FWD 2 Expanded Commission E: Ginger root

Herbal Medicine: Expanded Commission E

Ginger root

Latin Name: Zingiber officinale
Pharmacopeial Name: Zingiberis rhizoma
Other Names: ginger rhizome


Ginger is a large tuberous perennial plant native to southern Asia, now cultivated extensively in almost all tropical and subtropical countries, especially China, India, Nigeria, Australia, Jamaica, and Haiti (Bruneton, 1995; Budavari, 1996; Grieve, 1979; Leung and Foster, 1996; Reineccius, 1994). China and India are the world's leading producers of ginger. The material of commerce is supplied in "completely scraped" (peeled), "partially scraped," or "unpeeled" rhizomes. Peeled rhizomes ("white" ginger) are produced in Jamaica, while unpeeled rhizomes ("black" ginger) are mainly from China and Sierra Leone. Partially scraped rhizomes come from India, Bengal, Nigeria, Australia, and Japan (BHP, 1996; Felter and Lloyd, 1983; Reineccius, 1994; Wichtl and Bisset, 1994). Ginger became naturalized in the Caribbean and Central America early in the sixteenth century when Spaniards brought it from the East Indies and began to cultivate it on a large scale for export to Europe (Grieve, 1979).

Ginger has been used as a medicine since ancient times, recorded in early Sanskrit and Chinese texts and ancient Greek, Roman, and Arabic medical literature (Bone, 1997). In Asian medical practices, dried ginger has been used as a drug to treat stomachache, diarrhea, and nausea for thousands of years. It is traditionally prepared in aqueous decoctions and infusions (Bruneton, 1995; But et al., 1997; Kapoor, 1990; Leung and Foster, 1996). In Africa, dried ginger is used much as it is in Asia (GHP, 1992; Iwu, 1990). Today, ginger is official in the national pharmacopeias of Austria, China, Egypt, Germany, Great Britain, Japan, and Switzerland (BP, 1988; Bradley, 1992; DAB, 1997; JP XII, 1993; Newall et al., 1996; AB, 1981; Ph.Helv.VII, 1987; Tu, 1992). The Chinese pharmacopeia lists ginger for epigastric pain with cold feeling, vomiting and diarrhea accompanied by cold extremities and faint pulse, dyspnea, and cough with copious frothy expectoration (Tu,1992). The Ayurvedic Pharmacopoeia specifically recommends ginger for flatulent intestinal colic (Karnick, 1994).

In Germany, ginger is an economically important herb, imported on a large scale (Lange and Schippmann, 1997). It is official in the German Pharmacopoeia, approved in the Commission E monographs, and used as a component of anti-emetic stomach medicines (BAnz, 1998; DAB, 1997; Meyer-Buchtela, 1999; Wichtl and Bisset, 1994). In the United States, it is used singly and as a main component of digestive, antinausea, and cold and flu dietary supplements. It is also used extensively in Ayurvedic and traditional Chinese medicine herbal teas and by licensed acupuncturists and naturopathic physicians. Crude ginger, ginger fluidextract, and ginger oleoresin were formerly official in the United States Pharmacopeia (USP) and National Formulary as a carminative, aromatic, and stimulant. King's American Dispensatory indicated it for loss of appetite, flatulence, borborygmus (rumbling or gurgling sound of gas in the intestines), spasmodic gastric and intestinal contractions, and cool extremities (Felter and Lloyd, 1983; Leung and Foster, 1996; Taber, 1962).

The approved modern therapeutic applications for ginger are supportable based on its history of use in well established systems of traditional and conventional medicine, extensive phytochemical investigations, pharmacological studies in animals, and human clinical studies. In 1998, the USP issued a drug information monograph stating that despite its safety, the USP Advisory Panel did not recommend or support the use of ginger for prevention of motion sickness due to what it deemed a lack of sufficient quality studies (USP Consumer Information, 1998). Nonetheless, the data appear adequate to establish reasonable expectation of effectiveness, as documented in the following studies.

Modern human studies have investigated ginger as an anti-emetic (Bone et al., 1990; Phillips et al., 1993), anti-nausea treatment (Arfeen et al., 1995; Meyer et al., 1995; Pace, 1987), a prophylactic against motion sickness (Holtmann et al., 1989; Mowrey and Clayson, 1982; Riebenfeld and Borzone, 1986; Stewart et al., 1991; Stott et al., 1985; Wood et al., 1988) and/or seasickness (Grøntved et al., 1988; Schmid et al., 1994), a treatment for hyperemesis gravidarum (Fischer-Rasmussen et al., 1990), a treatment for vertigo (Grøntved and Hentzer, 1986), and for its effect on human platelet function (Lumb, 1994; Verma et al., 1993; Srivastava, 1989).

In a prospective, randomized, double-blind trial the incidence of postoperative nausea and vomiting was measured in 120 women presenting for elective laparoscopic gynecological surgery on a day-stay basis. Ginger (1 g oral) significantly (p=0.006) reduced postoperative nausea compared to placebo. Groups (n=40) were given either ginger (1 g), metoclopramide (10 mg), or placebo (1 g) postoperatively. The incidence of nausea and vomiting was similar in patients given metoclopramide and ginger (27% and 21%, respectively) and less than in those who received placebo (41%). The dosage requirement for postoperative anti-emetics was lower in those patients receiving ginger (15%) compared to the metoclopramide (32%) and placebo (38%) groups. The authors concluded that ginger is an effective and promising prophylactic anti-emetic that may be especially useful for day-case surgery (Phillips et al., 1993).

A double-blind randomized study tested the effectiveness of ginger (administered orally) as an anti-emetic agent, compared with placebo and metoclopramide (10 mg Maxolon® intravenously) in 60 women who had undergone major gynecological surgery. Patients were given 1 g of powdered ginger at the time of premedication before surgery. There were statistically significantly fewer incidents of nausea in the group that received ginger compared with placebo (p<0.05). The number of incidents of nausea in the groups (n=20) who received ginger or metoclopramide was comparable. Administration of post-operative anti-emetic was significantly less in the ginger and metoclopramide groups than in the placebo group (p<0.05) (Bone et al., 1990).

In one open study the use of ginger to prevent 8-MOP associated nausea was investigated. Eleven patients undergoing photophoresis therapy who regularly experienced nausea after ingestion of psoralen (8-MOP) were included in the study and acted as their own control. Patients undergoing photophoresis therapy are required to ingest psoralen before each treatment. This drug causes nausea. The authors reported that nausea was significantly reduced by ingesting three 530 mg capsules of ginger before taking psoralen (Meyer et al., 1995).

A double-blind, randomized, placebo-controlled trial tested the effect of powdered ginger rhizome on seasickness. Eighty naval cadets, unaccustomed to sailing in heavy seas, reported whether there were symptoms of seasickness every hour for four consecutive hours after ingestion of 1 g of the drug or placebo. The authors concluded that ginger reduced the tendency to vomiting and cold sweating significantly better than placebo (p<0.05) (Grøntved et al., 1988). In another double-blind, crossover, placebo trial, the effect of powdered ginger rhizome upon vertigo and nystagmus following caloric stimulation of the vestibular system (irrigation of the left ear with water at 44°C) was studied in eight healthy volunteers. In 3 out of 24 tests, nausea was present after placebo, but it did not occur after ingestion of ginger. The authors concluded that ginger reduced the induced vertigo significantly better than placebo (Grøntved and Hentzer, 1986).

Using the fact that ginger is approved by the Commission E as a nonprescription remedy for motion sickness in Germany, in 1995 the European-American Phytomedicine Coalition (EAPC) filed a citizens petition with the FDA for ginger to be reviewed as an OTC drug for anti-nausea and motion sickness in the United States (Pinco and Israelsen, 1995). The petition included clinical studies on ginger in experimental conditions as well as in situ (e.g., with first-time sailors at sea). It also contained extensive market data in Europe and other countries where ginger is employed as a medicine. The totality of the materials support the safety and efficacy of ginger as a medicine. By the summer of 1999 the FDA had not yet responded directly to this petition.

A standardized extract of ginger (Zintona®, Dalidar Pharma, Israel) has been approved as a nonprescription medicine for prevention of motion sickness in Germany, Switzerland, Austria, and Finland (Tenne, 1999).

Regarding quality control parameters, Chinese pharmacopeial grade ginger must be composed of the dried rhizome, removed from fibrous root, collected in winter, containing not less than 0.8% (ml/g) volatile oil. Botanical identity must be confirmed by macroscopic and microscopic examinations and organoleptic evaluation (Tu, 1992). Both the Austrian Pharmacopoeia and the German Pharmacopoeia require not less than 1.5% (m/v) volatile oil, botanical identity confirmation by thin-layer chromatography (TLC) and macroscopic and microscopic examinations, purity test for absence of bleaching agents (calcium carbonate), a test for absence of starch paste when boiled in water, and not less than 4% acetone-soluble extractive (DAB, 1997; AB, 1981; Wichtl and Bisset, 1994). The British Pharmacopoeia requires not less than 10% water-soluble extractive and not less than 4.5% ethanol-soluble extractive (BP, 1980, 1988; Wichtl and Bisset, 1994). The ESCOP ginger monograph requires the material to comply with the British Pharmacopoeia (ESCOP, 1997). The Ghana Herbal Pharmacopoeia requires not less than 1% volatile oil, botanical identity confirmation by examination of characteristic macroscopic and microscopic features, purity tests for absence of sclerenchymatous cells, trichomes and crystals of calcium oxalate, and not less than 4% ethanol-soluble extractive (GHP, 1992).


Ginger root consists of the peeled, finger-long, fresh or dried rhizome of Zingiber officinale Roscoe [Fam. Zingiberaceae] and its preparations in effective dosage. The rhizome contains essential oil and pungent principles.

Chemistry and Pharmacology

Ginger rhizome contains oleoresin (4.0–7.5%) composed of non-volatile pungent principles (phenols such as gingerols and their related dehydration products shogaols), non-pungent substances (fats and waxes), and volatile oils; volatile oil (1.0–3.3%), of which 30–70% are sesquiterpenes, mainly β-bisabolene, (–)-zingiberene, β-sesquiphellandrene, and (+)-ar-curcumene, and monoterpenes, mainly geranial and neral; carbohydrates, mainly starch (40–60%); proteins (9–10%); lipids (6–10%) composed of triglycerides, phosphatidic acid, lecithins, and free fatty acids; vitamins niacin and A; minerals; and amino acids (Bradley, 1992; Bruneton, 1995; Budavari, 1996; ESCOP, 1997; Leung and Foster, 1996; Newall et al., 1996; Wichtl and Bisset, 1994).

The Commission E reported anti-emetic, positively inotropic, promoting secretion of saliva and gastric juices, and cholagogue activity. In animals: antispasmodic. In humans: increase in tonus and peristalsis in intestines.

The British Herbal Compendium reported its actions as carminative, anti-emetic, spasmolytic, peripheral circulatory stimulant, and anti-inflammatory (Bradley, 1992). Powdered ginger root taken by naval cadets as a prophylactic against seasickness significantly reduced the tendency to vomit and cold sweating compared to placebo (Grøntved et al., 1988).


The Commission E approved the internal use of ginger for dyspepsia and prevention of motion sickness.

The British Herbal Compendium indicates ginger for atonic dyspepsia, colic, prophylaxis of travel sickness, and vomiting of pregnancy. Other uses include for anorexia, bronchitis, and rheumatic complaints (Bradley, 1992). ESCOP indicates its use for prophylaxis of the nausea and vomiting of motion sickness and as a postoperative anti-emetic for minor day-case surgical procedures (ESCOP, 1997).


With gallstones, first consult a physician.

Side Effects

None known.

Use During Pregnancy and Lactation

Not recommended (McGuffin et al., 1997).

Note: The Commission E contraindicates ginger as a remedy for morning sickness during pregnancy. However, there is no evidence that the therapeutic dosage for antinauseant activity cited by Commission E (1 gram of dried root) produces any harm to either the fetus or the mother. The Commission E presumably based its caution on two studies published in the 1980s in Japan on 6-gingerol, one of the compounds isolated from ginger rhizome. In vitro tests indicated that the gingerol had mutagenic activity in vitro at high doses (Namakura and Yamamoto, 1982; Nagabhushan et al., 1987). However, other compounds in ginger have been found to exhibit anti-mutagenic activity (Kada et al., 1978). Ginger is also widely used in traditional Chinese medicine (TCM), but without contraindications in pregnancy. "On the contrary, ginger has been traditionally used for nausea and vomiting in pregnancy, though as in typical TCM usage, rarely by itself. There is no lack of remedies for these conditions using ginger. Also, there is no contraindication of ginger in any of the recent issues of the Pharmacopoeia of the People's Republic of China (newest edition, 1995); the dosage is 3–9 grams for both fresh and dried ginger" (Leung, 1998). A literature review of all available clinical studies on ginger could find no scientific or medical evidence for Commission E's contraindication during pregnancy (Fulder and Tenne, 1996). Professor Schilcher, vice president of Commission E, agrees with this assessment of ginger's presumed safety during pregnancy (Schilcher, 1998).

Interactions with Other Drugs

None known.

Dosage and Administration

Unless otherwise prescribed: 2–4 g per day cut rhizome or dried extract.

Powdered rhizome: 0.25–1.0 g, three times daily.

Infusion or decoction: 0.25–1.0 g in 150 ml boiled water, three times daily.

Fluidextract 1:1 (g/ml): 0.25–1.0 ml, three times daily.

Tincture 1:5 (g/ml): 1.25–5.0 ml, three times daily.

[Note: A standardized ginger extract (Zintona®) is dosed in 250 mg capsules, recommended at two capsules 30 minutes before expected onset of symptoms, then two capsules every four hours "to ease discomfort of digestive upset (or motion sickness)" (Tenne, 1999).]


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BAnz. See Bundesanzeiger.

Bone, K. 1997. Ginger. Brit J Phytother 4(3):110-120.

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Holtmann, S., A.H. Clarke, H. Scherer, M. Hohn. 1989. The anti-motion sickness mechanism of ginger. A comparative study with placebo and dimenhydrinate. Acta Otolaryngol (Stockh) 108(34):168-174.

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Lange, D. and U. Schippmann. 1997. Trade Survey of Medicinal Plants in GermanyA Contribution to International Plant Species Conservation. Bonn: Bundesamt f r Naturschutz. 8384.

Leung, A.Y. 1998. Personal communication to Mark Blumenthal. Mar. 2.

Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.

Lumb, A.B. 1994. Effect of dried ginger on human platelet function. Thromb Haemost 71(1):110111.

McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.

Meyer, K., J. Schwartz, D. Crater, B. Keyes. 1995. Zingiber officinale (ginger) used to prevent 8-MOP associated nausea. Dermatol Nurs 7(4):242-244.

Meyer-Buchtela, E. 1999. Tee-RezepturenEin Handbuch für Apotheker und Ärzte. Stuttgart: Deutscher Apotheker Verlag.

Mowrey, D.B. and D.E. Clayson. 1982. Motion sickness, ginger, and psychophysics. Lancet 1(8273):655-657.

Nagabhushan, M., A.J. Amonkar, S.V. Bhide. 1987. Mutagenicity of gingerol and shogaol and antimutagenicity of zingerone in Salmonella/microsome assay. Cancer Lett 36(2):221-223.

Namakura, H. and T. Yamamoto. 1982. Mutagen and anti-mutagen in ginger, Zingiber officinale. Mutat Res 103(2):119-126.

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Pace, J.C. 1987. Oral ingestion of encapsulated ginger and reported self-care actions for the relief of chemotherapy-associated nausea and vomiting. Diss Abstr Int (Sci) 47(8):3297.

Pharmacopoeia Helvetica, 7th ed. Vol. 1-4. (Ph.Helv.VII). 1987. Bern: Office Central Fédréal des Imprimés et du Matériel.

Phillips, S., R. Ruggier, S.E. Hutchinson. 1993. Zingiber officinale (ginger)an anti-emetic for day case surgery. Anaesthesia 48(8):715-717.

Pinco, R.G. and L.D. Israelsen. 1995. European-American Phytomedicines Coalition Citizen Petition to Amend FDA's OTC Drug Review Policy Regarding Foreign Ingredients. Jul. 24.

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Riebenfeld, D. and L. Borzone. 1986. Randomised double-blind study to compare the activities and tolerability of Zintona and dimenhydrinate in 60 subjects with motion sickness. (Unpublished report, Pharmaton, Lugano, Switz.)

Schilcher, H. 1998. The Present State of Phytotherapy in Germany. Deutsche Apotheker Zeitung 138 Jahrgang, No. 3, Jan. 15:144-149.

Schmid, R., T. Schick, R. Steffen, A. Tschopp, T. Wilk. 1994. Comparison of Seven Commonly Used Agents for Prophylaxis of Seasickness. J Travel Med 1(4):203-206.

Srivastava, K.C. 1989. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostaglandins Leukot Essent Fatty Acids 35(3):183-185.

Stewart, J.J., M.J. Wood, C.D. Wood, M.E. Mims. 1991. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 41(2):111-120.

Stott, J.R.R., M.P. Hubble, M.B. Spencer. 1985. A double-blind comparative trial of powdered ginger root, Hyosine (sic) Hydrobromide and Cinnarizinein the prophylaxis of motion sickness induced by cross coupled stimulation. Advisory Group for Aerospace Research and Development, Conference Proceedings. 372, 39:16.

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Additional Resources

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Connel, D.W. and M.D. Sutherland. 1969. A re-examination of gingerol, shogaol and zingerone, the pungent principles of ginger (Zingiber officinale Roscoe). Austr J Chem 22:1033-1043.

Connel, D.W. 1969. The extraction of ginger. Food Technol Austr 21:570.

. 1970. The chemistry of the essential oil and oleoresin of ginger (Zingiber officinale Roscoe). Flavour Industry 1:677-693.

Council of Europe. 1981. Flavouring Substances and Natural Sources of Flavourings, 3rd ed. Strasbourg: Maisonneuve.

List, P.H. and L. Hörhammer (eds.). 1973-1979. Hagers Handbuch der Pharmazeutischen Praxis, Vols. 1-7. New York: Springer Verlag.

Marsh, A.C. et al. 1977. Composition of Foods, Spices, and Herbs: Raw, Processed, Prepared. Agriculture Handbook No. 82. Washington, D.C.: Agricultural Research Service, U.S. Department of Agriculture.

Ming, O. (ed.). 1989. Chinese-English Manual of Common-Used in Traditional Chinese Medicine. Hong Kong: Joint Publishing (H.K.) Co., Ltd. 162-163, 341, 498-499.

Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan. 1308-1315.

Reynolds, J.E.F. (ed.). 1989. Martindale: The Extra Pharmacopoeia, 29th ed. London: The Pharmaceutical Press.

. 1993. Martindale: The Extra Pharmacopoeia, 30th ed. London: The Pharmaceutical Press.

Rosengarten, F., Jr. 1969. The Book of Spices. Wynnewood, PA: Livingston.

Shoji, N., A. Iwasa, T. Takemoto, Y. Ishida, Y. Ohizumi. 1982. Cardiotonic principles of ginger (Zingiber officinale Roscoe). J Pharm Sci 71(10):1174-1175.

Srivastava, K.C. and T. Mustafa. 1989. Ginger (Zingiber officinale)and rheumatic disorders. Med Hypotheses 29(1):2528.

Suekawa, M. et al. 1984. Pharmacological studies on ginger. I. Pharmacological actions of pungent constituents, [6]-gingerol and [6]-shogaol. J Pharmacobiodyn 7(11):836-848.

Suekawa, M. et al. 1986. [Pharmacological studies on ginger. V. Pharmacological comparison between [6]-shogaol and capsaicin] [In Japanese]. Nippon Yakurigaku Zasshi 88(5):339-347.

Trease, G.E. and W.C. Evans. 1989. Trease and Evans' Pharmacognosy, 13th ed. London; Philadelphia: Baillière Tindall. 466.

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This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.

2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.

3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:

  • Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
  • Infusion: 2 g in 150 ml of water
  • Fluidextract 1:1 (g/ml): 2 ml
  • Tincture 1:5 (g/ml): 10 ml

4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.

Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.