Ginger - an overview | ScienceDirect Topics (2023)

Administration of ginger has also been reported to reverse the histological abnormalities in liver, enhance the antioxidant status, and normalize the activity of liver marker enzymes in the serum, which are altered by oxidants and xenobiotics [72–78].

From: Foods and Dietary Supplements in the Prevention and Treatment of Disease in Older Adults, 2015

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Anesthetic Implications of Complementary and Alternative Therapies

Michael A. Gropper MD, PhD, in Miller's Anesthesia, 2020


Ginger (Zingiber officinale) is a popular spice with a long history of use in Chinese, Indian, Arabic, and Greco-Roman herbal medicines. Ginger has a wide range of reported health benefits for those with arthritis, rheumatism, sprains, muscular aches, pains, sore throats, cramps, constipation, indigestion, nausea, vomiting, hypertension, dementia, fever, infectious diseases, and helminthiasis.50 Ginger contains up to 3% volatile oil, mostly monoterpenoids and sesquiterpenoids.51 Gingerols are representative compounds in ginger.52

Ginger is an antiemetic and has been used to treat motion sickness and to prevent nausea after laparoscopy.53 The number of postoperative antiemetic medications was significantly reduced after aromatherapy with essential oil of ginger.54 In another recent trial, ginger supplementation reduced the severity of acute chemotherapy-induced nausea in adult cancer patients and compared favorably to conventional antiemetics.55

In an invitro study, gingerols and related analogues inhibited arachidonic acid–induced human platelet serotonin release and aggregation, with a potency similar to that of aspirin.52 In another invitro study, the antiplatelet effects of 20 ginger constituents were evaluated. Five constituents showed antiplatelet activities at relatively low concentrations. One of the ginger compounds (8-paradol) was the most potent cyclooxygenase-1 inhibitor and antiplatelet aggregation drug.56 In a case report, a ginger-phenprocoumon combination resulted in an increased INR and epistaxis.57 Although the sample size was relatively small, the platelet inhibition potential of ginger has been suggested in a pilot clinical study.58 This result may warrant the discontinuation of ginger at least 2 weeks before surgery,


Aviva Romm Certified Professional Midwife, Herbalist, MD, ... Simon Mills MCPP, FNIMH, MA, in Botanical Medicine for Women's Health, 2010


Ginger has a long history of safe use both as a culinary and medicinal herb. It is considered safe when used as recommended, including when used within the prescribed pregnancy dose. Dose should not exceed 1 g daily in pregnancy, and 4 g per day for the general population. Theoretical herb drug interactions have been proposed (Table 1). Concerns have been expressed that ginger might increase the risk of bleeding, for example, with surgery, owing to platelet activating factor (PAF) inhibition; therefore, it is recommended that patients taking ginger should discontinue use 1 to 2 weeks prior to surgical procedures. Patients using oral hypoglycemic medications may require a dose adjustment as ginger may have hypoglycemic effects. Limited evidence suggests that ginger may interfere with antacids, sulcralfate, H2 antagonists, and proton pump inhibitors (PPIs) by increasing stomach acid production. Patients with gastric and duodenal ulcers are therefore sometimes advised to avoid using ginger other than for culinary purposes for this reason; however, animal experiments suggest a protective effect against gastric ulcers.

Patients with known allergy or hypersensitive to members of the Zingiberacae family, or those allergic to Balsam of Peru, may experience sensitivity or contact dermatitis with use of ginger. Ginger powder taken unencapsulated has been known to cause heartburn-like symptoms, and raw ginger taken in large boluses and poorly masticated has been reported in the literature to cause ileus in a limited number of case reports.

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J.K. Aronson MA, DPhil, MBChB, FRCP, HonFBPhS, HonFFPM, in Meyler's Side Effects of Drugs, 2016

Zingiber officinale

Zingiber officinale (ginger) contains a variety of compounds, including diarylheptanoids and the phenol gingerol. It has been used to treat motion sickness and other forms of nausea and vomiting, and may have some efficacy [8], for example in pregnancy-related nausea and vomiting [9–11] and postoperative nausea and vomiting [12]. Results of studies on its use in the management of nausea and vomiting during cancer chemotherapy have been variable and inconsistent [13]. It may be beneficial in mild migraine [14–16]. It has been suggested to have anti-inflammatory properties [17] but they have not been extensively studied clinically. Nor have its supposedly active ingredients, such as 6-gingerol and zingiberene, been extensively studied.

True ginger should not be confused with Jamaican ginger (Jake), a mixture of cheap alcohol with triorthocresyl phosphate, an organophosphate, which caused an axonal neuropathy in those who drank it during Prohibition in the USA in the 1920s and 1930s [18–21].

In a systematic review of 24 randomized controlled trials in 1073 patients ginger had no beneficial effects in postoperative nausea and vomiting [22]. Of 777 patients in 15 studies, 3.3% had mild adverse reactions, mainly mild gastrointestinal symptoms and sleepiness, not requiring specific treatment. There was one serious adverse event, abortion in the 12th week of gestation, but that could not clearly be attributed to the ginger.

Zingiber officinale

A.T. Mbaveng, V. Kuete, in Medicinal Spices and Vegetables from Africa, 2017


Zingiber officinale, commonly known as ginger, is a spice consumed worldwide for culinary and medicinal purposes. The plant has a number of chemicals responsible for its medicinal properties, such as antiarthritis, antiinflammatory, antidiabetic, antibacterial, antifungal, anticancer, etc. The present chapter compiled scientific data retrieved from websites, such as PubMed, ScienceDirect, Scopus, Web-of-Knowledge, Google Scholar, and others related to the phytochemistry and pharmacology of ginger. A synopsis of the world production of the plant as well as some patents related to Z. officinale are also provided.

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Coumarin anticoagulants

J.K. Aronson MA, DPhil, MBChB, FRCP, HonFBPhS, HonFFPM, in Meyler's Side Effects of Drugs, 2016

Zingiber officinale (ginger)

Despite anecdotal reports of a possible interaction [457,458], several studies in rats and humans have shown no effect of ginger on warfarin pharmacokinetics or pharmacodynamics [459,460].

The risk of bleeding and supratherapeutic INRs associated with the use of complementary and alternative medicine (CAM) in patients receiving warfarin has been studied prospectively in an acute care, academic, and research hospital in Canada [455]. Of 171 patients, 87 (51%) reported at least one bleeding event and 36 (21%) had a supratherapeutic INR; 73 (43%) had used at least one CAM product previously reported to interact with warfarin. Ginger was associated with an increased risk of self-reported bleeding (OR=3.20; 95% CI=2.42, 4.24).

Zingiber officinale

Tanuj Joshi, ... Mahendra Rana, in Naturally Occurring Chemicals Against Alzheimer's Disease, 2021


Ginger (Zingiber officinale) is a plant that carries huge potential to cure a number of physiological conditions. It is a drug that has been used in traditional and folk medicine for over two millennia. It is a drug mentioned in the Ayurveda. Despite all of these factors, ginger basically finds its use as a spice and hence its potential has not yet been realized. The large number of chemicals present in ginger can easily be associated with its pharmacological effect. Ginger has been characterized as a functional food due to its composition. The drug contains calcium, carbohydrates, carotene, dietary fiber, fat, iron, protein, and vitamin C. Formation of senile plaques, a characteristic marker in Alzheimer’s disease, is due to amyloid beta (Aβ) protein. Phytochemicals like gingerol play an important role in the mechanism of action of Z.officinale. A study of the mechanism of action and neuroprotective effect of [6]-gingerol against Aβ (25-35) protein, which induces oxidative and/or nitrosative stress cell death in SHSY5Y cells, was elucidated. Ginger is a good source of phytochemicals, which possess antioxidant and antiinflammatory properties. Because of these antioxidant and antiinflammatory potentials, it is used in the effective management and treatment of Alzheimer’s disease.

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Irritable Bowel Syndrome

Patrick J. Hanaway MD, in Integrative Medicine (Fourth Edition), 2018


Ginger (Zingiber officinale) can be used nutritionally in cooking or as an herbal remedy and has been evaluated in the treatment of postoperative nausea and vomiting. The active gingerols act as an antispasmodic and improve the tone of intestinal muscles. A recent small study demonstrated benefit in both the ginger and placebo groups, with fewer side effects in the ginger group.92 Ginger is available in many forms, and ginger root tea is particularly helpful after overeating.


Powdered root, 250–500 mg 3–4 times/day. Prepare ginger tea by chopping a piece of ginger the size of the patient’s fifth digit; place in 150 mL of boiling water for 5–10 minutes and strain. Drink one cup before meals.

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Recurring Abdominal Pain in Pediatrics

Joy A. Weydert MD, in Integrative Medicine (Fourth Edition), 2018

Ginger (Zingiber officinale)

Ginger contains many volatile oils (sesquiterpenes) and aromatic ketones (gingerols). Gingerols are believed to be the more pharmacologically active constituents of ginger. Historically, ginger has been used as far back as the fourth century BC for stomach aches, nausea, and diarrhea. Ginger has also been used as a carminative, appetite stimulant, and choleretic. Ginger can simultaneously improve gastric motility and exert antispasmodic effects.38 Studies have shown that ginger’s antispasmodic effects on visceral smooth muscle are likely attributable to antagonism of serotonin receptor sites. A double-blind, randomized crossover study reported a significant reduction in nausea and vomiting with the use of ginger in women with hyperemesis gravidarum.39 Due to its safety profile, ginger is regularly used in pregnancy with no untoward fetal effects.


Adults weighing approximately 150 lb: 1 to 2 g dry powdered ginger root per day (10 g fresh)

Children weighing approximately 75 lb: 0.5 to 1 g dry powdered ginger root per day (5 g fresh)

Children weighing approximately 35 lb: 0.25 to 0.5 g dry powdered ginger root per day (2.5 g fresh)

Ginger can improve gastric motility while also exerting an antispasmodic effect. The pharmacist can dissolve ginger capsules in an 8.4% bicarbonate suspension with good stability and bioavailability for use in children unable to swallow pills.

A one-fourth inch slice of fresh ginger root is approximately 10 g. This is equivalent to 1 to 2 g of a dry powder form of ginger that is a more concentrated form found in capsules. Fresh ginger can be brewed as a tea sweetened with honey or can be chopped and added to foods, soups, or salads.

A general rule of thumb for estimating the amount of fresh ginger to use in children is to use the child’s “pinky” finger (fifth finger) as the guide to the size of ginger to chop up and steep for tea.


Ginger is well tolerated when used in typical doses. At higher doses, side effects may include heartburn, abdominal discomfort, or diarrhea. Ginger may have antiplatelet effects and therefore may increase the risk of bleeding in some people.

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Nausea and Vomiting in Pregnancy

Andrea Gordon MD, Abigail Love MD, MPH, in Integrative Medicine (Fourth Edition), 2018

Ginger Root (Zingiber officinale)

Historically, ginger has been effectively and safely used to treat nausea, including that of pregnancy. Randomized controlled trials have shown that ginger is effective for treating NVP,22 and it is the most thoroughly studied herb for this indication. Some trials have shown ginger to be not only more effective than placebo23 but also comparable to or better than vitamin B624,25 and comparable to dimenhydrinate.26 It will reduce overall nausea symptoms but not the number of vomiting episodes significantly.27

Patients should be advised that it may take longer for ginger to work: up to 3 days, rather than 1 day for dimenhydrinate. The U.S. Food and Drug Administration (FDA) has listed ginger as a food supplement that is generally recognized as safe,28 and studies have not shown any increased incidence of malformations in children of mothers using ginger.29

Ginger seems to work primarily in the gastrointestinal tract on serotonin receptors in the ileum, the same receptors affected by some antiemetics, such as ondansetron. Some evidence indicates that ginger constituents may also have some action in the central nervous system.30 No toxicity has been demonstrated, although ginger can cause abdominal discomfort or heartburn when it is taken in large doses, especially on an empty stomach.


Most of the studies have used 1000 mg daily, in two or four divided doses.23,26,28,31 A higher dose of 650 mg three times daily has also been used,32 but total doses of less than 1500 mg a day are more effective.34 Ginger is available in a variety of forms, and an evaluation of products purchased in pharmacies and health food stores found a wide variation in the amount of active ingredients and suggested serving sizes.35 Women may prefer one form over another, so approximate equivalents can be calculated. In general, 1 g of standardized extract is equivalent to 1 teaspoon of fresh grated ginger root, two droppers (2 mL) of liquid extract, four 8-oz cups of prepackaged ginger tea, four 8-oz cups of tea made with 0.5 teaspoon of grated ginger steeped for 5–10 minutes, 8 oz of ginger ale (made with real ginger—most commercial ginger ales are not effective), two pieces of crystallized ginger (1 inch square, 0.25 inches thick), or two teaspoons (10 mL) of ginger syrup.36 Capsules of ginger come in various dosages, ranging from 100 to 1000 mg, and chewable tablets may contain 67 to 500 mg, so attention to the dosing of the product used is advisable, with the goal a total of less than 1500 mg a day.

Using ginger throughout the day is also helpful. Patients can incorporate ginger into their diet by sprinkling dried or candied ginger in oatmeal, having some ginger tea, and adding fresh ginger to soup or stir-fries.


There is a theoretical risk for bleeding as ginger inhibits thromboxane synthetase and may inhibit platelet function. This has not been demonstrated, but precaution should be taken when ginger is used concomitantly with anticoagulants.

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Mineral, Vitamin, and Herbal Supplements

Alan D. Kaye MD, PhD, ... Adam M. Kaye PharmD, FASCP, FCpha, in Anesthesia and Uncommon Diseases (Sixth Edition), 2012


Ginger has been used to treat nausea, vomiting, motion sickness, and vertigo.87 A study of the effects of ginger found that no subjects with vertigo taking ginger experienced nausea after caloric stimulation of the vestibular system, in contrast to those taking placebo.131 Ginger may be superior to dimenhydrinate in decreasing motion sickness.132 For vomiting episodes, ginger has also been effective in decreasing symptoms associated with hyperemesis gravidarum.133

The effect of ginger on the clotting pathway has also been investigated. Ginger has exhibited potent inhibition of thromboxane synthetase, which increases bleeding time and may cause morbidity.134 The ability of ginger constituents and related substances to inhibit arachidonic acid–induced platelet activation in human whole blood has been studied as well (see Box 16-1). The data revealed that ginger compounds and derivatives are more potent antiplatelet agents than aspirin under the conditions employed. [8]-Paradol, a constituent of ginger, was identified as the most potent antiplatelet aggregation agent and COX-1 inhibitor.135 In another study, administration of ginger resulted in decreases in blood pressure, serum cholesterol, and serum triglycerides in diabetic rats.136 Further investigation into these effects in diabetes is warranted.

Adverse effects of ginger include bleeding dysfunction, and its use is contraindicated in patients with coagulation abnormalities or those taking anticoagulants (NSAIDs, aspirin, warfarin, heparin).87 Ginger may increase bleeding risk, enhance barbiturate effects, and, as a result of an inotropic effect, interfere with cardiac medications. Large quantities of ginger may also cause cardiac arrhythmias and CNS depression137 (see Table 16-3).

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