NutriStack
Diclofenac and Ginkgo Biloba, a caution.
Ginkgo biloba may increase bleeding risk with diclofenac. Ginkgo has reported spontaneous bleeding cases, and diclofenac can cause NSAID-related GI injury and bleeding. The combination is more concerning with scheduled diclofenac, older age, ulcer history, or other antiplatelet or anticoagulant agents.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Diclofenac and Ginkgo Biloba
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Ginkgo biloba may increase bleeding risk with diclofenac. Ginkgo has reported spontaneous bleeding cases, and diclofenac can cause NSAID-related GI injury and bleeding. The combination is more concerning with scheduled diclofenac, older age, ulcer history, or other antiplatelet or anticoagulant agents.
Mechanism. Ginkgo may inhibit platelet activation, while diclofenac reduces protective gastric prostaglandins through COX inhibition. The combined effect can lower hemostatic reserve and increase bleeding from NSAID-related mucosal injury.
Recommendation. Avoid ginkgo while using diclofenac regularly. If you continue both, use the lowest diclofenac exposure possible and seek care for black stools, vomiting blood, severe headache, or unusual bruising.
Sources (2)
- Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with ginkgo biloba: a case report and systematic review of the literature. J Gen Intern Med. 2005;20(7):657-661. PMID 16050865
- Castellsague J, Riera-Guardia N, Calingaert B, Varas-Lorenzo C, Fourrier-Reglat A, Nicotra F, et al. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012;35(12):1127-1146. PMID 23137151
Stack Score
How this pair moves the number.
Effect on the composite score
If both Diclofenac 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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