GINKGO - GINKGO BILOBA

Date

July 25, 2025

Proper name(s), Common name(s), Source information

References: Proper name: USDA 2024; Common names: USDA 2024; Gardner and McGuffin 2013; WHO 1999; Source information: Birks and Evans 2007.

Route of administration

Oral

Dosage form(s)

This monograph excludes foods or food-like dosage forms as indicated in the Compendium of Monographs Guidance Document.

Acceptable dosage forms for oral use are indicated in the dosage form drop-down list of the web-based Product Licence Application form for Compendial applications.

Use(s) or Purpose(s)

• Helps to enhance cognitive function in adults (Cieza et al. 2003; Santos et al. 2003; Mix and Crews 2002; Stough et al. 2001; Kennedy et al. 2000; Mix and Crews 2000).
• Helps to enhance memory in adults (Santos et al. 2003; Stough et al. 2001; Kennedy et al. 2000; Mix and Crews 2000).
• Helps to support peripheral circulation (Boelsma et al. 2004; Mehlsen et al. 2002; Pittler and Ernst 2000).

Note: The above uses can be combined on the product label (e.g., Helps to enhance cognitive function in adults and support peripheral circulation).

Dose(s)

Subpopulation(s)

Adults 18 years and older

Quantity(ies)

Methods of Preparation: Standardized Extracts (Dry extract)

80 - 240 milligrams of extract, per day (quantity crude equivalent 4 - 12 grams of dried leaves), standardized to 22-27% flavonoid glycosides and 5-7% terpene lactones; and providing at least 80 milligrams of extract per single dose (Crew et al. 2005; Cieza et al. 2003; Santos et al. 2003; Mix and Crews 2002; Blumenthal et al. 2000; Kennedy et al. 2000; Pittler and Ernst 2000; WHO 1999).

Direction(s) for use

No statement required.

Duration(s) of use

Products providing 80 mg to less than 120 mg of extract (4 g to less than 6 g dried leaves), per day

Ask a health care practitioner/health care provider/health care professional/doctor/physician for use beyond 8 months (Santos et al. 2003; Le Bars et al. 1997; Grassel 1992).

Products providing 120 mg to 180 mg of extract (6 g to 9 g dried leaves), per day

Ask a health care practitioner/health care provider/health care professional/doctor/physician for use beyond 6 weeks (Elsabagh et al. 2005; Mix and Crews 2002; Mix and Crews 2000).

Products providing more than 180 mg to 240 mg of extract (more than 9 g to 12 g dried leaves), per day

Ask a health care practitioner/health care provider/health care professional/doctor/physician for use beyond 4 weeks (Cieza et al. 2003).

Risk information

Caution(s) and warning(s)

• Ask a health care practitioner/health care provider/health care professional/doctor/physician before use if you are pregnant or breastfeeding (Blumenthal et al. 2000; WHO 1999).
• Ask a health care practitioner/health care provider/health care professional/doctor/physician before use if you are taking diabetes, high blood pressure or seizure medications (Brinker 2010).

Contraindication(s)

• Do not use if you are having a surgery (Gardner and McGuffin 2013).
• Do not use if you are taking blood thinners or other health products that affect blood coagulation (Gardner and McGuffin 2013; Brinker 2010; Bent 2005).

Known adverse reaction(s)

No statement required.

Non-medicinal ingredients

Must be chosen from the current Natural Health Products Ingredients Database (NHPID) and must meet the limitations outlined in the database.

Storage conditions

Must be established in accordance with the requirements described in the Natural Health Products Regulations.

Specifications

• The finished product specifications must be established in accordance with the requirements described in the Natural and Non-prescription Health Products Directorate (NNHPD) Quality of Natural Health Products Guide.
• The medicinal ingredient must comply with the requirements outlined in the NHPID.
• Ginkgolic acids: Testing must be performed to ensure that the finished product meets the toxicity restrictions for Ginkgolic acids of not more than 5 ppm (NHPID).

EXAMPLE OF PRODUCT FACTS:

Consult the Guidance Document, Labelling of Natural Health Products for more details.

References cited

• Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with ginkgo biloba: a case report and systematic review of the literature. Journal of General Internal Medicine 2005;20(7):657-661.
• Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia (Review). Oxfordshire (UK): The Cochrane Database of Systematic Reviews; Issue 2. Art. No.: CD003120; 2007. DOI: 10.1002/14651858.CD003120.pub2
• Blumenthal M, Goldberg A, Brinkmann J, editors. Herbal Medicine: Expanded Commission E Monographs. Newton (MA): Integrative Medicine Communications; 2000.
• Boelsma E, Lamers RJ, Hendriks HF, Van Nesselrooij JH, Roza L. Evidence of the regulatory effect of Ginkgo biloba extract on skin blood flow and study of its effects on urinary metabolites in healthy humans. Planta Medica 2004;70(11):1052-1057.
• Brinker F. Herb Contraindications and Drug Interactions, 4^{th edition. Sandy (OR): Eclectic Medical Publications; 2010.}
• Cieza A, Maier P, Pöppel E. Effects of Ginkgo biloba on mental functioning in healthy volunteers. Archives of Medical Research 2003;34(5):373-381.
• Crews WD, Harrison DW, Griffin ML, Falwell KD, Crist T, Longest L, Hehemann L, Rey ST. The neuropsychological efficacy of Ginkgo preparations in healthy and cognitively intact adults: a comprehensive review. HerbalGram: The Journal of the American Botanical Council 2005;67:43-62.
• Elsabagh S, Hartley DE, Ali O, Williamson EM, File SE Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers. Psychopharmacology 2005;179(2):437-446.
• Gardner Z, McGuffin M, editors. American Herbal Products Association's Botanical Safety Handbook. Second Edition. Boca Raton (FL): Taylor and Francis Group; 2013.
• Grässel E. [Effect of Ginkgo-biloba extract on mental performance. Double-blind study using computerized measurement conditions in patients with cerebral insufficiency]. Fortschritte der Medizin 1992;110(5):73-76 (in German).
• Kennedy DO, Scholey AB, Wesnes KA. The dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers. Psychopharmacology 2000;151(4):416-423.
• Le Bars PL, Katz MM, Berman N, Itil TM, Freedman AM, Schatzberg AF. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. The Journal of the American Medical Association 1997;278(16):1327-1332.
• Mehlsen J, Drabaek H, Wiinberg N, Winther K. Effects of a Ginkgo biloba extract on forearm haemodynamics in healthy volunteers. Clinical Physiology and Functional Imaging 2002;22(6):375-378.
• Mix JA, Crews WD. A double-blind, placebo-controlled, randomized trial of Ginkgo biloba extract EGb 761 in a sample of cognitively intact older adults: neuropsychological findings. Human Psychopharmacology: Clinical and Experimental 2002;17(6):267-277.
• Mix JA, Crews WD. An examination of the efficacy of Ginkgo biloba extract EGb761 on the neuropsychologic functioning of cognitively intact older adults. Journal of Alternative and Complementary Medicine 2000;6(3):219-229.
• Pittler MH, Ernst E. Ginkgo biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials. The American Journal of Medicine 2000;108(4):276-281.
• Santos RF, Galduróz JC, Barbieri A, Castiglioni ML, Ytaya LY, Bueno OF. Cognitive performance, SPECT, and blood viscosity in elderly non-demented people using Ginkgo biloba. Pharmacopsychiatry 2003;36(4):127-133.
• Stough C, Clarke J, Lloyd J, Nathan PJ. Neuropsychological changes after 30-day Ginkgo biloba administration in healthy participants. The International Journal of Neuropsychopharmacology 2001;4(2):131-134.
• USDA 2024: United States Department of Agriculture, Agricultural Research Service (USDA ARS), Germplasm Resources Information Network (GRIN) - Global. U.S. National Plant Germplasm System. [Accessed 2024 August 20]. Available from: https://npgsweb.ars-grin.gov/gringlobal/taxon/taxonomysearch
• WHO 1999: World Health Organization. WHO monographs on selected medicinal plants, Volume 1. Geneva (CHE): World Health Organization; 1999.

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