Danshen - Akynzeo (Netupitant, Palonosetron (Oral)) Interaction
Herbal: Danshen
Also Known As: Salvia bowleyana, Ch'ih Shen, Chinese Red Sage, Chinese Sage, Chinese Salvia, Dan Shen, Dan-Shen, Huang Ken, Racine de Salvia, Red Root Sage, Red Rooted Sage, Red Sage, Salvia Przewalskii Mandarinorum, Salvia Root, Shu-Wei Ts'ao, Tan Seng, Tan-Shen, Tzu Tan-Ken
Drug: Netupitant, Palonosetron (Oral)
Brand names:
Akynzeo
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Netupitant, Palonosetron (Oral) is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Danshen might alter the levels and clinical effects of drugs metabolized by CYP3A4.
Preliminary clinical research in healthy males shows that the administration of danshen for 10-14 days induces intestinal CYP3A4 and increases the clearance of midazolam, a CYP3A4 substrate. The maximum concentration of midazolam was decreased by 31% to 67%, and drug levels were decreased by 27% to 80%. However, a single dose of danshen has the opposite effect, increasing maximum concentrations of midazolam by 87%.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Qiu F, Wang G, Zhang R, Sun J, et al. Effect of danshen extract on the activity of CYP3A4 in healthy volunteers. Br J Clin Pharmacol 2010;69:656-62.
- Qiu F, Jiang J, Ma Y, Wang G, Gao C, Zhang X, Zhang L, Liu S, He M, Zhu L, Ye Y, Li Q, Miao P. Opposite Effects of Single-Dose and Multidose Administration of the Ethanol Extract of Danshen on CYP3A in Healthy Volunteers. Evid Based Complement Alternat Me
Danshen Overview
Danshen, also known as Salvia miltiorrhiza, is a herb native to China and other parts of Asia. It is a member of the mint family and has been used for centuries in traditional Chinese medicine based on its purported anti-inflammatory and blood-thinning properties. It has historically been used to treat cardiovascular diseases, such as angina, and improve circulation. It has also been used to treat anxiety and stress, as it is thought to have calming and relaxing effects. The root of Danshen is what is utilized in dietary supplements.
Netupitant, Palonosetron (Oral) Overview
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The combination of netupitant and palonosetron is used to prevent nausea and vomiting caused by cancer chemotherapy. Netupitant is in a class of medications called neurokinin (NK1) antagonists. It works by blocking neurokinin, a natural substance in the brain that causes nausea and vomiting. Palonosetron is in a class of medications called 5-HT3 receptor antagonists. It works by blocking serotonin, a natural substance in the body that causes nausea and vomiting.
Danshen - More Interactions
Danshen interacts with 1011 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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