Answer: Ginkgo biloba makes platelets less sticky, so combined with warfarin, apixaban, rivaroxaban, clopidogrel or daily aspirin it can raise the risk of bruising and bleeding. Anyone on those medicines should get their doctor's approval before any ginkgo product, and everyone should stop ginkgo two weeks before surgery.
- Ginkgo affects platelets, not clotting factors, so the effect adds to most blood thinners.
- Warfarin, DOACs, clopidogrel and aspirin all count.
- Stop two weeks before surgery, dental extractions included.
- NeuroRecall puts this caution above its price on purpose.
What ginkgo does to blood
Ginkgo's terpene lactones, particularly ginkgolide B, block platelet-activating factor, which platelets use to clump. Less clumping means better flow through small vessels, the intended benefit, and slower clotting when you cut yourself, the unintended one. In most healthy people the effect is small. Added to a medicine that already slows clotting, it can matter. The NCCIH lists this as ginkgo's main safety concern.
Which medicines are affected
| Medicine | Type | Action |
|---|---|---|
| Warfarin | Vitamin K antagonist | Doctor approval; INR checks |
| Apixaban, rivaroxaban, dabigatran | Direct oral anticoagulants | Doctor approval |
| Clopidogrel, ticagrelor | Antiplatelet | Doctor approval |
| Daily low-dose aspirin | Antiplatelet | Ask; effects add |
| Ibuprofen, naproxen (regular use) | NSAID | Ask; bleeding risk adds |
| Fish oil, vitamin E, garlic (high dose) | Supplements | Effects can stack |
Surgery and dental work
Surgeons and anaesthetists routinely ask patients to stop ginkgo, along with fish oil, garlic and vitamin E, two weeks before an operation. Dental extractions count. Bring a photo of every supplement label to your pre-operative appointment; the questionnaire asks about medicines and most people forget the supplement shelf.
Signs to watch for
Unexplained bruising, nosebleeds that take longer to stop, bleeding gums, blood in urine or stool, or a headache after a minor knock. Any of these on ginkgo plus a blood thinner means stop the ginkgo and call your doctor the same day. Rare but serious bleeding events have been reported in case studies, nearly always in people also taking an anticoagulant.
How NeuroRecall handles it
Ginkgo is one of NeuroRecall's six ingredients, and this is the reason the bleeding caution appears above the price on the NeuroRecall official website, in the footer of every page, and in the first five questions on our answers page. We would rather lose the sale than have someone on warfarin find out from a bruise. If your doctor approves, the NeuroRecall discount applies as normal; if not, the other five ingredients are not worth the risk of the sixth.
The broader lesson
Effective herbs are pharmacologically active, and active things interact. A two-minute conversation with a pharmacist, bottle in hand, is the cheapest safety step in supplement use. The NCCIH guide to using supplements wisely makes the same point without the bruises.
Three bottles covers a fair trial
Bacopa needs twelve weeks; the NeuroRecall discount on three bottles covers it with free US shipping.
See NeuroRecall DiscountFrequently asked questions
Can I take ginkgo with aspirin?
Ask your doctor. Both reduce platelet function and the effects add.
How long before surgery should I stop?
Two weeks is the standard advice, including for dental extractions.
Is the ginkgo dose in NeuroRecall high enough to matter?
Any ginkgo matters if you are anticoagulated. The amount is on the bottle; the caution applies at any dose.