Drug & supplement interaction

Danshen + Conjugated Estrogens, Methyltestosterone

Conjugated Estrogens, Methyltestosterone brand name: Premarin with Methyltestosterone.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Conjugated Estrogens, Methyltestosterone falls into 3 drug categories that Danshen can interact with; the most serious is rated moderate. Danshen might alter the levels of drugs cleared by p-glycoprotein.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Danshen and Conjugated Estrogens, Methyltestosterone

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Danshen interacts with whole categories of medication. Conjugated Estrogens, Methyltestosterone falls into 3 of those categories, so it can interact with Danshen in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 3

Why this applies to Conjugated Estrogens, Methyltestosterone

Conjugated Estrogens, Methyltestosterone falls under P-GLYCOPROTEIN SUBSTRATES — the group Danshen interacts with.

Danshen might alter the levels of drugs cleared by p-glycoprotein.
Pharmacokinetic research in healthy volunteers suggests that danshen might affect p-glycoprotein activity. Taking danshen extract 1 gram three times daily for 10 days prior to receiving fexofenadine 60 mg increases peak levels of fexofenadine, a p-glycoprotein substrate, by 27.4% and area under the curve (AUC) by 37.2%.
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

Here's the gist of why this combo gets a second look. Danshen seems to slow down a transporter in your body called p-glycoprotein, which helps move certain drugs out. In one small study, blocking it nudged drug levels up by around 30 to 40 percent. The hormones in Premarin with Methyltestosterone aren't prodrugs, so if Danshen raises how much hangs around, you'd simply see more of their usual effects.

In real life that might mean more breast tenderness, bloating, nausea, mood shifts, or acne and oily skin from the testosterone part. The evidence here is modest, and food-level amounts in cooking are unlikely to matter much more than concentrated supplement doses. Still, please run it by your pharmacist or doctor before mixing the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Qiu F, Zeng J, Liu S, He M, Zhu L, Ye Y, Miao P, Shen S, Jiang J. Effects of danshen ethanol extract on the pharmacokinetics of fexofenadine in healthy volunteers. Evid Based Complement Alternat Med. 2014;2014:473213. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Conjugated Estrogens, Methyltestosterone 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

Here's the gist for your Premarin with Methyltestosterone. Both the estrogen and the testosterone parts get processed by a liver and gut enzyme called CYP3A4, and Danshen seems to nudge that enzyme in different directions depending on how it's taken. In one small study, taking Danshen steadily for about 10 to 14 days sped up this enzyme, which could mean your body clears the hormones faster and you get a weaker effect (think return of hot flashes, night sweats, or less symptom relief). Oddly, a single dose did the opposite and pushed levels up.

This is based on limited research using a different drug, so it's more of a heads-up than a red alert. Before mixing the two, please run it by your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
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

GLUCURONIDATED DRUGS

3 of 3

Conjugated Estrogens, Methyltestosterone also falls under GLUCURONIDATED DRUGS.

Theoretically, danshen might affect the levels and clinical effects of drugs requiring glucuronidation.
In vitro research shows that danshen induces the expression of glucuronosyltransferases. However, it also inhibits the activity of glucuronosyltransferases, including various members of the 1A and 2B families. The extent of inhibition of a specific glucuronosyltransferase seems to be dependent on whether or not the danshen is processed via 'sweating'. This type of processing may affect the levels of constituents in danshen that alter glucuronosyltransferase activity. So far, this interaction has not been reported in humans.
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 quick version for Premarin with Methyltestosterone. Your body partly clears estrogens through a process called glucuronidation, basically tagging the hormone so it can be removed. In lab dishes, Danshen seems to pull in two directions on the enzymes that do this tagging: sometimes speeding them up, sometimes slowing them down, depending on how the root was processed. So we can't even predict which way your estrogen levels might shift.

The big caveat: this has only been seen in test tubes and animals, never reported in real people, so it's mostly theoretical. Still, if Danshen did nudge your hormone levels, you might notice more estrogen-type effects (breast tenderness, nausea, fluid retention) or less benefit. Danshen can also thin the blood. Please run it by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Liu J, Shi Y, Wu C, et al. Comparison of sweated and non-sweated ethanol extracts of Salvia miltiorrhiza Bge. (Danshen) effects on human and rat hepatic UDP-glucuronosyltransferase and preclinic herb-drug interaction potential evaluation. Curr Drug Metab

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 123 major, 935 moderate known drug interactions in our database — the Conjugated Estrogens, Methyltestosterone one above is among them. If you take anything else, check it against the full list below.

Major 123 Moderate 935 No known interaction 1,772 (incl. Conjugated Estrogens, Methyltestosterone)
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 Conjugated Estrogens, Methyltestosterone

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Conjugated Estrogens, Methyltestosterone page lists 226 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 184 moderate · 36 minor.

From our pharmacist’s overview on the Conjugated Estrogens, Methyltestosterone page

“If you take conjugated estrogens with methyltestosterone (Premarin with Methyltestosterone), a hormone combination used for menopausal symptoms, read the six major-rated entries here before adding any supplement. Most of the 226 ingredients on file change how your body handles the hormones themselves.”

Reviewed by 2 · Jul 18, 2026

Open the Conjugated Estrogens, Methyltestosterone 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 Conjugated Estrogens, Methyltestosterone 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 Conjugated Estrogens, Methyltestosterone 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

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

29 days ago today
Medication Conjugated Estrogens, Methyltestosterone
Top half

#1,007 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.

123Major
935Moderate
0Minor
1,771No known interaction
123 Major 935 Moderate 1,771 No interaction
Major

123 interactions

Showing 60 of 123 major interactions — see all 123 on the Danshen page.

Moderate

935 interactions

Showing 60 of 935 moderate interactions — see all 935 on the Danshen page.

No interaction 1,771 drugs checked — show the list

We also checked Danshen against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,771 medications checked with no known interaction — see the full Danshen list.

See the full Danshen interactions page
See every supplement checked against Conjugated Estrogens, Methyltestosterone, ranked by severity
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

Keep exploring
Danshen monograph › Uses, safety, and every drug interaction in one place Conjugated Estrogens, Methyltestosterone supplement interactions › Every supplement checked against Conjugated Estrogens, Methyltestosterone, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Danshen and Conjugated Estrogens, Methyltestosterone Together: Common Questions

Can you take Danshen with Conjugated Estrogens, Methyltestosterone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Danshen and Conjugated Estrogens, Methyltestosterone?
Conjugated Estrogens, Methyltestosterone 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 Conjugated Estrogens, Methyltestosterone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Conjugated Estrogens, Methyltestosterone and Danshen?

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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.