Drug & supplement interaction

Danshen + Diclofenac Potassium

Diclofenac Potassium brand names: Voltaren Rapide, Cataflam, Cataflam IR, Voltarol Rapid, Cambia.

Major Interaction
The bottom line Major

Diclofenac Potassium 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 Potassium

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 Potassium 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 Potassium

Diclofenac Potassium 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 keep in mind if you take diclofenac potassium (Cataflam, Voltaren Rapide) along with Danshen. Diclofenac is an NSAID, and like other anti-inflammatory pain relievers, it can already irritate the stomach lining and make it easier to bruise or bleed. Danshen appears to have its own blood-thinning, anti-clotting effect. Put the two together and you may nudge your bleeding risk higher than either one alone.

What might that look like? Things like stomach upset or pain, dark or tarry stools, unusual bruising, nosebleeds, or bleeding that's slow to stop. I'll be honest with you: this concern is mostly theoretical and based on animal data and case reports, not strong human studies. Still, since it's flagged as potentially serious, please check with your pharmacist or doctor before combining them.

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 Potassium 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 simple version. Your body clears diclofenac (Cataflam, Voltaren Rapide) mainly through a liver enzyme called CYP2C9. Lab studies suggest that compounds in Danshen can slow that same enzyme down. If that happens, diclofenac could clear more slowly and build up a bit, which may nudge up the usual side effects of this kind of pain reliever, like stomach upset, heartburn, ulcers or bleeding in the gut, and added strain on the kidneys or blood pressure.

Now the reassuring part. This is theoretical, based only on test-tube and animal data, and it hasn't actually been reported in people. Danshen may also affect clotting on its own, which matters with NSAIDs. I wouldn't panic, but please run this combination past 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

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 Potassium 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.

From our Q&A

Questions About Danshen or Diclofenac Potassium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Danshen or Diclofenac Potassium, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Diclofenac Potassium

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac Potassium page lists 306 supplements it has a documented interaction with, worst first, each one explained.

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

Open the Diclofenac Potassium 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 Potassium 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 Potassium 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

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

29 days ago today
Medication Diclofenac Potassium
Top half

#1,198 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
Medication

About Diclofenac

What Is Diclofenac Used For?

Brand names: Voltaren Rapide, Cataflam, Cataflam IR, Voltarol Rapid, Cambia

Diclofenac sodium topical gel is used to treat actinic keratoses (AK) — rough, scaly skin patches that form after years of sun exposure. These patches are considered precancerous, meaning they can develop into skin cancer if left untreated.

This is a topical gel, meaning it is applied directly to the skin over the affected area rather than taken by mouth. It belongs to the NSAID (nonsteroidal anti-inflammatory drug) family.

See full Diclofenac drug information
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

Keep exploring
Pharmacist Counseling Corner

Taking Danshen and Diclofenac Potassium Together: Common Questions

Can you take Danshen with Diclofenac Potassium?
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 Potassium?
Diclofenac Potassium 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 Potassium 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.