NutriStack
Fluoxetine and Ginkgo Biloba, a caution.
Fluoxetine depletes platelet serotonin and impairs aggregation; ginkgo's ginkgolides inhibit platelet-activating factor. The combination compounds bleeding risk, with ginkgo-plus-SSRI accounting for a substantial share of documented herbal-psychotropic bleeding complications.
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
- Fluoxetine and Ginkgo Biloba
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- 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 · Moderate evidence
Caution
What is happening. Fluoxetine depletes platelet serotonin and impairs aggregation; ginkgo's ginkgolides inhibit platelet-activating factor. The combination compounds bleeding risk, with ginkgo-plus-SSRI accounting for a substantial share of documented herbal-psychotropic bleeding complications.
Mechanism. Fluoxetine blocks platelet SERT, depleting 5-HT needed for aggregation. Ginkgolides A and B inhibit PAF receptors, an independent antiplatelet pathway.
Recommendation. Avoid Ginkgo biloba while on fluoxetine. Watch for bruising, nosebleeds, or GI bleeding if you have already combined them, and stop Ginkgo 7-14 days before any planned surgery.
Sources (2)
- Woroń J, Siwek M. Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts. Psychiatr Pol. 2018;52(6):983-996. PMID 30659561
- Andrade C, Sandarsh S, Chethan KB, Nagesh KS. Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. J Clin Psychiatry. 2010;71(12):1565-75. PMID 21190637
Stack Score
How this pair moves the number.
Effect on the composite score
If both Fluoxetine 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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