Drug & supplement interaction

Danshen + Diclofenac epolamine

Diclofenac epolamine brand names: Flector, Licart.

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

Diclofenac epolamine falls into 2 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
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Danshen and Diclofenac epolamine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Danshen interacts with whole categories of medication. Diclofenac epolamine falls into 2 of those categories, so it can interact with Danshen in 2 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 2

Why this applies to Diclofenac epolamine

Diclofenac epolamine 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

Here's the thing to know about pairing Danshen with Flector or Licart (diclofenac epolamine). Even though this is a patch you apply to your skin, diclofenac is an NSAID, and NSAIDs can nudge up your bleeding risk by affecting platelets and irritating the stomach lining. Danshen, on its own, may also thin the blood a bit. Stack the two, and you could in theory bruise more easily, bleed longer from a cut, or have a higher chance of a stomach bleed.

I want to be honest about the evidence here: this is mostly theoretical, built on animal studies and case reports, not solid human trials. A topical patch delivers far less drug than pills, so the real-world risk is likely smaller. Still, please check with your pharmacist or doctor before combining them, especially if you take other blood thinners.

Contact Dr. Brian directly if you have additional questions on this interaction
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 2C9 (CYP2C9) SUBSTRATES

2 of 2

Diclofenac epolamine also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP2C9.
In vitro research shows that various constituents of danshen inhibit the activity of CYP2C9. 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 gist for the Flector or Licart patch. Diclofenac is an NSAID, and your body relies on a liver enzyme called CYP2C9 to help clear it. In lab tests, certain compounds in danshen slow that enzyme down. If that happened in real life, your diclofenac could build up a little more than expected, which might mean stronger effects and more of the usual NSAID side effects, like stomach upset, heartburn, or in some cases higher blood pressure or fluid retention.

I want to be honest about how soft this evidence is: it comes from test-tube studies only, and this interaction has not actually been reported in people. The patch also delivers less drug into your blood than the pills do, which lowers the worry further. Danshen on its own may also affect bleeding, so it's worth a quick chat with your pharmacist or doctor before combining them.

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

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 Diclofenac epolamine one above is among them. If you take anything else, check it against the full list below.

Major 122 Moderate 936 No known interaction 1,772 (incl. Diclofenac epolamine)
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 Diclofenac epolamine

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac epolamine page lists 292 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Asarabacca (major), Beer (major), Piracetam (major), Siberian Cocklebur (major) and Wine (major).

By severity: 6 major · 259 moderate · 27 minor.

From our pharmacist’s overview on the Diclofenac epolamine page

“Even as a patch, diclofenac epolamine (Flector, Licart) is still an NSAID that reaches the bloodstream, and its 292 supplement interactions call for genuine care, six of them rated major. The bulk of the list, 202 ingredients, thins the blood or slows clotting, which stacks onto an NSAID's built-in bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Diclofenac epolamine 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 Diclofenac epolamine 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 Diclofenac epolamine 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

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

29 days ago today
Medication Diclofenac epolamine
Top 25%

#564 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
122 Major 936 Moderate 1,771 No 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

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 Diclofenac epolamine, 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 Diclofenac epolamine supplement interactions › Every supplement checked against Diclofenac epolamine, 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 Diclofenac epolamine Together: Common Questions

Can you take Danshen with Diclofenac epolamine?
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 2 interactions listed for Danshen and Diclofenac epolamine?
Diclofenac epolamine 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 Diclofenac epolamine 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

Still Have a Question About Diclofenac epolamine 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.