Ginkgo
HerbalAlso called · 7 names▾▴
Ginkgo biloba, fossil tree, maidenhair tree, Japanese silver apricot, gingko, ginkgo leaf, ginkgo extract
Herbal supplement (memory and cognition)
Herbs and supplements are not FDA-approved before sale. About these sources
- Other
- Food / spice
Research strength: 1 / 5
NCCIH warns Ginkgo might cause early labor or extra bleeding during delivery if used near that time. The European Medicines Agency (EMA) lists pregnancy as a contraindication for its medicinal Ginkgo leaf extract and says platelet effects may raise bleeding risk; it also reports insufficient animal reproductive data. A Swedish registry study of herbal medicines found no significant overall infant outcomes, but the authors said low exposure numbers could not rule out rare outcomes and did not report a Ginkgo-specific result. The registry does not estimate Ginkgo-specific miscarriage or birth-defect risk in the first trimester. Ask your provider about your situation.
Last reviewed: 2026-10-16
Research strength: 1 / 5
NCCIH warns Ginkgo might cause early labor or extra bleeding during delivery if used near that time. EMA's Ginkgo leaf monograph lists pregnancy as a contraindication and links the concern to possible platelet effects; it says animal reproductive studies are insufficient. A Swedish registry study of early-pregnancy herbal use did not report a Ginkgo-specific result. A 2017 randomized trial included women at 28 to 30 weeks with fetal growth restriction, so it does not establish effects in the second trimester. Ask your provider about your situation.
Last reviewed: 2026-10-16
Sources
- NCCIH: Ginkgo: Usefulness and SafetyUS government
- EMA: European Union herbal monograph on Ginkgo biloba L., foliumEU agencyEuropean guidance
- Holst et al., Use of herbal drugs during early pregnancy in relation to maternal characteristics and pregnancy outcomeUS government
- Abd El Aal et al., Effects of oral ginkgo biloba extract on pregnancy complicated by asymmetrically intrauterine growth restriction
Research strength: 2 / 5
NCCIH warns Ginkgo might cause early labor or extra bleeding during delivery if used near that time. EMA lists pregnancy as a contraindication for its medicinal Ginkgo leaf extract because platelet effects may raise bleeding risk, while noting that animal reproductive studies are insufficient. In a 2017 randomized trial, 226 women at 28 to 30 weeks with fetal growth restriction received ginkgo extract or placebo for six weeks; authors reported higher estimated fetal weight and increased fetal-maternal blood flow in the Ginkgo group. The authors' stated outcomes were fetal weight and blood flow, not birth defects or delivery bleeding. Ask your provider about your situation.
Last reviewed: 2026-10-16
Sources
- NCCIH: Ginkgo: Usefulness and SafetyUS government
- EMA: European Union herbal monograph on Ginkgo biloba L., foliumEU agencyEuropean guidance
- Abd El Aal et al., Effects of oral ginkgo biloba extract on pregnancy complicated by asymmetrically intrauterine growth restriction
Ginkgo — Breastfeeding
Research strength: 1 / 5
LactMed reports no published experience with ginkgo during breastfeeding and no data on use in nursing mothers or infants. LactMed also reports that no Ginkgo components have been measured in milk after ingestion. EMA says it is unknown whether Ginkgo compounds enter human milk, and that a risk to a newborn or infant cannot be excluded; its monograph does not recommend use during lactation when data are lacking. LactMed says an alternate therapy may be preferred, especially for a newborn or preterm infant. Ask your provider about your situation.
Last reviewed: 2026-10-16
Pregnancy
Human pregnancy data are sparse. A 2017 double-blind randomized trial enrolled 226 pregnant women with asymmetric intrauterine growth restriction at 28 to 30 weeks. It tested 80 mg per day of Ginkgo extract or placebo for six weeks, and 216 participants were included in the final analysis. The authors reported higher estimated fetal weight and increased fetal-maternal blood flow in the Ginkgo group. The study did not establish broad pregnancy outcomes such as miscarriage, birth defects, delivery bleeding, or newborn health. A 2008 Swedish registry study examined herbal drug use in early pregnancy among 860,215 women; 787 reported herbal drug use. The study found no significant overall infant outcome associations, but its authors said the exposure count could not rule out rare outcomes and did not report a Ginkgo-specific result. A PubMed search for 2025-10-16 through 2026-10-16 found no direct human Ginkgo pregnancy study. A 2026 study tested ginkgolide B in pregnant mice with gestational diabetes; this animal research does not establish effects of leaf supplements in human pregnancy.
Breastfeeding
LactMed reports that no Ginkgo components have been measured in human milk after maternal ingestion, and that published information on infant levels, infant effects, or effects on lactation was not found. EMA says it is unknown whether Ginkgo metabolites are excreted in human milk, that infant risk cannot be excluded, and that use during lactation is not recommended when data are insufficient. NCCIH also says little is known about use while breastfeeding. No human milk or infant outcome data were identified in the reviewed sources.
NCCIH says the most commonly used form is Ginkgo leaf, usually as an extract. LactMed describes leaf flavonoids such as quercetin and kaempferol, along with terpene trilactones such as ginkgolides and bilobalide. LactMed notes that supplement labels may not match the actual ingredients or amounts, and that results from one product may not apply to another. Raw seeds contain cyanogenic glycosides; roasted seeds and crude plant material have also been linked to serious side effects in NCCIH's summary.
What was tested
The 2017 pregnancy trial compared Ginkgo extract with placebo in women with fetal growth restriction at 28 to 30 weeks; it measured fetal weight and uterine, umbilical, and middle cerebral artery blood flow. A 2025 retrospective study reviewed records for patients prescribed Ginkgo extract at one hospital and examined drug interactions, bleeding symptoms, and coagulation tests. A 2026 animal study tested ginkgolide B, a Ginkgo compound, in a gestational-diabetes mouse model. None of these studies establishes an overall pregnancy or breastfeeding risk for typical Ginkgo leaf supplements.
Bleeding risk when Ginkgo is used with warfarin or other antithrombotic medicines
- Source A says
- NCCIH says Ginkgo may increase bleeding risk with anticoagulant medicines such as warfarin. A Veterans Affairs medical-record study found an association between concurrent Ginkgo and warfarin use and bleeding. (NCCIH: Ginkgo: Usefulness and Safety, Stoddard et al., Ginkgo and Warfarin Interaction in a Large Veterans Administration Population)
- Source B says
- EMA's monograph says available studies with warfarin did not indicate an interaction with Ginkgo products, while advising monitoring when treatment or product changes. (EMA: European Union herbal monograph on Ginkgo biloba L., folium)
- Why they differ
- The VA study used retrospective real-world records and assessed bleeding events during concurrent use. EMA's monograph summarizes warfarin studies of medicinal Ginkgo products and recommends monitoring. A 2025 hospital-record study also found associations between Ginkgo extract drug interactions and bleeding, but it could not establish that Ginkgo alone caused bleeding.
- What the evidence shows overall
- These sources address different settings. An association during use with other medicines does not prove that Ginkgo alone causes bleeding, while findings from controlled studies do not rule out uncommon interaction events. The evidence is mixed for warfarin combinations, and the reviewed sources do not report pregnancy-specific or infant bleeding outcomes.
General research, not specific to pregnancy.
NCCIH says Ginkgo may increase bleeding risk in people taking anticoagulants such as warfarin. A 2015 Veterans Affairs record study found an association between concurrent Ginkgo and warfarin use and bleeding, while EMA's monograph says available warfarin studies did not indicate an interaction. A 2025 hospital-record study of patients prescribed Ginkgo extract reported bleeding symptoms among patients assessed for bleeding, but its retrospective design cannot establish that the extract caused them. These findings concern possible interactions with other medicines and do not establish a bleeding effect from Ginkgo alone.
- NCCIH reports a possible increase in bleeding risk with anticoagulant medicines such as warfarin; EMA's monograph notes that available warfarin studies did not indicate an interaction and advises monitoring during product or dose changes. (NCCIH: Ginkgo: Usefulness and Safety, EMA: European Union herbal monograph on Ginkgo biloba L., folium)
- A 2015 Veterans Affairs record study found an association between concurrent Ginkgo and warfarin use and bleeding; a 2025 hospital-record study also found an association between Ginkgo extract drug interactions and bleeding, but neither study establishes that Ginkgo alone caused bleeding. (Stoddard et al., Ginkgo and Warfarin Interaction in a Large Veterans Administration Population, Mai et al., Impact of Ginkgo biloba drug interactions on bleeding risk and coagulation profiles)
- NCCIH: Ginkgo: Usefulness and SafetyUS governmentSecondary
- LactMed: GinkgoUS governmentSecondaryPage dated 2025-04-15
- EMA: European Union herbal monograph on Ginkgo biloba L., foliumEU agencySecondaryPage dated 2015-01-28Independent checkEuropean guidance
- Holst et al., Use of herbal drugs during early pregnancy in relation to maternal characteristics and pregnancy outcomeUS governmentPrimaryIndependent check
- Abd El Aal et al., Effects of oral ginkgo biloba extract on pregnancy complicated by asymmetrically intrauterine growth restrictionPrimaryIndependent check
- Cao et al., Ginkgolide B and gestational diabetes in pregnant miceUS governmentPrimary
- Stoddard et al., Ginkgo and Warfarin Interaction in a Large Veterans Administration PopulationUS governmentPrimaryIndependent check
- Mai et al., Impact of Ginkgo biloba drug interactions on bleeding risk and coagulation profilesUS governmentPrimaryIndependent check
Last reviewed 2026-10-16
Independent check 2026-10-16
Not yet clinician-reviewed
Ask your provider about your situation.
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