Drug General Information (ID: DDI75Z8SPQ)
Drug Name			Ginkgo biloba		Drug Info		Blinatumomab		Drug Info
Drug Type		Natural product				Monoclonal antibody
Therapeutic Class		Herbal Products				Antineoplastics/Cd19 Monoclonal Antibodies

Mechanism of Ginkgo biloba-Blinatumomab Interaction (Severity Level: Moderate)
Increased risk of lowers seizure threshold Click to Show/Hide Mechanism Graph
Drug Name		Ginkgo biloba				Blinatumomab
Mechanism		Lower seizure threshold				Lower seizure threshold
Key Mechanism Factor 1
		Factor Name		Lowers seizure threshold
		Factor Description		The combination of medications that lower the seizure threshold is a factor that makes people with epilepsy more likely to have seizures. A seizure is a sudden, uncontrolled electrical disturbance in the brain that can cause changes in your behavior, movements or sensations, and level of consciousness.
Mechanism Description		Increased risk of lowers seizure threshold by the combination of Ginkgo biloba and Blinatumomab

Recommended Action
Management		Patients should consult a healthcare provider before taking any herbal or alternative medicine. Because of inconsistencies in formulation and potency of commercial herbal preparations, there is no way to verify without laboratory testing if and in what quantity 4'-O-methylpyridoxine may be present in a given ginkgo preparation. Patients treated with agents that can lower the seizure threshold should preferably avoid the use of products containing ginkgo biloba.

References
1	Kajiyama Y, Fujii K, Takeuchi H, Manabe Y "Ginkgo seed poisoning." Pediatrics 109 (2002): 325-7. [PMID: 11826216]
2	Granger AS "Ginkgo biloba precipitating epileptic seizures." Age Ageing 30 (2001): 523-5. [PMID: 11742783]
3	Miller LG "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med 158 (1998): 2200-11. [PMID: 9818800]
4	Spinella M "Herbal medicines and epilepsy: the potential for benefit and adverse effects." Epilepsy Behav 2 (2001): 524-32. [PMID: 12609386]
5	Gregory PJ "Seizure associated with Ginkgo biloba?." Ann Intern Med 134 (2001): 344. [PMID: 11182853]
6	Harms SL, Garrard J, Schwinghammer P, Eberly LE, Chang Y, Leppik IE "Ginkgo biloba use in nursing home elderly with epilepsy or seizure disorder." Epilepsia 47 (2006): 323-9. [PMID: 16499756]
7	Miwa H, Iijima M, Tanaka S, Mizuno Y "Generalized convulsions after consuming a large amount of Gingko nuts." Epilepsia 42 (2001): 280-1. [PMID: 11240603]
8	Kupiec T, Raj V "Fatal seizures due to potential herb-drug interactions with Ginkgo biloba." J Anal Toxicol 29 (2005): 755-8. [PMID: 16419414]