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Ginkgo
Ginkgo — what the European monograph actually supports, what it is not for, the form and how long it is meant to be used, side effects, and the 4 medicine interactions documented for it.
This is a reference page, not a diagnosis and not a prescription. Herbal products are real pharmacology: they have effects, side effects and interactions with medicines. Tell your doctor and your pharmacist everything you take, including teas and supplements, and never stop or change a prescribed medicine because of anything you read here.
What it is
Ginkgo biloba L. — leaf (Ginkgo folium)
Local names across the region this site serves: hõlmikpuu (ET) · neidonhiuspuu (FI) · гинкго (RU).
Grouped here under Mind, mood and fatigue. Regulatory position: EU herbal monograph — well-established use for a standardised leaf dry extract; traditional use for other preparations.
What the evidence supports
The registered indication: Improvement of cognitive impairment and of quality of life in mild dementia, for a specific standardised leaf dry extract used under medical supervision.
The EU monograph recognises one narrow thing: a defined standardised leaf dry extract, in people with mild dementia, with a doctor involved. That is not what most ginkgo is bought for. The popular use is healthy adults taking it to sharpen memory or ward off dementia, and on that question the largest test available is unambiguous — a long-running NIH-funded randomised prevention trial in several thousand older adults, reported in 2008, found ginkgo did not reduce the rate of progression to dementia. Reviews of ginkgo for memory in healthy people find no reliable benefit either. There is a real product with a real, narrow indication here, and a much larger market built on a claim the trials do not support.
A — Recognised efficacy A European Union herbal monograph carries a well-established-use indication for a defined preparation, meaning the regulator accepted clinical evidence.
What it is not for
Memory enhancement in healthy people, dementia prevention, and tinnitus, where the evidence is not convincing. Sudden memory change or confusion is a reason to be assessed, not supplemented.
Form, strength and how long
Standardised leaf dry extracts in tablets and drops. Leaf teas and home preparations are not the studied product and can contain higher levels of the allergenic ginkgolic acids that manufacturing removes.
Duration. The dementia indication is a long-term, supervised one. Self-treating cognitive symptoms for months without a diagnosis is the risk worth naming.
No gram figure appears on this page on purpose. The plant part, the extraction solvent and the drug-to-extract ratio together define a preparation, and a number taken from one does not describe another. The reasoning is set out on the hub; the amount that applies to you is the one printed on the pack you are holding, and a pharmacist will read it with you.
Side effects
Headache, dizziness, stomach upset and allergic skin reactions. Bleeding events have been reported, mostly as case reports rather than in controlled trials.
Who should avoid it
Not for children or adolescents; not established in pregnancy or breastfeeding. A separate warning belongs here: ginkgo seeds, the nuts sold in Asian food shops, are a different product from the leaf extract and are toxic in quantity, especially to children, because they contain a compound that interferes with vitamin B6.
Interactions with medicines
| Medicine or substance | What is described |
|---|---|
| Anticoagulants and antiplatelets (warfarin, DOACs, aspirin, clopidogrel) | Ginkgo antagonises platelet-activating factor, and case reports of bleeding — including intracranial bleeding — are what put it on every pre-surgical stop list. Controlled studies have been less alarming than the case reports, but with warfarin, a DOAC, aspirin or clopidogrel the sensible position is to tell the prescriber rather than to weigh the literature yourself. |
| Anti-inflammatory painkillers (NSAIDs) | The same bleeding concern applies when it is stacked with regular anti-inflammatory painkillers, which irritate the stomach in their own right. |
| Anti-seizure medicines and epilepsy | Ginkgo has been reported to lower the seizure threshold, and preparations contaminated with seed material carry a further risk through ginkgotoxin. With epilepsy, ask before starting. |
| Planned surgery and anaesthesia | Standard advice is to stop ginkgo well before planned surgery and to tell the surgical team you have taken it. |
The reverse view — start from the medicine rather than the plant — is in the medicine, food and alcohol interactions reference, and summarised for every herb on this site.
Sources: European Medicines Agency — Committee on Herbal Medicinal Products (HMPC), European Union herbal monographs · NIH National Center for Complementary and Integrative Health — herb fact sheets · checked 2026-09-06
Frequently asked questions
What is ginkgo used for?
Improvement of cognitive impairment and of quality of life in mild dementia, for a specific standardised leaf dry extract used under medical supervision. The EU monograph recognises one narrow thing: a defined standardised leaf dry extract, in people with mild dementia, with a doctor involved. That is not what most ginkgo is bought for. The popular use is healthy adults taking it to sharpen memory or ward off dementia, and on that question the largest test available is unambiguous — a long-running NIH-funded randomised prevention trial in several thousand older adults, reported in 2008, found ginkgo did not reduce the rate of progression to dementia. Reviews of ginkgo for memory in healthy people find no reliable benefit either. There is a real product with a real, narrow indication here, and a much larger market built on a claim the trials do not support.
Does ginkgo work?
Graded A here: A European Union herbal monograph carries a well-established-use indication for a defined preparation, meaning the regulator accepted clinical evidence. Memory enhancement in healthy people, dementia prevention, and tinnitus, where the evidence is not convincing. Sudden memory change or confusion is a reason to be assessed, not supplemented.
How much ginkgo should I take?
This reference does not print gram figures, because they do not transfer between preparations of different extract strength. What can be said honestly is the form and the duration: Standardised leaf dry extracts in tablets and drops. Leaf teas and home preparations are not the studied product and can contain higher levels of the allergenic ginkgolic acids that manufacturing removes. The dementia indication is a long-term, supervised one. Self-treating cognitive symptoms for months without a diagnosis is the risk worth naming.
What are the side effects of ginkgo?
Headache, dizziness, stomach upset and allergic skin reactions. Bleeding events have been reported, mostly as case reports rather than in controlled trials.
Does ginkgo interact with medicines?
Yes — documented for Anticoagulants, warfarin, NSAIDs, Epilepsy, Surgery. Each one is described on this page, with a link to the medicine-side reference where one exists.
Others in mind, mood and fatigue
St John's wort
Mild to moderate depressive episodes, for particular standardised dry extracts; traditional-use preparations are also registered for temporary mental exhaustion and, externally, for minor wounds and skin inflammation.
Ginseng (Panax)
Symptoms of asthenia such as fatigue and weakness.
Rhodiola (roseroot)
Temporary relief of symptoms of stress, such as fatigue and a sensation of weakness.
Ashwagandha
Nothing a European regulator has assessed. It is marketed for stress, sleep, testosterone and athletic performance.
Keep the whole list in one place
TempoLife logs supplements alongside food, sleep and how you actually felt — so the answer to "what are you taking?" is a screen, not a guess.