Zingiberaceae

Common Trade Names

Multi-ingredient preparations: Cayenne Ginger, Gingerall, Ginger Ease, Ginger Peppermint Combo, Ginger Power, Ginger Root Alcohol Free, Ginger Trips, Low Alcohol Misty Ginger Blend

Common Forms

Capsules, liquid, powder: 100 mg, 465 mg

Extract: 250 mg

Root: 530 mg

Tablets (chewable): 67.5 mg Also available as teas.

Source

Ginger (Zingiber officinale) is a perennial that grows in India, Jamaica, and China. The plant produces green-purple flowers that resemble orchids. The rhizome (root) is found underground and usually the most valued part of the plant.

Chemical Components

The root contains both volatile and nonvolatile compounds. The nonvolatile constituents, which include the gingerols and gingerol-like compounds, are thought to be responsible for ginger's flavor, aromatic properties, and any pharmacologic activity. The volatile oil contains zingiberol, zingeberene, curcumene, farnesene, bis-abolene, sesquiphellandrene, and several monoterpenes (linalool, borneol, neral, geraniol, and others). Other compounds present are zingibain (a proteolytic enzyme), oleoresins, fats, waxes, carbohydrates, vitamins, and minerals.

Actions

Human studies have shown that ginger inhibits platelet aggregation induced by adenosine diphosphate and epinephrine . Other studies have demonstrated a lack of effects on platelet aggregation . Ginger extracts have documented anti-inflammatory effects in rodent models . Specific components of ginger produce varying CV effects. Methanolic extracts of ginger have shown positive inotropic effects in a guinea pig model.

Other studies in animals have suggested that components in ginger may be gastroprotective against various chemical insults and stressors. The GI protective action is postulated to be promoted by increased mucosal resistance and potentiation of the defensive mechanism against chemicals or alterations in prostaglandins, providing more protective effects. A study of acetone extracts in mice found them to have similar stimulatory effects on GI motility as those seen with metoclopramide and domperidone .

Reported Uses

Claims for ginger include its use as an antiemetic, an anti-inflammatory useful for arthritis treatment, an antioxidant, an antitumorigenic drug, a CV stimulant, and a GI protectant and as a therapy for microbial and parasitic infestations.

The antiemetic effects of ginger have been extensively studied in humans for morning, motion, and sea sickness and for postoperative nausea and vomiting; most findings provided support for this action. Doses and duration of therapy varied considerably with each study. The antiemetic properties of ginger probably result from local effects on the GI tract rather than the CNS. Increased gastric peristalsis has been shown in animals, but any mechanism in humans is considered speculative.

Ginger has provided relief from pain and swelling in patients with muscle discomfort, osteoarthritis, or rheumatoid arthritis . A proposed mechanism is that it inhibits prostaglandin, thromboxane, and leukotriene biosynthesis.

Dosage

Dosage forms and strength vary with each disease state. As an antiemetic, studies used 500 to 1,000 mg of powdered ginger P.O., or 1,000 mg of fresh ginger root P.O.

Adverse Reactions

CNS: CNS depression (with overdose).

CV: arrhythmias (with overdose).

GI: heartburn.

Interactions

Anticoagulants: Increased risk of bleeding. Avoid administration with ginger.

Contraindications And Precautions

Ginger is contraindicated in pregnant patients; effects are unknown. Some components of ginger have been determined to be mutagenic, whereas others appear to exert an antimutagenic effect. The net effect of these components is unknown . Use only under medical supervision in patients receiving anticoagulants because it may affect bleeding time by inhibiting platelet function.

Special Considerations

Advise women to avoid excessive use of ginger during pregnancy.

Instruct the patient to watch for signs of bleeding when taking ginger.

No consensus exists with respect to dosing and monitoring.

Commentary

Although some data support the use of ginger as an antiemetic in humans, results from several trials have conflicted. Recommendation of ginger for use as an antiemetic, an anti-inflammatory, or a gastroprotective agent, before long-term, controlled, pharmacologic studies of its constituents have been conducted, is premature. Pregnant women should probably avoid excessive consumption of ginger until the effects of all its constituents are understood.