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Author Topic: Don't take Gingko with efavirenz  (Read 9010 times)

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Offline John2038

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Don't take Gingko with efavirenz
« on: May 22, 2009, 11:13:40 am »



The herbal remedy Ginkgo should not be taken with the anti-HIV drug efavirenz, Dutch investigators warn in the June 1st edition of AIDS. They report the case of an individual whose viral load became detectable with the development of drug resistance because Ginkgo interacted with efavirenz.


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Ginkgo biloba on wikipedia

Offline sdguyloveslife

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Re: Don't take Gingko with efavirenz
« Reply #1 on: July 20, 2009, 03:00:35 pm »
I found this article / scientific publication in the AIDS Journal rather odd.  This "conclusion," which seems like quite a leap, that was reached by the Dutch investigators was only seen in one single patient.  I haven't worked in a lab for many years, but I seem to remember enough that the "experiment" should be repeatable.  I'm wondering why they didn't repeat and/or confirm their results with other gingko-ingesting patients on sustiva therapy?  I'm surprised that the journal would publish this based on a single patient study.  Or, did I miss something? 
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Offline Ann

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Re: Don't take Gingko with efavirenz
« Reply #2 on: July 20, 2009, 03:32:55 pm »

I'm wondering why they didn't repeat and/or confirm their results with other gingko-ingesting patients on sustiva therapy?  I'm surprised that the journal would publish this based on a single patient study.  Or, did I miss something? 


Probably because it would be unethical to have someone take a substance that is believed to cause resistance. Given that Ginko hasn't really been proven to have any substantial benefits, why bother in the first place? Better to be safe than sorry if you take Sustiva and lay off the Ginko.

Ann
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Offline physicsguy

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Re: Don't take Gingko with efavirenz
« Reply #3 on: July 20, 2009, 04:01:00 pm »
Quote
I'm surprised that the journal would publish this based on a single patient study.  Or, did I miss something? 
It's just a correspondence, not a full paper.  These are frequently single-patient things.

They do have measurements showing that the efavirenz concentration decreased dramatically when he started taking the gingko and the patient apparently had never had any previous compliance issues, and Gingko has been shown to interfere with the same proteins used to metabolize efavirenz.

So while this is just one person and certainly not definitive, it's not like the authors simply took a stab in the dark.

Offline madbrain

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Re: Don't take Ginkgo with efavirenz
« Reply #4 on: July 20, 2009, 06:16:13 pm »
Given that Ginko hasn't really been proven to have any substantial benefits, why bother in the first place?

Actually, I am not sure this is true. According to http://www.raysahelian.com/ginkgo.html , it has a number of benefits - on memory, cognitive decline and liver, .

Some high-end multi-vitamins, such as the NOW adam I take, contain ginkgo (30mg). One may not be fully aware of the issue with the multis. FYI, my bf took that multi for a year while on atripla, which contains sustiva, and did not run into resistance issues - he was always undetectable. He no longer takes this multi now.

Quote
Better to be safe than sorry if you take Sustiva and lay off the Ginko.

Agreed.

Offline Ann

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Re: Don't take Gingko with efavirenz
« Reply #5 on: July 20, 2009, 06:42:01 pm »

Actually, I am not sure this is true. According to http://www.raysahelian.com/ginkgo.html , it has a number of benefits - on memory, cognitive decline and liver, .


Yeah, of course he's going to make those claims - he's selling the stuff! As I said, it's never actually been PROVEN to have any substantial benefit. The only studies where any benefit was shown were studies created, conducted and funded by manufacturers of Ginkgo supplement products. ::) Studies conducted by independent outfits did not have similar findings.

It is a really pretty plant though. Wonder if it makes a good houseplant?

Ann
« Last Edit: July 20, 2009, 06:49:21 pm by Ann »
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

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HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline physicsguy

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Re: Don't take Gingko with efavirenz
« Reply #6 on: July 20, 2009, 07:08:03 pm »
There actually are some studies in AMA journals that show at least a little short-term cognitive improvement in Alzheimer's patients who take GB.

But yeah, the evidence is light and someone who sells it is most certainly not a reliable source of objective information.

Offline Ann

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Re: Don't take Gingko with efavirenz
« Reply #7 on: July 20, 2009, 07:27:49 pm »

There actually are some studies in AMA journals that show at least a little short-term cognitive improvement in Alzheimer's patients who take GB.


Yes, that's why I said substantial  benefit. The tiny amounts they've shown wouldn't, to my mind, be great enough to risk becoming resistant to a whole class of hiv meds over. But maybe that's just me.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline GNYC09

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Re: Don't take Gingko with efavirenz
« Reply #8 on: July 20, 2009, 09:48:42 pm »
I can't help but chime in since I really love the gingko tree...although gingko is reputed to help with memory, Ann is right in that there isn't much research proving this (see the U.S. Nat'l Institute of Health page: http://nccam.nih.gov/health/ginkgo/#science). 

As an aside, gingko is one of the top urban trees (at least in the NE U.S.) because it tolerates pollution well + churns out more oxygen than many other species of trees.  

Anyhow, I agree that it's better to be safe than sorry and not take it with Sustive or Atripla...

Offline mecch

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Re: Don't take Gingko with efavirenz
« Reply #9 on: July 21, 2009, 08:09:25 am »
. Given that Ginko hasn't really been proven to have any substantial benefits, why bother in the first place?

Gingko is prescribed in Switzerland by doctors to help with concentration.  So not sure its useless.  But clearly its counter indicated in a person using HAART, so yeah, don't take it.
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