SPECIAL NOTE. A case study suggests that taking Ginkgo MAY impact on levels of the NNRTI drug, efavirenz (also known as Sustiva or Stocrin). It may be best to avoid using ginkgo if this drug is part of your regimen. Unfortunately, this was a poorly reported case of one individual who was using Ginkgo for "several months", with no comment on what dosage, brand or any other agents he may have been using. Stored blood samples, however, suggested blood levels of efavirenz declined, associated with an increase in viral load. NYBC will investigate this further--but it may be best to avoid ginkgo if taking Sustiva, Atripla (which contains Sustiva), etc.

Ginkgo-D (MMS). Each bottle, 90 tablets, each tablet, 60 mg of Ginkgo biloba, a dried leaf extract standardized to 24% ginkgo flavone glycosides and 6% terpene lactones. Suggested use: Take one tablet two times daily with water at mealtimes, or as directed by your healthcare professional. For intensive use, take up to two tablets two times daily with water.

Caution: Do not use this with blood thinners (like Coumadin) or before surgery.

Some PWHIV believe ginkgo extracts may be helpful in providing antioxidant action, reducing chronic inflammation (particularly of the central and peripheral nervous systems which HIV definitely attacks), enhancing oxygen supply and improving cerebral (brain) functions of memory and retention. A number of German studies with standardized 24% ginkgo extract have showed statistically significant improvements in memory, retention and recall in the elderly. It is not known if this has relevance to HIV-related cognitive problems or dementia. There are some theoretical reasons to believe it might. A recent American study showing no benefit using gingko was undertaken among healthy adults. Well, this is not a big surprise if they did not have any constriction in blood flow that would interfere wtih cognitive function. Whether it would help with HIV-related cognitive trouble is not clear--unless the root for an individual was vascular constriction. In general, HIV related cognitive problems seem to arise more because of oxidative stress from inflammatory products produced by HIV-infected cells that enter nervous tissues. So if it helps, it would probably be more due to other antioxidant properties of gingko. Would a combination with Bacopa work better?

http://www.drweil.com/drw/u/id/WBL02045
Ginseng and Ginkgo Don't Interfere with Drugs

Recent research showing that St. John's wort may affect the activity of many pharmaceutical drugs has led to speculation that other popular therapeutic herbs might have similar effects.

But on May 1, 2007, at a conference called Experimental Biology 2007, a University of Kansas Medical Center scientist reported on a study of 72 healthy adults using supplements. The investigators found daily use of ginseng or ginkgo biloba supplements at the recommended doses, or the combination of both supplements, is unlikely to alter the rate at which most prescription drugs are absorbed, distributed, metabolized, or eliminated by the body.

This is good news. Integrative medicine often recommends the use of herbal medicines in conjunction with conventional therapies. It now appears that the beneficial effects of ginkgo and ginseng can be employed by nearly everyone: those who take pharmaceuticals, as well as those who don't.