NutriStack
Clopidogrel and Ginkgo Biloba, a caution.
Ginkgo biloba has significant antiplatelet activity (PAF antagonism) that adds to clopidogrel's platelet inhibition, substantially increasing bleeding risk. Case reports have documented serious bleeding events with this combination, including intracerebral hemorrhage.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Clopidogrel and Ginkgo Biloba
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 4 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Ginkgo biloba has significant antiplatelet activity (PAF antagonism) that adds to clopidogrel's platelet inhibition, substantially increasing bleeding risk. Case reports have documented serious bleeding events with this combination, including intracerebral hemorrhage.
Mechanism. Clopidogrel irreversibly blocks P2Y12 receptors, and ginkgolide B antagonizes platelet-activating factor (PAF). The combination inhibits platelets through two independent pathways, creating significantly greater platelet inhibition than either agent alone and substantially increasing bleeding risk.
Recommendation. Avoid ginkgo biloba while taking clopidogrel. The additive antiplatelet effect creates a serious bleeding risk. If you are taking ginkgo, inform your cardiologist and discontinue it.
Sources (4)
- Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med. 1997;336(15):1108. PMID 9091812
- Lun R, Dhaliwal S, Zitikyte G, Roy DC et al.. Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysis. JAMA Neurology. 2022. PMID 34870698
- Mousavi SN, Hosseinikia M, Yousefi Rad E, Saboori S. Beneficial effects of Ginkgo biloba leaf extract on inflammatory markers: A systematic review and meta-analysis of the clinical trials. Phytotherapy Research. 2022. PMID 35781715
- Tabrizi R, Nowrouzi-Sohrabi P, Hessami K et al.. Effects of Ginkgo biloba intake on cardiometabolic parameters in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials. Phytotherapy Research. 2020. PMID 33090588
Stack Score
How this pair moves the number.
Effect on the composite score
If both Clopidogrel and Ginkgo Biloba are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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