PDR for Herbal Medicines

340 /GINGER PDR FOR HERBAL MEDICINES

trip were symptom-free for the 6-hour duration. The =

incidence of severe vomiting did not differ in a statistically

significant way between Ginger and any of the other test

groups (Schmid, 1994).

Postoperative Nausea and Vomiting

A double-blind, placebo-controlled study involving 120

females that underwent gynecologic outpatient surgery was

performed. The participants were randomly given either 1

gm of powdered Ginger root or 10 mg of metoclopramide

orally and evaluated for incidence of postoperative nausea

and vomiting. Ten percent of the patients in the Ginger group

had one or more episodes of vomiting. 17.59c of the

metoclopramide arm and 22.5% of the placebo group had

one or more episodes of vomiting. Fifteen percent of the

Ginger group and 32.5% of the metoclopramide group

required antiemetic treatment compared to 37.5% of the

placebo group. The authors concluded that the Ginger group

had a statistically significant lower incidence of nausea and

vomiting when compared to placebo (Phillips, 1993).

INDICATIONS AND USAGE

Approved by Commission E:

• Loss of appetite


• Travel sickness


• Dyspeptic complaints
  Unproven Uses: In folk medicine. Ginger is used as a
  carminative, expectorant, and astringent.
  Chinese Medicine: In China. Ginger is used to treat colds,
  nausea, vomiting and shortness of breath.
  Indian Medicine: Indian medicine uses include anorexia,
  dyspeptic symptoms and pharyngitis.
  CONTRAINDICATIONS
  The German Commission E contraindicates the use of
  Ginger in morning sickness associated with pregnancy. Most
  research provides evidence that Ginger can be used and is
  effective in the treatment of morning sickness. It is
  recommended that excessive doses are avoided for this
  purpose (see PRECAUTIONS and ADVERSE REACTIONS).

Because of its cholagogic effect, the drug should not be

taken in the presence of gallstone conditions except after

consultation with a physician.

Ginger has been found to inhibit thromboxane synthesis,
therefore it should not be used by patients who are at risk for
hemorrhage (Bracken, 1991)

PRECAUTIONS AND ADVERSE REACTIONS
General: No health hazards or side effects are known in
conjunction wiuh the proper administration of designated
therapeutic dosages.

It has been reported that administration of 6 grams of dried

powdered Ginger has been shown to increase the exfoliation

of gastric surface epithelial cells in human subjects. It is

postulated that this action may possibly lead to ulcer

formation. Therefore, it- is recommended that dosages on an

empty stomach be limited to 6 grams (Desai, 1990).

There have been reports that Ginger can cause hypersensitiv-

ity reactions resulting in dermatitis. Large overdoses can

cause central nervous system depression and cardiac

arrhythmias.

Pregnancy: A study in 27 pregnant patients with hypereme-

sis gravidarum (persistent vomiting occurring prior to the

20th week of pregnancy and requiring hospitalization) found

that 1 gram per day (250 milligrams 4 times a day) for 4 days

caused no adverse effects. One spontaneous abortion oc-

curred; a causal relationship between the abortion and the

use of Ginger was not determined. All infants were normal

(Fischer-Rasmussen, 1990).

Drug Interactions: More than one in-vitro study confirms an

antithrombotic effect. It is recommeded that patients taking

anticoagulants or those with bleeding disorders avoid the use

of large doses of Ginger.

OVERDOSAGE

According to research, the LD50 of 6-gingerol and 6-shogaol

is set between 250 and 680 mg/kg. (Fulder & Tenne, 1991;

Suekawa et al, 1984.) Toxicity tests in mice using a Ginger

extract via lavage resulted in no mortality or adverse effects

in doses up to 2.5 g/kg over a 7 day period. When the dose

was increased to between 3 and 3.5 g/kg, a 10% to 30%

mortality rate was reported (Macola, 1989.)

Overdosage may cause cardiac arrhythmia and CNS depres-

sion (Iwu, 1993).

DOSAGE

Mode of Administration: Comminuted rhizome and dry

extracts for teas and other galenic preparations for internal

use. The powdered drug is used in some stomach

preparations.

How Supplied:

Capsules — 100 mg, 400 mg, 420 mg, 460 mg, 470 mg, 500

mg, 550 mg, 1000 mg

Chewable Tablets — 67.5 mg

Fluid Extract — 1:1

Liquid — 1:4

Oil — 100%

Tea Bags