Association of
            <i>Ginkgo biloba</i>
            with intracerebral hemorrhage

Matthews, Michael K.

doi:10.1212/wnl.50.6.1933

Cited by 249 publications

(101 citation statements)

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“…109 Ginkgo biloba is an over-the-counter herbal extract used by many people in the US and Europe as a "memory aid;" several case reports have described an association between its use and ICH. 78 A possible antiplatelet effect and Coumadin potentiation mechanism has been postulated.…”

Section: Causes Of Sichmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

149

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Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of all strokes and is associated with a higher mortality rate than either ischemic stroke or subarachnoid hemorrhage. Common causes include hypertension, amyloid angiopathy, coagulopathy, vascular anomalies, tumors, and various drugs. Hypertension, however, remains the single greatest modifiable risk factor for SICH. Computerized tomography scanning is the initial diagnostic modality of choice in SICH, and angiography should be considered in all cases except those involving older patients with preexisting hypertension in thalamic, putaminal, or cerebellar hemorrhage. Medical management includes venous thrombosis prophylaxis, gastric cytoprotection, and aggressive rehabilitation. Anticonvulsant agents should be prescribed in supratentorial SICH, whereas the management of hypertension is controversial. To date, nine prospective randomized controlled studies have been conducted to compare surgical and medical management of SICH. Although definitive evidence favoring surgical intervention is lacking, there is good theoretical rationale for early surgical intervention. Surgery should be considered in patients with moderate to large lobar or basal ganglia hemorrhages and those suffering progressive neurological deterioration. Elderly patients in whom the Glasgow Coma Scale score is less than 5, those with brainstem hemorrhages, and those with small hemorrhages do not typically benefit from surgery. Patients with cerebellar hemorrhages larger than 3 cm, those with brainstem compression and hydrocephalus, or those exhibiting neurological deterioration should undergo surgical evacuation of the clot. It is hoped that the forthcoming results of the International Surgical Trial in IntraCerebral Hemorrhage will help formulate evidence-based recommendations regarding the role of surgery in SICH.

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Section: Causes Of Sichmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

149

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“…Several reports of bleeding associated with its concurrent use with drugs like aspirin, warfarin, acetaminophen, or an ergotamine caffeine preparation have been documented (24,25). Matthew MK, reported the association of a recent use of Gingko biloba with the occurrence of cerebral haemorrage in a patient who had been stabilized for five years on warfarin (26). Also, a combined use of ginkgo with a thiazide diuretic may precipitate high blood pressure and coma when combined with trazodone (27,28).…”

Section: Pharmacokinetics and Drug Interactions Of Herbal Medicines: mentioning

confidence: 99%

Pharmacokinetics and Drug Interactions of Herbal Medicines: A Missing Critical Step in the Phytomedicine/Drug Development Process

Obodozie¹

2012

Readings in Advanced Pharmacokinetics - Theory, Methods and Applications

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“…Um paciente de 78 anos desenvolveu hemorragia intracerebral após uso concomitante de varfarina e de um medicamento fi toterápico à base de ginkgo (Matthews, 1998;Lambrecht et al, 2000). Um caso de hifema espontâneo, hematoma subfrênico e hemorragia vítreos foi relatado após o uso concomitante de ácido acetilsalicílico e ginkgo (Rosenblatt & Mindel, 1997).…”

Section: Anticoagulantes Orais E Antiplaquetáriosunclassified

Interações entre fármacos e medicamentos fitoterápicos à base de ginkgo ou ginseng

Alexandre¹,

Bagatini²,

Simões³

2008

Rev. bras. farmacogn.

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RESUMO:Os medicamentos fi toterápicos são amplamente utilizados, principalmente, pelos portadores de doenças crônicas e em associações medicamentosas com diversos fármacos. As possíveis interações entre eles estão sendo muito estudadas, pois podem alterar os perfi s de efi cácia e segurança de muitos fármacos. Nesta revisão, as informações foram localizadas, avaliadas e sistematizadas e contêm as principais interações entre fármacos e medicamentos fi toterápicos elaborados com ginkgo ou ginseng. Verifi cou-se que os medicamentos fi toterápicos elaborados com tais plantas podem interferir na farmacocinética e/ou farmacodinâmica de diversos fármacos, podendo provocar conseqüências graves aos pacientes. O ginkgo pode interferir com anticoagulantes orais, antiplaquetários e com fármacos metabolizados pelo sistema P450-CYP3A4. O ginseng pode interagir com antidepressivos inibidores da monoamino oxidase, anticoagulantes orais, anti-hipertensivos, e contraceptivos à base de estrogênios. Além disso, não é recomendada a administração concomitante de ginkgo ou ginseng com antineoplásicos. Nesse sentido, o uso concomitante de medicamentos fi toterápicos à base de ginkgo ou ginseng com outros fármacos deve ser adequadamente monitorado. Unitermos: Ginkgo biloba, Panax ginseng, ginkgo, ginseng, interações medicamentosas.ABSTRACT: "Interactions between drugs and ginkgo or ginseng herbal medicines". Herbal medicines are widely used especially by patients with chronic diseases, often administered concomitantly with synthetic drugs, raising the potential of pharmacokinetic and pharmacodynamic drug-herb interactions. From the last years, there is an increasing interest in this subject refl ected by the great number of documented case reports, in vivo studies, and also clinical trials evaluating drug-herb interactions. The aim of this paper was to review the literature in order to identify reported interactions between ginkgo or ginseng herbal medicines and drugs as well as to evaluate and summarize these information. Interactions between ginkgo or ginseng herbal medicines and drugs can occur and may lead to serious consequences. Ginkgo has the potential to cause signifi cant interactions with anticoagulant and antiplatelet drugs, and also with drugs metabolized by the cytochrome P450 enzyme system, especially by CYP3A4. Ginseng has the potential to cause signifi cant interactions with monoamine oxidase inhibitors, warfarin, antihypertensive agents and estrogens. Additionally, both should be avoided with anticancer drugs. Based on these data and regarding patient's safety, the concomitant use of herbal medicines and drugs has to be properly surveyed by physicians and/or other health care professionals.Keywords: Ginkgo biloba, Panax ginseng, ginkgo, ginseng, drug-herb interactions. INTRODUÇÃOA utilização de plantas medicinais e medicamentos fi toterápicos para a recuperação da saúde é uma prática generalizada, sendo o resultado do acúmulo secular de conhecimentos empíricos sobre a ação dos vegetais por diversos grupos étnicos (Simõe...

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Association of Ginkgo biloba with intracerebral hemorrhage

Cited by 249 publications

References 0 publications

Spontaneous intracerebral hemorrhage: a review

Spontaneous intracerebral hemorrhage: a review

Pharmacokinetics and Drug Interactions of Herbal Medicines: A Missing Critical Step in the Phytomedicine/Drug Development Process

Interações entre fármacos e medicamentos fitoterápicos à base de ginkgo ou ginseng

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