ginger

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.

REMS

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)

Action ⬆ ⬇

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.

Therapeutic effects:

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

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

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.

Adv. Reactions/Side Effects ⬆ ⬇

GI: minor heartburn

Derm: dermatitis (when used topically)

Interactions ⬆ ⬇

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.

Route/Dosage ⬆ ⬇

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.

Availability ⬆ ⬇

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

Assessment ⬆ ⬇

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.

Lab Test Considerations:

Monitor blood glucose and coagulation panels periodically during therapy.

Implementation ⬆ ⬇

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.

Patient/Family Teaching ⬆ ⬇

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.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇