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

Dysmenorrhea.
Dyspepsia.
Flatulence.
Lower blood glucose.
Lower cholesterol.
Migraine headache.
Osteoarthritis.
Prevention and treatment of nausea and vomiting associated with motion sickness, loss of appetite, pregnancy, surgery, and chemotherapy.
Prevention of postoperative nausea and vomiting.
Rheumatoid arthritis.
Sore throat.

Action ⬆ ⬇

Antiemetic effect due to ↑ GI motility and transport; may act on serotonin receptors.
Shown to be hypoglycemic, hypotensive, or hypertensive.
Inhibits prostaglandins and platelets, ↓ cholesterol, and ↑ appetite and digestion.

Therapeutic effects:

Reduced nausea and vomiting.
Reduced joint pain and improved joint motion.
Increased antioxidant effects.
Reduced migraine headaches.

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:

Allergy to plants in the Zingiberaceae family (turmeric, cardamom);
Bleeding disorders;
Surgery (discontinue ≥2 wk before procedure);
Gallstones.

Use Cautiously in:

Cardiovascular disease;Diabetes;
Gastroesophageal reflux disease;
Peptic ulcers;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

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 and calcium channel blockers.

Natural-Natural Products:

Herbs with anticoagulant or antiplatelet properties may ↑ bleeding risk when combined with chamomile, including: anise, asafoetida, bogbean, boldo, capsicum, celery, clove, danshen, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, Panax ginseng, horse chestnut, horseradish, licorice, meadowsweet, prickly ash, onion, papain, passionflower, poplar, quassia, red clover, turmeric, wild carrot, wild lettuce, and willow.

Route/Dosage ⬆ ⬇

PO (Adults ): Motion sickness: 1000 mg dried ginger root taken 30 min–4 hr before travel or 250 mg 4 times daily. 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 3 times daily or 255 mg twice daily of ginger extract. 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 ⬆ ⬇

Antiemetic agent: Assess for nausea, vomiting, abdominal distention, and pain before and after administration.
Arthritis: Assess pain, swelling, and range of motion in affected joints before and after administration.
Gastroprotective agent: Assess for epigastric pain before and after administration.
Migraine attack: Assess pain location, duration, intensity, and associated symptoms (photophobia, phonophobia, nausea, vomiting).
Monitor BP and HR in patients with cardiovascular disease, including hypertension.

Lab Test Considerations:

Monitor blood glucose and coagulation panels periodically during therapy.

Implementation ⬆ ⬇

PO: Administer before situations where nausea or vomiting is anticipated (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 ⬆ ⬇

Explain purpose and side effects of herb to patient.
Advise patient to consult with health care provider before using any herbal supplement, especially when taken concurrently with Rx or OTC medications or vitamins.
Advise patient receiving anticoagulants not to take this herb without the advice of health care provider (↑ risk of bleeding).
Advise patient to stop the herb immediately if palpitations occur and to notify health care provider.
Advise patient to observe for easy bruising or other signs of bleeding. Advise to stop the herb immediately and notify health care provider if symptoms occur.
Advise patient with a history of gallbladder disease to use this herb only under the supervision of health care provider.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or breastfeeding before using this herb.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇