Page 135 - 2018 SP Product Guide

Recommended Action Monitor (medium level of risk). Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants. L Monitor (low level of risk) Prescribe cautiously. Reduce drug if necessary in conjunction with prescribing physician. Monitor (low level of risk) Monitor (medium level of risk). Monitor (low level of risk).

Basis of Concern Case reports, two with well-controlled epilepsy, 77 others anecdotal and uncertain. 78-80 Concern based on antiplatelet activity. Bleeding events associated with Ginkgo alone or in combination with these and other drugs have been reported but a causal relationship was not established conclusively. Although a retrospective population-based study found risk of hemorrhage was associated with elderly patients (65 years or older) who were taking Ginkgo

Potential Interaction May decrease the effectiveness of drug. Prolongation of bleeding and/or increased bleeding tendency. May potentiate the efficiency of drug in patients with schizophrenia. HIV integrase inhibitors eg raltegravir: May alter drug levels HIV non-nucleoside transcriptase inhibitors eg efavirenz: May decrease drug levels. May alter drug level.

Ginkgo K Ginkgo biloba Anticonvulsant medication eg carbamazepine, sodium valproate Antiplatelet and anticoagulant Antipsychotic medication eg haloperidol, olanzapine, clozapine Antiretroviral drugs Atorvastatin – See Statin drugs below

Drug drugs Benzodiazepines

134 MediHerb Product Catalog 2018 • Herb-Drug Interaction Chart
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