The short answer
The added bleeding risk from Ginkgo biloba with sulindac is uncertain. Review the exact product, dose and your bleeding history with your prescriber.
What this answer covers
Oral Ginkgo biloba with oral sulindac 150 or 200 mg tablets. Exact formulation, dose and duration matter; other NSAIDs and other supplement preparations are not interchangeable.
- Supplement or preparation
- Ginkgo biloba
- Medication ingredient
- sulindac
What the evidence shows
A short study in healthy men found no additional measured bleeding-time or platelet effect when a defined ginkgo extract was added to aspirin. This is useful counterevidence, but it did not test this NSAID or patients with a history of GI bleeding.
Consider this medicine’s own effects
Sulindac forms an active sulfide metabolite and an inactive sulfone metabolite. A short healthy-volunteer study found less fecal blood loss than high-dose aspirin, but the label retains serious GI warnings. That comparison does not establish long-term safety or the risk of adding a supplement.
Review the exact product
The final European ginkgo monograph cautions about use with medicines affecting clotting, including other NSAIDs. Review the exact leaf extract and dose with your pharmacist. This precaution does not establish a measured increase in bleeding for every ginkgo product.
Know when to get help
oral sulindac 150 or 200 mg tablets can cause serious GI bleeding even without a supplement. Seek urgent care for vomiting blood or black, tarry stools, and report persistent stomach pain or unusual bleeding. Tell your prescriber about other pain medicines, aspirin and anticoagulants. A few hours of separation has not been shown to prevent an added bleeding effect.
Evidence and practical considerations
Side effects & toxicity
An increased bleeding or GI-injury rate specifically from Ginkgo biloba with sulindac has not been established.
- Exact scope
- Oral Ginkgo biloba with oral sulindac 150 or 200 mg tablets. Exact formulation, dose and duration matter; other NSAIDs and other supplement preparations are not interchangeable. with Exact sulindac IN 10237. Oral prodrug reversibly reduced to active sulfide and irreversibly oxidized to inactive sulfone. Metabolites do not replace the medication identity.
- Medication form and route
- Oral
What remains uncertain
- Available supplement-only and other-drug studies do not establish exact-pair clinical harm or exclude rare events. No validated preventive spacing interval.
Factors that may matter: Exact preparation and dose; Fasting versus fed dosing; Bleeding and ulcer history; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Prescription oral oral sulindac 150 or 200 mg tablets users; short human pharmacology studies where described.
GI and renal warnings remain despite comparatively low fecal blood loss in a short volunteer study. Hyperkalemia is reported; active sulfide and inactive sulfone have distinct roles.
How this applies: Exact current product label. Exact sulindac IN 10237. Oral prodrug reversibly reduced to active sulfide and irreversibly oxidized to inactive sulfone. Metabolites do not replace the medication identity.
Exact oral product label; no measured botanical co-use incidence. Ingredient, route, preparation and comparator differences must be retained.
Source 2: Original clinical research
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 50 healthy men aged 20-44.
No added measured bleeding-time or platelet/coagulation effect.
How this applies: Indirect for oral sulindac 150 or 200 mg tablets co-use; exact preparation and endpoint retained.
Abstract-only; aspirin is a different medicine and the short study does not exclude rare bleeding.
Source 3: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
sulindac is IN.
How this applies: Exact identity.
Not clinical evidence.
Research assessment: · Open full citations ↗
Side effects & toxicity
Defined ginkgo preparations warrant review with NSAIDs under regulatory guidance.
- Exact scope
- Oral Ginkgo biloba with oral sulindac 150 or 200 mg tablets. Exact formulation, dose and duration matter; other NSAIDs and other supplement preparations are not interchangeable. with Exact sulindac IN 10237. Oral prodrug reversibly reduced to active sulfide and irreversibly oxidized to inactive sulfone. Metabolites do not replace the medication identity.
- Medication form and route
- Oral
What remains uncertain
- Precaution based on defined supplement evidence and the individual drug label; no exact combination event rate or universal discontinuation rule.
Factors that may matter: Exact preparation and dose; Fasting versus fed dosing; Bleeding and ulcer history; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Prescription oral oral sulindac 150 or 200 mg tablets users; short human pharmacology studies where described.
GI and renal warnings remain despite comparatively low fecal blood loss in a short volunteer study. Hyperkalemia is reported; active sulfide and inactive sulfone have distinct roles.
How this applies: Exact current product label. Exact sulindac IN 10237. Oral prodrug reversibly reduced to active sulfide and irreversibly oxidized to inactive sulfone. Metabolites do not replace the medication identity.
Exact oral product label; no measured botanical co-use incidence. Ingredient, route, preparation and comparator differences must be retained.
Source 2: Final regulatory herbal monograph
ema.europa.eu · Source check Sep 10, 2026
Population: Users of specified ginkgo leaf preparations.
Cautions that anticoagulant/antiplatelet effects, including those of other NSAIDs, may be influenced.
How this applies: NSAID class precaution with individual drug counterevidence retained.
Regulatory precaution, not exact oral sulindac 150 or 200 mg tablets trial. Different extracts and populations may differ.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Sources checked and article drafted. | |
| Research summary published |
Article revision: f5708933ce5fffd5
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.