Meta Information
ID:ginger
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger possesses antiplatelet properties by inhibiting thromboxane synthase, which can be additive with blood-thinning medications (e.g., warfarin, clopidogrel, aspirin, apixaban), significantly increasing the risk of bleeding.
Actionable advice:
High-dose ginger supplements should be avoided when taking any blood-thinning medication; it is important to talk to a physician before use.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Non-steroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have the potential to interact with herbal supplements that are known to possess antiplatelet activity (ginkgo, garlic, ginger, bilberry, dong quai, feverfew, ginseng, turmeric, meadowsweet and willow), with those containing coumarin (chamomile, motherworth, horse chestnut, fenugreek and red clover) and with tamarind, enhancing the risk of bleeding.
Label source:
PubMed: Herbal medication: potential for adverse interactions with analgesic drugs. (PMID 12472978)
Action type:
avoid
Target id:
/procedure/surgery
Target name:
Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
168
Hours after target:
48
Description:
Ginger's antiplatelet effects can impair normal blood clotting, increasing the risk of excessive bleeding during and after surgical procedures.
Actionable advice:
High-dose ginger supplements should be discontinued at least 1 week before any scheduled surgery and not resumed until bleeding risk has subsided post-op.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Other herbal medicines have also been associated with potential increased bleeding including garlic, feverfew, ginger, and ginseng.
Label source:
PubMed: Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. (PMID 11206893)
Action type:
avoid
Target id:
/condition/bleeding-disorders
Target name:
Bleeding Disorders
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Due to its antiplatelet properties, ginger can worsen bleeding tendencies in individuals with pre-existing conditions like hemophilia or von Willebrand disease.
Actionable advice:
Ginger supplements should be strictly avoided if there is a diagnosed bleeding disorder.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Gingerol concentration-dependently (0.5-20 microM) inhibited the aggregation and release reaction of rabbit washed platelets induced by arachidonic acid and collagen, but not those induced by platelet-activating factor (PAF), U46619 (9,11-dideoxy-9 alpha,11 alpha-methano-epoxy-PGF2 alpha) and thrombin.
Label source:
PubMed: The Journal of pharmacy and pharmacology (1995)
Source url:
Exact phrase from label:
[8]-Gingerol, [8]-shogaol, [8]-paradol and gingerol analogues (1 and 5) exhibited anti-platelet activities with IC(50) values ranging from 3 to 7 microM, whilst under similar conditions the IC(50) value for aspirin was 20+/-11 microM.
Label source:
PubMed: Thrombosis research (2003)
Source url:
Exact phrase from label:
The major consequences of these interactions were increased bleeding risks due to the additive anticoagulant or antiplatelet effects of the CHMs, specifically danshen, dong quai, ginger, ginkgo, licorice, and turmeric.
Label source:
PubMed: PloS one (2013)
Action type:
avoid
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger can lower blood glucose levels by improving insulin sensitivity. When combined with diabetes medications (e.g., metformin, insulin, sulfonylureas), this can lead to an excessive drop in blood sugar (hypoglycemia).
Actionable advice:
Blood glucose is best monitored closely if combining ginger with diabetes medications, and it is important to consult a doctor about potential dose adjustments.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The present work aimed at investigating the effect of ginger on the blood glucose level of GDM women with impaired glucose tolerance test (GTT).
Label source:
PubMed: Effect of ginger on the blood glucose level of women with gestational diabetes mellitus (GDM) with impaired glucose tolerance test (GTT): a randomized double-blind placebo-controlled trial. (PMID 32306991)
Action type:
adjust_with_prescriber
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger may promote vasodilation and act as a natural calcium channel blocker, leading to a reduction in blood pressure. This effect is additive with antihypertensive drugs, potentially causing hypotension (blood pressure that is too low).
Actionable advice:
Blood pressure should be monitored regularly if combining ginger supplements with blood pressure-lowering medications.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
These data indicate that the blood pressure-lowering effect of ginger is mediated through blockade of voltage-dependent calcium channels.
Label source:
PubMed: Journal of cardiovascular pharmacology (2005)
Source url:
Exact phrase from label:
promote vasodilation, which lowers blood pressure;
Label source:
PubMed: Nutrition reviews (2023)
Source url:
Exact phrase from label:
Concurrent treatment with Z. officinale + amlodipine (SBP 129.4 ± 4.5) or H. sabdariffa + amlodipine (SBP 130.4 ± 3.9) showed higher decrease in BP (mean, 1-24h), than individually administered amlodipine (SBP 149.5 ± 2.4) or Z. officinale (SBP 150.2 ± 3.1) or H. sabdariffa (SBP 139.1 ± 1.2).
Label source:
PubMed: The Journal of pharmacy and pharmacology (2021)
Action type:
monitor
Target id:
/class/immunosuppressants
Target name:
Calcineurin Inhibitors
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger may inhibit the CYP3A4 enzyme and P-glycoprotein transporter, which are crucial for metabolizing immunosuppressants like tacrolimus and cyclosporine. This can lead to dangerously high drug levels and increased toxicity risk.
Actionable advice:
Ginger supplements are best avoided when taking calcineurin inhibitor immunosuppressants like tacrolimus or cyclosporine.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Enzyme assays showed that ginger extract and its phytochemicals dramatically inhibited the catalytic activity of CYP3A4, 2C9, 1A2, and 2B6, and efflux transport capabilities of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP).
Label source:
PubMed: Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. (PMID 37134183)
Action type:
avoid
Target id:
/condition/gallstones
Target name:
Gallstones
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger stimulates the production and release of bile. In individuals with gallstones, this can cause a stone to move and obstruct a bile duct, leading to severe pain (biliary colic).
Actionable advice:
It is important to talk to a doctor before using ginger supplements with a known history of gallstones.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
Ginger supplements may increase the flow of bile.
Label source:
Anecdotal: MSKCC
Action type:
informational_none
Target id:
/class/herbal-anticoagulants
Target name:
Herbal Anticoagulants/Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The antiplatelet effects of ginger are additive with other supplements that thin the blood, such as ginkgo biloba, garlic, fish oil (high dose), and vitamin E, increasing the cumulative risk of bleeding.
Actionable advice:
Multiple blood-thinning supplements are best not combined unless directed by a healthcare professional.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
This review considers the potential of certain dietary supplements, including garlic, Ginkgo biloba, ginger, ginseng, fish oil, and vitamin E, to interfere with hemostasis.
Label source:
PubMed: Nutrition reviews (2012)
Source url:
Exact phrase from label:
The major consequences of these interactions were increased bleeding risks due to the additive anticoagulant or antiplatelet effects of the CHMs, specifically danshen, dong quai, ginger, ginkgo, licorice, and turmeric.
Label source:
PubMed: PloS one (2013)
Source url:
Exact phrase from label:
omega 3-fatty acids in fish oil, ajoene in garlic, ginger, ginko, and vitamin E (antiplatelet properties)
Label source:
PubMed: Methods in molecular biology (Clifton, N.J.) (2010)
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
While commonly used for morning sickness, high doses of ginger supplements (>1 gram/day) are controversial due to a theoretical risk of affecting fetal hormones or increasing bleeding risk. Culinary amounts are generally considered safe.
Actionable advice:
It is important to talk to an obstetrician before using ginger supplements during pregnancy, and intake is best limited to standard culinary amounts.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
However, some evidence suggests that ginger tea should not be consumed close to labor, as ginger may increase the risk of bleeding and may be associated with preterm labor.
Label source:
Anecdotal: Healthline
Action type:
informational_none
Target id:
/class/cyp2c9-substrates
Target name:
Drugs Metabolized by CYP2C9
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger can moderately inhibit the CYP2C9 enzyme, slowing the metabolism of drugs like warfarin, phenytoin, and some NSAIDs (e.g., ibuprofen, celecoxib). This can increase drug concentrations and the risk of side effects.
Actionable advice:
This is best used with caution, and it is important to talk to a pharmacist when taking medications metabolized by CYP2C9.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In summary, overconsumption of ginger may disturb the normal homeostasis of CYPs and ABC transporters, which in turn, may elevate the risk for HDIs when consumed concomitantly with conventional medications.
Label source:
PubMed: Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. (PMID 37134183)
Action type:
informational_none
Target id:
/class/cyp3a4-substrates
Target name:
CYP3A4 Substrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Some evidence suggests ginger may mildly inhibit the CYP3A4 enzyme, a major pathway for drug metabolism. This could theoretically increase levels of sensitive drugs, such as certain statins or calcium channel blockers.
Actionable advice:
This potential interaction is worth keeping in mind, especially when taking drugs with a narrow therapeutic window metabolized by CYP3A4.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
All three gingerols potently inhibited CYP2C9 activity, exerted moderate inhibition on CYP2C19 and CYP3A4, and weak inhibion on CYP2D6. 8-Gingerol was the most potent in inhibition of P450 enzymes with IC50 values of 6.8, 12.5, 8.7, and 42.7 μmol/L for CYP2C9, CYP2C19, CYP3A4, and CYP2D6, respectively.
Label source:
PubMed: Acta pharmacologica Sinica (2013)
Source url:
Exact phrase from label:
Enzyme assays showed that ginger extract and its phytochemicals dramatically inhibited the catalytic activity of CYP3A4, 2C9, 1A2, and 2B6, and efflux transport capabilities of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP).
Label source:
PubMed: Journal of agricultural and food chemistry (2023)
Source url:
Exact phrase from label:
TAC bioavailability was increased when co-administered with grapefruit juice (GFJ), schisandra, berberine, turmeric, pomegranate juice, pomelo, and ginger in human and or animal models by inhibition effect on CYP450 system and/or P-gp efflux pump.
Label source:
PubMed: Die Pharmazie (2021)
Action type:
informational_none
Target id:
/class/cyp2d6-substrates
Target name:
CYP2D6 Substrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ginger may weakly inhibit the CYP2D6 enzyme, which metabolizes many antidepressants (e.g., fluoxetine), beta-blockers (e.g., metoprolol), and opioids. This interaction is generally minor but could affect sensitive individuals.
Actionable advice:
It is worth watching out for increased side effects if taking medications primarily metabolized by CYP2D6.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
2.4 Dosage Recommendations for Concomitant Use with Strong CYP2D6 Inhibitors
The recommended dosage of AUVELITY when co-administered with strong CYP2D6 inhibitors is one tablet once daily in
the morning [see Drug Interactions (7.1), Clinical Pharmacology (12.3)].
Label source:
Action type:
monitor
Target id:
/condition/cardiac-arrhythmia
Target name:
Cardiac Arrhythmia
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
At very high, non-standard doses, ginger has been anecdotally reported to cause heart palpitations or affect heart rhythm in susceptible individuals. This risk is considered low and not well-established with typical supplement use.
Actionable advice:
High-dose ginger supplements are best used with caution in those with a history of cardiac arrhythmias.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
informational_none