Ginkgo + Aspirin: High bleeding risk
Both ginkgo and aspirin inhibit platelet aggregation through different mechanisms. Ginkgo inhibits platelet-activating factor (PAF), while aspirin inhibits COX-1. Combined effect significantly increases bleeding risk, including intracranial bleeding.
Avoid ginkgo if taking aspirin regularly. If combining, inform all doctors.
Stop ginkgo 2 weeks before any surgery
Ginkgo + Aspirin: High bleeding risk. Avoid ginkgo if taking aspirin regularly. If combining, inform all doctors.
Stop ginkgo 2 weeks before any surgery
This interaction is rated “Danger” by Formulate. Both ginkgo and aspirin inhibit platelet aggregation through different mechanisms. Ginkgo inhibits platelet-activating factor (PAF), while aspirin inhibits COX-1. Combined effect significantly increases bleeding risk, including intracranial bleeding.
Studies from our registry that mention both aspirin and ginkgo biloba. Each links to the primary source and the other Formulate pages citing it.
Both substances · 2025
Impact of Ginkgo biloba drug interactions on bleeding risk and coagulation profiles
Primary literature · Observational study
Ginkgo + aspirin: bleeding risk OR 1.12 (95% CI 1.07-1.18, p<0.001); abnormal coagulation OR 1.48 (95% CI 1.32-1.66, p<0.001). Ginkgo + clopidogrel: bleeding risk OR 1.10 (95% CI 1.05-1.15, p<0.001); abnormal coagulation OR 1.58 (95% CI 1.40-1.77, p<0.001). Ginkgo + warfarin: NO statistically significant correlation with bleeding or coagulation.
Both substances · 2008
Potential interaction of Ginkgo biloba leaf with antiplatelet or anticoagulant drugs: what is the evidence?
Bone · Mol Nutr Food Res
Reviews multiple controlled studies showing ginkgo does NOT significantly impact hemostasis or aspirin/warfarin safety. Notes EGb 761 (standardized extract) is not generally implicated in case reports. Quality of published case reports is low. Mechanism (ginkgolide B as PAF antagonist) is real but clinically modest.
Both substances · 2007
Effect of Ginkgo biloba (EGb 761) and aspirin on platelet aggregation and platelet function analysis among older adults at risk of cardiovascular disease
Gardner et al. · Blood Coagul Fibrinolysis
EGb 761 300 mg/day + aspirin 325 mg/day vs placebo + aspirin: no clinically or statistically significant differences on any platelet aggregation or PFA-100 endpoint. No adverse bleeding events.
Mentions ginkgo biloba · 2015
Ginkgo and Warfarin Interaction in a Large Veterans Administration Population
Millery et al. · AMIA Annu Symp Proc
Hazard ratio for bleeding adverse event with concurrent ginkgo + warfarin: 1.38 (95% CI 1.20-1.58, p<0.001).
Other interactions to know
Ginkgo may modestly increase bleeding risk with warfarin, aspirin, or clopidogrel. Evidence is mixed but precaution is warranted.
Fish oil adds to aspirin's antiplatelet effect
Vitamin E enhances aspirin's antiplatelet effect
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Medical disclaimer. This page is for educational purposes only and does not replace advice from a qualified healthcare provider.
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