title: Ginkgo and Warfarin Interaction in a Large Veterans Administration Population.
abstract: Ginkgo biloba is a widely used herbal product that could potentially have a severe interaction with warfarin, which is the most frequently prescribed anticoagulant agent in North America. Literature, however, provides conflicting evidence on the presence and severity of the interaction. In this study, we developed text processing methods to extract the ginkgo usage and combined it with prescription data on warfarin from a very large clinical data respository. Our statistical analysis suggests that taking concurrently with warfarin, gingko does significantly increase patients' risk of a bleeding adverse event (hazard ratio = 1.38, 95%CI: 1.20 to 1.58, p<.001). This study also is the first attempt of using a large medical record databaseto confirm a suspected herb-drug interaction.
authors.affiliation: Department of Internal Medicine, University of Utah.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Stoddard
authors.affiliation: College of Pharmacy, University of Utah.
authors.forename: Melissa
authors.initials: M
authors.lastname: Archer
authors.affiliation: College of Pharmacy, University of Utah.
authors.forename: Laura
authors.initials: L
authors.lastname: Shane-McWhorter
authors.affiliation: Department of Biomedical Informatics, University of Utah.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Bray
authors.affiliation: Department of Biomedical Informatics, University of Utah.
authors.forename: Doug F
authors.initials: DF
authors.lastname: Redd
authors.affiliation: Department of Biomedical Informatics, University of Utah.
authors.forename: Joshua
authors.initials: J
authors.lastname: Proulx
authors.affiliation: Department of Biomedical Informatics, University of Utah; Veteran Affairs Salt Lake City Healthcare System.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zeng-Treitler
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology*; D020441:Ginkgo biloba / Q000737:chemistry*; D006470:Hemorrhage / Q000139:chemically induced; D041743:Herb-Drug Interactions; D006801:Humans; D013223:Statistics as Topic; D014481:United States; D014493:United States Department of Veterans Affairs; D014859:Warfarin / Q000494:pharmacology*
chemical_list: D000925:Anticoagulants; D014859:Warfarin