Mesalamine Rectal and Tan-Shen: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mesalamine Rectal
Tan-Shen
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased free salicylate serum concentration and decreased tan-shen (Danshen) concentration
Interaction Deep Dive
In vitro data suggests that the concurrent presence of tan-shen (Danshen) and salicylate in serum increased the free serum concentration of salicylate and decreased the concentration of Danshen1. Until human bioavailability studies are performed, caution is advised when using these two substances concomitantly.
Why it happens (mechanism)
Displacement of salicylate from protein binding sites by tan-shen (Danshen)
Literature reports
1 report — tap to read
a) The simultaneous presence of both Danshen and salicylate in serum samples (in vitro) increased free salicylate and decreased Danshen concentrations. When concentrations of salicylate were sub-therapeutic (less than 150 micrograms/milliliter (mcg/ml)), no significant changes were noted in the Danshen components. However, once therapeutic concentrations of salicylate (greater than 150 mcg/ml) were introduced, significant reductions in Danshen free activity was noted (p less than 0.05). Concentrations of free salicylate increased from 43.2 mcg/ml (control) to 68.6 mcg/ml when Danshen extract was added 1.
Common questions
Can I take Mesalamine Rectal and Tan-Shen together?
Increased free salicylate serum concentration and decreased tan-shen (Danshen) concentration Always confirm with your pharmacist or prescriber before making any change.
How serious is the Mesalamine Rectal and Tan-Shen interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Mesalamine Rectal or Tan-Shen need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Gupta D, Jalali M, Wells A, et al: Drug-herb interactions: unexpected suppression of free Danshen concentrations by salicylate. J Clin Lab Anal 2002; 16(6):290-4. PubMed
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