)
Hemorrhage (Risk factors)
Author: Gaby, Alan R.
Pub Date: 04/01/2012
Publication: Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 The Townsend Letter Group ISSN: 1940-5464
Issue: Date: April, 2012 Source Issue: 345
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 286257209
Full Text: A meta-analysis was conducted on 18 randomized controlled trials with a total of 1985 adults that examined the effect of Ginkgo biloba extract (ginkgo) or placebo in patients with dementia, peripheral artery disease, or diabetes mellitus (13% were healthy volunteers). In the pooled analysis, ginkgo significantly reduced blood viscosity, but had no significant effect on ADP-induced platelet aggregation, fibrinogen concentration, prothrombin time, or activated partial thromboplastin time. Subgroup analyses revealed a significant reduction in activated partial thromboplastin time for subgroups receiving high-dose ginkgo (240 mg per day or more) and for studies including only patients, not healthy volunteers; however, both findings were not considered clinically relevant.

Comment: Because ginkgo has been reported to inhibit platelet-activating factor, concerns have been raised that this herb could increase the risk of bleeding. There have been several case reports in which spontaneous or excessive bleeding (including one case of subdural hematoma) occurred in individuals taking ginkgo. However, a cause-effect relationship was not proven in any of these cases. In a study of 309 demented patients randomly assigned to receive 120 mg per day of ginkgo or placebo for 12 months, one subdural hematoma occurred in the placebo group and none in the ginkgo group. The results of the present study suggest that ginkgo is unlikely to increase the risk of bleeding.

Kellermann AJ, Kiofl C. Is (hero a risk of bleeding associated with standardized Ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy. 2011;31:490-502.
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