Neurology and Psychiatry

Ginkogol Tablet

Ginkogol 3d

Indications

Vascular insufficiency ( both brain and peripheral arterial insufficiency ), impaired mental performance, short term memory loss, vertigo, headache, ringing in the ears (tinnitus), lack of vigilance, depression, Alzheimer's disease.

Dosage

Take one to two tablets three times a day with some water.

Contraindication

It is not recommended in patients with Seizure disorders

Druginteractions:Thefollowing Drugs arenottobe usedwithGinkogol:

  1. Antidepressants:Fluxetin,Serteralin,Paritin.
  2. Anticagulants :Warfarin,Heparin,Aspirin, Dipiridam,Ticlopidine,Clopidrel.
  3. NSAIDS:Ibprufen.
  4. Nifedipine.

Sideeffects:   Veryseldom cases ofstomach or intestinalupsets,headaches , orallergicskinreactions.

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Composition

Each film coated tablet contains : 40 mg dry extract of ginkgo biloba (Standardized to contain 24% flavonoid glycosides) .

Constituents

The active components of ginkgo (GBE) leaves are the ginkgoflavone glycosides or ginkgo heterosides ; several terpene molecules unique to ginkgo ( ginkgolides and bilobalide) and organic acids. The three major backbone flavonoids, the Ginkgo biloba flavonols are quercetin, kaempferol , and isorhamnetin , other significant flavonoid components of the extract include proanthocyanidins, the major terpene molecules of GBE are ginkgolids and bilobalid, proanthocyanidins , bilobetin, ginkgetin, isoginkgetin and catechins.

Drug Form

Film coated tablet

Pharmacological actions

The standardized concentrated extract of the leaves of Ginkgo biloba (GBE), has demonstrated remarkable pharmacological effects. Interestingly, the total extract is more active than single isolated components (1). This suggests synergism between the various components of GBE , an explanation which is well supported in more than 400 clinical and experimental studies utilizing the extract. Platelet – activating factor ( PAF ). PAF is an etherlinked phospholipid which is formed by platelets, basophils, neutrophils, monocytes and macrophages. It is a potent platelet –aggregating agent and inducer of systemic anaphylactic symptoms. The ginkgolides are potent and specific PAF antagonists (2). Their effects are long – lived and are rapidly established after oral doses. No side effects were recorded, even when given in high doses ( 120mg of a ginkgolide mixture to healthy human subjects. High doses of ginkgolides control mast cell degranulation , and have been used to treat systemic mastocytosis (3).
Ginkgolides partially countered PAF - induced and antigen – induced bronchoconstriction and inhibited the induction of airway hyperreactivity by PAF in vivo (4).

Effects on ischaemia and blood flow :Ginkgolides prevent the metabolic damage caused by experimental cerebral ischaemia and have even a normalizing effect when given 1 hour after the event. They reduce the infarct size in experimental myocardial occlusion. Arrhythmias induced by experimental myocardial ischaemia are significantly countered by the prior administration of ginkgolides (5).
Bilobalide has demonstrated a potent neuroprotective effect against ischaemic damage,which is stronger than ginkgolide B. There is much experimental evidence to support the view that Ginkgo extracts have neuroprotective properties under conditions such as hypoxia / ischaemia, seizure activity and peripheral nerve damage .In a randomized placebo – controlled cross – over study of 10 healthy subjects, Ginkgo markedly decreased erythrocyte aggregation and increased blood flow in the nail fold capillaries .

Reference

1.Defeudis FV ed. Ginkgobiloba extract ( EGb761 ). Pharmacological activities and clinical application , Elsevier : Paris, 1991.

2.Pietta P G. , Gardanac , Mauri P L . J. Chromatog and Biomed Appl . 1995 ; 673 ( 1) : 75 – 80 .

3.K Leijnen J . Knipschild P ., Lancet 1992 ; 340 (8828) .

4.Chung KE, Dent G , Mccusker M ; Lancet 1987 ; 1 (8527) : 248-251.

5.Stanworth DR , Griffiths HR , Braquet D. New Trends Lipid Mediat Res 1988; 2:18 – 25 .

6.Roberts NM . Mccusker M Chung KF ; Br J Clin Pharmacol 1988 ; 26 : 65 – 72 .

7.Braquet P , Paubert – Braquet M , Koltai M ; Trends Pharmacol Sci 1989 , 10 ( 1) : 23 – 30 .

8.Heiss WD, Zeiler K .Pharmakother 1978;1:137 – 149 .

9.Joyeux M ,Lobestein A.Anton R; Planta Med 1995;61 (2):126-129 .

10.Maitra I , MarcoecilL , Droy - lefaix M ; Biochem Pharmacol 1995 ; 49 (11) : 1649 – 1655.

11.Seif – El Nasr M , El - Fattah AA ; Pharmacol Res 1995 ; 32 ( 5 ) : 273 – 278 .
12.Kobachi H ; Biochem Pharmacol 1997 ; 53 (6) .
897 – 903 .