Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions

Medicinal herbs have recently received considerable public attention for their therapeutic properties. Traditional healing systems such as Ayurveda, traditional Chinese medicine, and traditional Persian medicine highly rely on medicinal plants to treat many diseases. However, herbal medicines are u...

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Main Authors: Zahra Moeinipour, Maryam Akaberi, Zahra Sobhani
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2024-12-01
Series:Traditional and Integrative Medicine
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Online Access:https://jtim.tums.ac.ir/index.php/jtim/article/view/1481
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author Zahra Moeinipour
Maryam Akaberi
Zahra Sobhani
author_facet Zahra Moeinipour
Maryam Akaberi
Zahra Sobhani
author_sort Zahra Moeinipour
collection DOAJ
description Medicinal herbs have recently received considerable public attention for their therapeutic properties. Traditional healing systems such as Ayurveda, traditional Chinese medicine, and traditional Persian medicine highly rely on medicinal plants to treat many diseases. However, herbal medicines are usually not standardized and despite their widespread use, there is limited scientific evidence on their safety and interactions. Ginkgo biloba L. is a medicinal plant whose biological properties have been confirmed in previous studies. Its leaf extract exhibited anti-inflammatory, antioxidant, neuroprotective, and anti-apoptotic properties. Nevertheless, G. biloba contains various pharmacologically active components, such as terpene lactones and flavonoids that could cause drug interactions through multiple mechanisms, including the effect on cytochrome isozymes and p-glycoprotein (P-gp). Thus, conducting studies to evaluate this plant's safety profile and drug interactions seems necessary. In the current paper, we reviewed the pharmacokinetics, drug interactions, and pharmacological properties of G. biloba plant. According to the included studies, bioactive compounds found in G. biloba extract have antagonistic activity against platelet aggregation and could inhibit human thrombin, thereby increasing the risk of severe bleeding. We also identified several other potential drug interactions for G. biloba, including risperidone, thiazides, mycophenolic acid, and diltiazem. Data on drug interactions between G. biloba and digoxin, simvastatin, nicardipine, and midazolam were less consistent. Therefore, caution should be taken in consuming this plant with anticoagulants or platelet inhibitors such as warfarin, ticlopidine, clopidogrel, and aspirin. However, patients’ age, gender, and dosage forms of medicine seem to play an essential role in drug interactions. In summary, further clinical and laboratory research is necessary to elucidate the risk of G. biloba drug interactions. Also, the use of technologies such as genomics, metabolomics, and transcriptomics can provide a more comprehensive understanding of how G. biloba interacts with drugs at the molecular level.
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spelling doaj-art-9048dc05ca1d40998900ee5f1f3af6e32025-02-09T09:11:21ZengTehran University of Medical SciencesTraditional and Integrative Medicine2476-51042476-51122024-12-019410.18502/tim.v9i4.17478Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug InteractionsZahra Moeinipour0Maryam Akaberi1Zahra Sobhani2Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Medicinal herbs have recently received considerable public attention for their therapeutic properties. Traditional healing systems such as Ayurveda, traditional Chinese medicine, and traditional Persian medicine highly rely on medicinal plants to treat many diseases. However, herbal medicines are usually not standardized and despite their widespread use, there is limited scientific evidence on their safety and interactions. Ginkgo biloba L. is a medicinal plant whose biological properties have been confirmed in previous studies. Its leaf extract exhibited anti-inflammatory, antioxidant, neuroprotective, and anti-apoptotic properties. Nevertheless, G. biloba contains various pharmacologically active components, such as terpene lactones and flavonoids that could cause drug interactions through multiple mechanisms, including the effect on cytochrome isozymes and p-glycoprotein (P-gp). Thus, conducting studies to evaluate this plant's safety profile and drug interactions seems necessary. In the current paper, we reviewed the pharmacokinetics, drug interactions, and pharmacological properties of G. biloba plant. According to the included studies, bioactive compounds found in G. biloba extract have antagonistic activity against platelet aggregation and could inhibit human thrombin, thereby increasing the risk of severe bleeding. We also identified several other potential drug interactions for G. biloba, including risperidone, thiazides, mycophenolic acid, and diltiazem. Data on drug interactions between G. biloba and digoxin, simvastatin, nicardipine, and midazolam were less consistent. Therefore, caution should be taken in consuming this plant with anticoagulants or platelet inhibitors such as warfarin, ticlopidine, clopidogrel, and aspirin. However, patients’ age, gender, and dosage forms of medicine seem to play an essential role in drug interactions. In summary, further clinical and laboratory research is necessary to elucidate the risk of G. biloba drug interactions. Also, the use of technologies such as genomics, metabolomics, and transcriptomics can provide a more comprehensive understanding of how G. biloba interacts with drugs at the molecular level. https://jtim.tums.ac.ir/index.php/jtim/article/view/1481Ginkgo bilobaHerb–drug interactionCytochrome P450PhytochemicalsNeurodegenerative disordersPharmacokinetics
spellingShingle Zahra Moeinipour
Maryam Akaberi
Zahra Sobhani
Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions
Traditional and Integrative Medicine
Ginkgo biloba
Herb–drug interaction
Cytochrome P450
Phytochemicals
Neurodegenerative disorders
Pharmacokinetics
title Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions
title_full Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions
title_fullStr Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions
title_full_unstemmed Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions
title_short Ginkgo biloba L.: An Updated Review on the Pharmacological Activities, Pharmacokinetics and Drug Interactions
title_sort ginkgo biloba l an updated review on the pharmacological activities pharmacokinetics and drug interactions
topic Ginkgo biloba
Herb–drug interaction
Cytochrome P450
Phytochemicals
Neurodegenerative disorders
Pharmacokinetics
url https://jtim.tums.ac.ir/index.php/jtim/article/view/1481
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AT zahrasobhani ginkgobilobalanupdatedreviewonthepharmacologicalactivitiespharmacokineticsanddruginteractions