Ginkgo biloba and ginkgotoxin.

Products prepared from Ginkgo biloba are top-selling phytopharmaceuticals especially in Europe and major botanical dietary supplements in the United States. In European medicine, G. biloba medications are used to improve memory, to treat neuronal disorders such as tinnitus or intermittent claudication, and to improve brain metabolism and peripheral blood flow. The whole array of indications is reflected by a number of defined natural product constituents in G. biloba. The most well-known ones are flavonoids and terpene lactones, but they also include allergenic and toxic compounds such as ginkgotoxin (1). Consequently, there are reports attributing beneficial as well as adverse effects to G. biloba products. The present paper summarizes recent experiences with G. biloba and its derived products and explains why their restricted use is recommended.