Evaluating dosing guidelines for Ginkgo biloba: An evidence-based approach to standardisation

The widespread use of Ginkgo biloba extracts as a complementary therapy for neurological conditions has outpaced the development of standardised dosing guidelines, particularly in jurisdictions like South Africa where regulatory frameworks remain fragmented. This scoping review critically evaluates existing dosing recommendations for standardised G. biloba extracts, specifically EGb 761 and GBE50, across global regulatory bodies (FDA, EMA, EDA, Health Canada) and clinical literature, with the aim of informing evidence-based standardisation tailored to the South African regulatory context. Using the PRISMA 2020 framework, 29 human studies were synthesised, focusing on efficacy in cognitive impairment, dementia, stroke and stroke recovery, and neuropsychiatric conditions. Dosage ranges varied from 120 to 450 mg/day, with higher doses (≥240 mg/day) consistently linked to improved cognitive outcomes in symptomatic populations. This review highlights significant variability in phytochemical composition, safety profiles, and regulatory oversight, underscoring the need for harmonised dosing protocols. Dose ranges identified are stratified by indication and presented as inputs to regulatory risk-benefit assessment; the absence of clinical trial data from sub-Saharan African populations is acknowledged as a key limitation.