The effect of Ginkgo biloba extract (120 mg twice daily for 4 weeks) on the steady state pharmacokinetics of lopinavir/ritonavir (400/100 mg twice daily) or single doses of midazolam (8 mg) was studied in 14 HIV- subjects. Coadministration had no effect on lopinavir or ritonavir concentrations, but decreased midazolam AUC by 34% and Cmax by 31%. The results suggest that Gingko biloba extract is unlikely to reduce exposure of ritonavir-boosted protease inhibitors, but unboosted regimens may be affected.
Effect of Ginkgo biloba extract on lopinavir, midazolam and fexofenadine pharmacokinetics in healthy subjects. Robertson SM, Davey RT, Voell J, et al. Curr Med Res Opin, 2008, 24(2): 591-599.