Ginkgo Biloba for Tinnitus: Evidence, Dosage & Safety

Ginkgo biloba (standardized extract EGb 761®) has mixed evidence for tinnitus.

Evidence Summary

• Cochrane reviews: No consistent benefit over placebo for primary tinnitus.
• Some RCTs: Modest improvement in tinnitus loudness/annoyance, especially with vascular component.
• Mechanism: ↑ cerebral/cochlear blood flow, antioxidant, platelet-activating factor antagonism.

Dosing & Form

• Standardized extract (24% flavone glycosides, 6% terpene lactones).
• 120–240 mg/day divided BID/TID.
• Trial 6–12 weeks; discontinue if no benefit.

Safety & Interactions

• Bleeding risk: Inhibits platelet aggregation. Caution with anticoagulants, antiplatelets, NSAIDs, fish oil, vitamin E, surgery.
• GI upset, headache, dizziness.
• Contraindicated in pregnancy/lactation.
• Interacts with MAOIs, SSRIs (serotonin syndrome theoretical).

Bottom Line

Not a first-line tinnitus treatment. May be tried if vascular etiology suspected, but discuss with audiologist/ENT first. Sound therapy, CBT, hearing aids have stronger evidence.