Drug & supplement interaction

Danshen + Aspirin, Caffeine, Hydrocodone

Aspirin, Caffeine, Hydrocodone brand name: Damason-P.

Major Interaction
The bottom line Major

Aspirin, Caffeine, Hydrocodone falls into 4 drug categories that Danshen can interact with; the most serious is rated major. Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Danshen and Aspirin, Caffeine, Hydrocodone

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Danshen interacts with whole categories of medication. Aspirin, Caffeine, Hydrocodone falls into 4 of those categories, so it can interact with Danshen in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 4

Why this applies to Aspirin, Caffeine, Hydrocodone

Aspirin, Caffeine, Hydrocodone falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Danshen interacts with.

Theoretically, danshen may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Danshen has been reported to have antithrombotic effects. Animal research also suggests that taking a danshen combination formula with clopidogrel exhibits a synergistic increase in antiplatelet aggregation and prolongation of coagulation time when compared with either taken alone.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

The piece of this combo pill that matters here is the aspirin. Aspirin already thins your blood by making platelets less sticky, which is why it can cause bruising, nosebleeds, or stomach irritation and bleeding. Danshen seems to work in a similar direction, nudging your blood toward clotting more slowly. Put the two together and you could tip the balance toward easier bleeding.

To be fair, this concern is mostly theoretical and rests on animal studies and scattered case reports, not solid human trials. Still, because the potential outcome (bleeding) is serious, it's worth respecting. Watch for unusual bruising, bleeding gums, dark or bloody stools, or cuts that won't stop. Please check with your pharmacist or doctor before pairing Danshen with this medicine rather than changing anything on your own.

References
  1. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  2. Yin QS, Chen L, Mi RH, Ai H, Yin JJ, Liu XJ, Wei XD. Efficacy and safety of danshen compound tablets in preventing thalidomide-associated thromboembolism in patients with multiple myeloma: a multicenter retrospective study. Med Sci Monit. 2016 Oct 20;22:3 PubMed
  3. Zheng D, Zhang W, Hou M, et al. Evaluation of herb-drug interactions between compound Danshen dripping pills and clopidogrel based on the pharmacokinetics and pharmacodynamics in rats. Biomed Chromatogr. 2023;37(9):e5684. PubMed
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 4

Aspirin, Caffeine, Hydrocodone also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research shows that danshen tincture and various constituents of danshen inhibit the activity of CYP1A2. However, this activity has not been shown in humans when theophylline, a CYP1A2 substrate, was used as a target drug.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the piece of your combo product (Damason-P) that this note is really about: the caffeine. Caffeine is cleared by a liver enzyme called CYP1A2, and lab studies suggest Danshen can slow that enzyme down. In theory, that could let caffeine linger longer in your system, so you might feel jittery, have a racing heart, or trouble sleeping. None of these ingredients are prodrugs that Danshen would weaken.

I'll be honest with you though: this is only based on test-tube research, and when scientists tested it in actual people, they did not see a real effect. So this is more theoretical than proven. A bigger reason to be cautious is that both Danshen and the aspirin here can thin the blood, raising bruising or bleeding risk. Please run this combination by your pharmacist or doctor first.

References
  1. Wang X, Cheung CM, Lee WY, Or PM, Yeung JH. Major tanshinones of Danshen (Salvia miltiorrhiza) exhibit different modes of inhibition on human CYP1A2, CYP2C9, CYP2E1 and CYP3A4 activities in vitro. Phytomedicine. 2010 Sep;17(11):868-75. PubMed
  2. Wang X, Yeung JH. Investigation of cytochrome P450 1A2 and 3A inhibitory properties of Danshen tincture. Phytomedicine. 2012 Feb 15;19(3-4):348-54. PubMed
  3. Zhou X, Chan K, Yeung JH. Herb-drug interactions with Danshen (Salvia miltiorrhiza): a review on the role of cytochrome P450 enzymes. Drug Metabol Drug Interact. 2012 Mar 2;27(1):9-18.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 4

Aspirin, Caffeine, Hydrocodone also falls under 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%.
Severity Moderate Likelihood Possible Evidence B

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

This combo medicine pairs aspirin and caffeine with hydrocodone, a narcotic pain reliever. Hydrocodone is partly processed by a liver and gut enzyme called CYP3A4, and the research on Danshen here is a little tricky. Taking Danshen daily for a week or two seems to speed up CYP3A4, which could clear hydrocodone faster and leave you with weaker pain relief. But a single dose of Danshen did the opposite, raising drug levels, which could mean more drowsiness, constipation, or slowed breathing.

Because the direction can flip and the evidence is still early, this is hard to predict. Please check with your pharmacist or doctor before mixing the two, and don't change anything on your own.

References
  1. 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. PubMed
  2. 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 PubMed
Moderate

ASPIRIN

4 of 4
Theoretically, danshen may increase the levels of aspirin and the risk of bleeding.
Research in healthy adult males shows that taking a combination of danshen and kudzu with aspirin increases plasma aspirin area under the curve by approximately 3.4-fold. Animal research also shows that taking a combination of danshen and kudzu (danshen-gegen formula) with aspirin increases maximal blood levels of aspirin and salicylic acid by approximately 4-fold and 3.7-fold, respectively, without impacting blood loss. Taking danshen increases the antiplatelet activity of aspirin and might increase the side effects of aspirin.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Your medicine (brand name Damason-P) combines aspirin, caffeine, and hydrocodone. The piece that matters here is the aspirin. Danshen seems to do two things: it can raise the amount of aspirin in your blood (one study in healthy men saw aspirin levels go up about 3 times higher), and on its own danshen can thin the blood a bit too. Stacked together, that means a higher chance of bleeding problems.

In real life, watch for things like easy bruising, nosebleeds, stomach upset or stomach bleeding, or dark, tarry stools. The evidence is a mix of one small human study and animal work, so it is not ironclad, but it is reasonable enough that I would not combine these without checking first. Please talk with your pharmacist or doctor before using danshen with this medicine.

References
  1. Zhou L, Wang S, Zhang Z, Lau BS, Fung KP, Leung PC, Zuo Z. Pharmacokinetic and pharmacodynamic interaction of Danshen-Gegen extract with warfarin and aspirin. J Ethnopharmacol. 2012 Sep 28;143(2):648-55. PubMed
  2. Zhang Y, Yang M, Ho NJ, et al. Is it safe to take Radix Salvia Miltiorrhiza - Radix Pueraria Lobate product with warfarin and aspirin? A pilot study in healthy human subjects. J Ethnopharmacol. 2020 Nov 15;262:113151. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Danshen Also Interacts With Other Medications

Danshen has 122 major, 936 moderate known drug interactions in our database — the Aspirin, Caffeine, Hydrocodone one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Danshen

Covers the 2,830 medications we’ve checked against Danshen. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Aspirin, Caffeine, Hydrocodone

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Caffeine, Hydrocodone page lists 398 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Ephedra (major).

By severity: 17 major · 334 moderate · 47 minor.

From our pharmacist’s overview on the Aspirin, Caffeine, Hydrocodone page

“Damason-P packs three drugs into one tablet, the opioid hydrocodone, aspirin, and caffeine, so a supplement can collide with any one of them, and its list of 398 interacting ingredients earns real respect. More than 200 of those can add to aspirin's bleeding risk, while 78 can deepen the opioid's sedation.”

Reviewed by 2 · Jul 18, 2026

Open the Aspirin, Caffeine, Hydrocodone interaction page

One more smart check

Taking Danshen as Part of a Dietary Supplement Product? Check It for Interactions

We hold 18 real supplement products containing Danshen, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Danshen. Your product may carry other ingredients that interact with Aspirin, Caffeine, Hydrocodone too, on top of Danshen — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Danshen and Aspirin, Caffeine, Hydrocodone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Danshen
Top half

#624 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Aspirin, Caffeine, Hydrocodone
Top 5%

#101 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Danshen

What is Danshen?

Danshen
  • Heart and circulation support
  • Angina (chest pain)
  • High blood pressure
  • Anxiety and stress
  • Liver health

Danshen is a root used in traditional Chinese medicine, mainly for heart and circulation problems. Some early research is promising, but the evidence is not strong enough to confirm it works for any condition, and it may affect blood clotting. Talk to a pharmacist or doctor before using it, especially if you take other medicines or have a health condition.

Read the full Danshen monograph & all interactions
Keep checking

Other Drugs & Danshen

Browse every other medication we’ve checked against Danshen — both the ones with a known interaction and the ones without. Select any drug for the full detail.

122Major
936Moderate
0Minor
1,771No known interaction
Major

122 interactions

Showing 60 of 122 major interactions — see all 122 on the Danshen page.

Moderate

936 interactions

Showing 60 of 936 moderate interactions — see all 936 on the Danshen page.

No interaction 1,771 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Danshen and Aspirin, Caffeine, Hydrocodone Together: Common Questions

Can you take Danshen with Aspirin, Caffeine, Hydrocodone?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 4 interactions listed for Danshen and Aspirin, Caffeine, Hydrocodone?
Aspirin, Caffeine, Hydrocodone belongs to more than one drug category, and Danshen interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Danshen and Aspirin, Caffeine, Hydrocodone interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.