JIN-jer

Therapeutic Classification: antiemetics

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

• Prevention and treatment of nausea and vomiting associated with motion sickness, loss of appetite, pregnancy, surgery, and chemotherapy
• Prevention of postoperative nausea and vomiting
• May be used for dyspepsia, flatulence, relief of joint pain in rheumatoid arthritis, cramping, and diarrhea
• Migraine headache
• Tonic (toning/strengthening agent) in gout, gas, respiratory infections, anti-inflammatory, stimulant (tones the gut, increases saliva and gastric juices, acts as anticoagulant, decreases blood cholesterol)

• Antiemetic effect due to increasing GI motility and transport; may act on serotonin receptors.
• Shown to be hypoglycemic, hypotensive, or hypertensive, and positive inotropic agent.
• Inhibits prostaglandins and platelets, lowers cholesterol, and improves appetite and digestion.

• ↓nausea and vomiting due to motion sickness, surgery, and chemotherapy.
• ↓joint pain and improvement of joint motion in rheumatoid arthritis.
• Antioxidant.

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-life: Unknown.

Contraindicated in:

• Lactation (if using large amounts)
• Gallstones.

Use Cautiously in:

• Pregnancy (preliminary evidence that ginger might affect fetal sex hormones)
• Patients with ↑ risk of bleeding
• Diabetes
• Anticoagulant therapy
• Cardiovascular disease.

GI: minor heartburn.

Derm: dermatitis (when used topically).

Natural-Drug Products:

• May ↑ risk of bleeding when used with anticoagulants, antiplatelet agents, and thrombolytics.
• May have additive effects with antidiabetic agents (causing hypoglycemia) and calcium channel blockers (causing hypotension).

Natural-Natural Products:

• May theoretically ↑ risk of bleeding when used with other herbs that have anticoagulant or antiplatelet activities.

• PO (Adults): Motion sickness: 1000 mg dried ginger root taken 30 min–4 hr before travel or 250 mg qid. Postoperative nausea prevention: 1000 mg ginger taken 1 hr before induction or anesthesia. Chemotherapy-induced nausea: 2–4 g/day. Up to 2 g freshly powdered drug has been used as an antiemetic (not to exceed 4 g/day). Migraine headache: 500 mg at onset then 500 mg every 4 hr up to 1.5–2 g/day for 3–4 days. Osteoarthritis: 170 mg tid or 255 mg bid of ginger extract. Whole root rhizome: 0.25–1 g for other illnesses. Tea: pour 150 mL boiling water over 0.5–1 g of ginger and strain after 5 min. Tinture: 0.25–3 mL.

• Alone or in combination with other herbal medicinals: ^OTC;
• Dried powdered root: ^OTC;
• Syrup: ^OTC;
• Tincture: ^OTC;
• Tablets: ^OTC;
• Capsules (550 mg): ^OTC;
• Spice: ^OTC;
• Tea: ^OTC;

• Assess patient for nausea, vomiting, abdominal distention, and pain prior to and after administration of the herb when used as an antiemetic agent.
• Assess pain location, duration, intensity, and associated symptoms (photophobia, phonophobia, nausea, vomiting) during migraine attack.
• Assess pain, swelling, and range of motion in affected joints prior to and after administration when used in the treatment of arthritis.
• Assess patient for epigastric pain prior to and after administration when used as a gastroprotective agent.
• Monitor BP and heart rate in patients with cardiovascular disease including hypertension.

• Monitor blood glucose and coagulation panels periodically during therapy.

• Administer ginger prior to situations where nausea or vomiting is anticipated (e.g., motion sickness).
• Dose form and strengths vary with each disease state. Ensure that proper formulation and dose are administered for the indicated use.

• Instruct patients receiving anticoagulants not to take this herb without the advice of health care professional (increased risk of bleeding).
• Advise patient to stop the herb immediately if palpitations occur and notify health care professional.
• Advise patient to observe for easy bruising or other signs of bleeding. If they occur, stop the herb immediately and notify health care professional.
• Counsel patients with a history of gallbladder disease to use this herb only under the supervision of health care professional.
• Instruct patient to consult health care professional before taking any Rx, OTC, or other herbal products concurrently with ginger.
• Herb is meant to be used as a tonic, not for long-term use.

• Prevention of nausea and vomiting.
• Relief of epigastric pain.
• Improved joint mobility and relief of pain.
• Relief of migraine headache.

Calicut, cochin, gengibre, ginger root, imber, ingwerwurzel, ingwer, Jamaica ginger, jenjibre, kankyo, jiang, zingiber