NutriStack
Ginkgo Biloba and Ticagrelor, a caution.
Ginkgo biloba inhibits platelet-activating factor and platelet aggregation. Added to ticagrelor's reversible P2Y12 inhibition, the antiplatelet effect of ginkgo creates an additive bleeding risk, including the spontaneous intracranial and ocular bleeding reported in ginkgo case literature.
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At a glance
- Substances
- Ginkgo Biloba and Ticagrelor
- 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. Ginkgo biloba inhibits platelet-activating factor and platelet aggregation. Added to ticagrelor's reversible P2Y12 inhibition, the antiplatelet effect of ginkgo creates an additive bleeding risk, including the spontaneous intracranial and ocular bleeding reported in ginkgo case literature.
Mechanism. Ginkgolides (notably ginkgolide B) are PAF antagonists that inhibit platelet aggregation. This pharmacodynamic effect is additive to ticagrelor's blockade of ADP-mediated platelet activation via P2Y12.
Recommendation. Avoid ginkgo biloba while on ticagrelor. If you have been combining them, stop the ginkgo and call your prescriber if you notice unusual bruising, nosebleeds, or any sign of bleeding.
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):657-61. PMID 16050865
- Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized Ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy. 2011;31(5):490-502. PMID 21923430
Stack Score
How this pair moves the number.
Effect on the composite score
If both Ginkgo Biloba and Ticagrelor 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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