Rupatadine and <em>Ginkgo biloba</em>: Common Actions and Potential Synergy in Otorhinolaryngology

Otorhinolaryngologic (ENT) disorders, including allergic rhinitis, chronic rhinosinusitis, and inner ear diseases, frequently involve complex inflammatory and vascular mechanisms. Rupatadine, a second-generation H₁-antihistamine with additional platelet-activating factor (PAF) receptor antagonism, has demonstrated efficacy in allergic airway conditions by addressing both histamine- and PAF-mediated inflammation. Ginkgo biloba, a herbal extract rich in ginkgolides, also exhibits PAF antagonism, alongside antioxidant and microcirculatory-enhancing properties, making it relevant to neurotologic and vascular ENT conditions. This narrative review synthesizes human clinical evidence from the past decade, exploring the individual and potential combined therapeutic effects of rupatadine and Ginkgo biloba in ENT pathologies. Clinical studies support rupatadine’s role in allergic rhinitis and inflammation-driven sinus disease, while Ginkgo has shown benefit in sudden hearing loss, tinnitus, and vertigo associated with vascular compromise. The concept of synergy—where co-administration targets multiple pathogenic pathways more effectively than monotherapy—is explored, particularly in conditions at the intersection of allergy, inflammation, and vascular dysfunction. While current evidence for combination therapy remains theoretical, the overlapping pharmacodynamics of these agents suggest a promising complementary approach. Future research, including controlled clinical trials, is warranted to evaluate the safety, efficacy, and optimal use of this potential synergy in ENT care.