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Inhibition of CYP3A4 has been demonstrated in vitro (Budzinski et al 2000); however, two clinical studies have produced contradictory results (Chavez et al 2006).

Evidence from a recent in vitro study that investigated the effect of individual Ginkgo biloba 527

constituents in ginkgo suggests that several constituents found within ginkgo have

significant inhibitory activity; however, the principal components (terpene trilactones and flavonol glycosides) do not (von Moltke et al 2004). Ultimately, the clinical importance of these potential inhibitors will depend on their concentration within a commercial product and the extent of their bioavailability.

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