Danshen

Danshen/Drug Interactions:

  • ACE inhibitorsACE inhibitors: Based on an animal study, danshen may produce dose-dependent hypotension (35). This effect was potentiated by administration of captopril, an angiotensin-converting enzyme inhibitor.
  • AlcoholAlcohol: Based on animal studies, danshen and miltirone, a constituent of danshen, may reduce alcohol intake and reduced alcohol levels in the blood (6; 7; 42).
  • AntibioticsAntibiotics: Based on animal evidence, danshen may have antiseptic properties (8).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Based on an animal study, danshen may increase prothrombin time and steady-state plasma concentrations of warfarin (31). In case reports, over-anticoagulation due to danshen use (32) and prolonged prothrombin time/international normalized ratio (INR) were reported (33).
  • AntihypertensivesAntihypertensives: Based on an animal study, danshen may produce dose-dependent hypotension (35).
  • Anti inflammatory agentsAnti inflammatory agents: Based on a review, danshen root may have anti-inflammatory activity by possibly inhibiting the enzymatic activity of cyclooxygenase-2 (COX-2) (9; 10).
  • Antilipemic agentsAntilipemic agents: Based on human study, danshen in combination with a lipid-lowering agent may decrease total-, VLDL-, and LDL- cholesterol and triglycerides, and increase HDL-cholesterol (43; 44).
  • AntineoplasticagentsAntineoplasticagents: Based on in vitro study, danshen may have antineoplastic activity, including induction of apoptosis (18) and growth inhibition (19; 17).
  • AspirinAspirin: In case reports, over-anticoagulation due to danshen use (32) and prolonged prothrombin time/international normalized ratio (INR) were reported (33).
  • BenzodiazepinesBenzodiazepines: In vitro, miltirone, a tanshinone isolated from danshen, had high potency in the central benzodiazepine receptor binding assay (24).
  • Cardiac glycosidesCardiac glycosides: Danshen may have positive inotropic effects (45). In addition, danshen use may falsely elevate serum digoxin levels (36; 37; 38).
  • Cardiovascular agentsCardiovascular agents: Based on preliminary evidence in humans, danshen may have cardiovascular activity (46; 47; 9; 48).
  • Cytochrome P450 metabolized agentsCytochrome P450 metabolized agents: Based on animal studies, the ethyl acetate extract of danshen may induce CYP activity (49).
  • ImmunosuppressantsImmunosuppressants: Based on preliminary human and animal evidence, danshen may have immunosuppressant activity (20; 21). However, in a clinical trial, danshen was associated with enhancement of cell-mediated immunity (30).
  • InotropesInotropes: Based on animal evidence, danshen may have positive inotropic effects (45).
  • NitratesNitrates: In humans, danshen could partially prevent the occurrence of tolerance to nitrate ester (50).
  • Nonsteroidal antiinflammatory agents (NSAIDs), COX 2 inhibitorsNonsteroidal antiinflammatory agents (NSAIDs), COX 2 inhibitors: Based on a review, danshen root may have anti-inflammatory activity by possibly inhibiting the enzymatic activity of cyclooxygenase-2 (COX-2) (9; 10).
  • P-glycoprotein regulated drugsP-glycoprotein regulated drugs: Based on an animal study, tanshinone IIB extracted from danshen may be a substrate for p-glycoprotein (27).
  • PropranololPropranolol: In humans, liver antifibrotic effects of a combination of propranolol and danshen have been investigated (51).
  • SedativesSedatives: Based on in vitro and animal studies, miltirone, a tanshinone isolated from danshen, may have high potency as a sedative (24; 25).
  • SteroidsSteroids: Based on a study in children with primary nephritic syndrome, combined use of steroidal agents and danshen may decrease levels of serum endothelin and soluble interleukin-2 receptor (sIL-2R) to a greater extent than steroidal agents alone (22).

    • Danshen/Herb/Supplement Interactions:

  • AntibacterialsAntibacterials: Based on mouse study, danshen may have antiseptic properties (8).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Based on an animal study, prothrombin time and steady-state plasma concentrations of warfarin may increase when used concomitantly with danshen (31). In case reports, over-anticoagulation due to danshen use (32) and prolonged prothrombin time/international normalized ratio (INR) were reported (33).
  • Anti inflammatory herbsAnti inflammatory herbs: Based on a review, danshen root may have anti-inflammatory activity by possibly inhibiting the enzymatic activity of cyclooxygenase-2 (COX-2) (9; 10).
  • AntilipemicsAntilipemics: Based on human study, danshen in combination with a lipid-lowering agent may decrease total-, VLDL-, and LDL- cholesterol and triglycerides, and increase HDL-cholesterol (43; 44).
  • AntineoplasticsAntineoplastics: Based on in vitro study, danshen may have antineoplastic activity, including induction of apoptosis, (18) and growth inhibition (19; 17).
  • AntioxidantsAntioxidants: Based on in vitro and clinical studies, danshen may inhibit oxidation (11; 12; 13; 14; 15).
  • AntiviralsAntivirals: Based on in vitro study, danshen may have antiviral activity, especially against enterovirus (16).
  • AstragalusAstragalus: Based on human study, a combination of danshen and Astragalus membranaceus may improve liver fibrosis indices and portal hypertension (52), as well as vision and visual fields in glaucoma patients (53).
  • Cardiac glycosidesCardiac glycosides: Based on animal study, danshen may have positive inotropic effects (45). In addition, danshen use may falsely elevate serum digoxin levels (36; 37; 38).
  • Cardioactive herbsCardioactive herbs: Based on preliminary evidence in humans, danshen may have cardiovascular activity (46; 47; 9; 48).
  • Chronotropic herbsChronotropic herbs: Danshen may have negative chronotropic effects (45).
  • COX inhibitorsCOX inhibitors: Based on a review, danshen root may have anti-inflammatory activity by possibly inhibiting the enzymatic activity of cyclooxygenase-2 (COX-2) (9; 10).
  • Cytochrome P450 metabolized agentsCytochrome P450 metabolized agents: Based on animal studies, the ethyl acetate extract of danshen may induce CYP activity (49).
  • Drugs that affect GABADrugs that affect GABA: In vitro, miltirone, a tanshinone isolated from danshen, had high potency in the central benzodiazepine receptor binding assay (24).
  • Gexia zhuyu decoctionGexia zhuyu decoction: Based on human study, a combination of gexia zhuyu and danshen may have antifibrotic activity in the liver (3). This combination may also lower alanine transaminase, aspartate aminotransferase, and the liver fibrosis indices procollagen type III, collagen type IV, and hyaluronic acid.
  • Hydrophilic herbsHydrophilic herbs: Danshen may increase the effects of hydrophilic agents because danshen has been shown to contain hydrophilic compounds (54).
  • HypotensivesHypotensives: Based on an animal study, danshen may produce dose-dependent hypotension (35).
  • ImmunomodulatorsImmunomodulators: Based on preliminary human and animal evidence, danshen may have immunosuppressant activity (20; 21). However, in a clinical trial, danshen was associated with enhancement of cell-mediated immunity (30).
  • Inotropic herbsInotropic herbs: Danshen may have positive inotropic effects (45).
  • LicoriceLicorice: In humans, liver antifibrotic effects of a combination of diammonium glycyrrhizinate injection and danshen have been investigated (55).
  • Ligusticum chuanxiongLigusticum chuanxiong: Based on a clinical trial, a combination of danshen and Ligusticum chuanxiong rhizome may improve vision and visual fields in glaucoma patients (53).
  • Ligustrum lucidumLigustrum lucidum: Based on a clinical trial, a combination of danshen and Ligustrum lucidum fruit may improve vision and visual fields in glaucoma patients (53).
  • P-glycoprotein modulatorsP-glycoprotein modulators: Based on a study in rats, tanshinone IIB extracted from danshen may be a substrate for p-glycoprotein (27).
  • Polyporus umbellatusPolyporus umbellatus: Based on a clinical trial, danshen and Polyporus umbellatus may normalize ALT levels in patients with hepatitis B (2).
  • Salicylate containing herbsSalicylate containing herbs: Based on an animal study, prothrombin time and steady-state plasma concentrations of warfarin may increase when used concomitantly with danshen (31). In case reports, over-anticoagulation due to danshen use (32) and prolonged prothrombin time/international normalized ratio (INR) were reported (33).
  • SedativesSedatives: Based on in vitro and animal study, miltirone, a tanshinone isolated from danshen, may have high potency as a sedative (24; 25).
  • SerissaSerissa: In a case report, use of danshen with herba serissa caused complex neurological manifestations, primarily including convulsions, mental changes, and dystonia syndromes (39).
  • Sophora subprostrataSophora subprostrata: In three case reports, use of danshen with Sophora subprostrata root caused complex neurological manifestations, primarily including convulsions, mental changes, and dystonia syndromes (39).
  • SteroidsSteroids: Based on a study in children with primary nephritic syndrome, combined use of steroidal agents and danshen may decrease levels of serum endothelin and soluble interleukin-2 receptor (sIL-2R) to a greater extent than steroidal agents alone (22).
  • Yun zhiYun zhi: In humans, a combination of yun zhi and danshen offered immunological benefit in terms of enhancement of cell-mediated immunity (30).

    • Danshen/Food Interactions:

  • Insufficient available avoidance.

    • Danshen/Lab Interactions:

  • Alcohol levels (serum)Alcohol levels (serum): In animal studies, danshen and miltirone, a constituent of danshen, reduced alcohol levels in the blood (6; 7; 42).
  • Alkaline phosphatase (ALP)Alkaline phosphatase (ALP): In humans, danshen is associated with normalization of transaminases (2; 56).
  • Atrial natriuretic polypeptide (ANP)Atrial natriuretic polypeptide (ANP): In an animal study, danshen reduced levels of ANP (57).
  • Blood pressureBlood pressure: In an animal study, danshen produced dose-dependent hypotension in normotensive rats (35).
  • CD4 countCD4 count: Based on preliminary human and animal evidence, danshen may have immunosuppressant activity, including reduced T cell counts (20; 21). However, in a clinical trial, danshen was associated with enhancement of cell-mediated immunity, including higher T cell counts (30).
  • Chest X-ray (CXR)Chest X-ray (CXR): In humans, danshen improved CXR in patients with asthmatic bronchitis (58).
  • Coagulation panel (PT/INR)Coagulation panel (PT/INR): Based on an animal study, prothrombin time and steady-state plasma concentrations of warfarin may increase when used concomitantly with danshen (31). In case reports, over-anticoagulation due to danshen use (32) and prolonged prothrombin time/international normalized ratio (INR) were reported (33).
  • Creatine kinaseCreatine kinase: In humans, danshen use during anesthesia decreased plasma creatine kinase in children undergoing cardiopulmonary bypass for congenital heart defects (13).
  • Drug levels (CYP450 metabolized agents)Drug levels (CYP450 metabolized agents): In animal studies, the ethyl acetate extract of danshen induced CYP activity (49).
  • DigoxinDigoxin: Danshen use may falsely elevate serum digoxin levels (36; 37; 38).
  • Electrocardiogram (ECG)Electrocardiogram (ECG): In humans, ECG changes occur with danshen use (44).
  • InterleukinsInterleukins: In a mouse study, tanshinone pigments from danshen inhibited IL- production (21).
  • Intraocular pressure (IOP)Intraocular pressure (IOP): In humans, danshen reduced IOP in glaucoma patients (53).
  • Lactate dehydrogenase (LDH)Lactate dehydrogenase (LDH): Danshen has been associated with normalization of transaminases (2; 56).
  • Lipid profileLipid profile: Based on human study, danshen in combination with a lipid-lowering agent may decrease total-, VLDL-, and LDL- cholesterol and triglycerides, and increase HDL-cholesterol (43; 44). In a study in patients with ischemic infarction, danshen decreased levels of ApoB100 and increased levels of ApoA1 in serum (14).
  • Liver function testsLiver function tests: In human study, danshen reduced levels of aminotransferase (ALT) and aspartate aminotransferase (AST) (3). In humans, danshen is associated with normalization of transaminases (2; 56). In human studies, liver fibrosis indices have also improved (52; 3). In humans, danshen is associated with normalization of transaminases (2; 56).
  • Pulmonary function tests (PFTs)Pulmonary function tests (PFTs): In humans, danshen improved PFTs (58).