Drug & supplement interaction

Danshen + Ibuprofen, Acetaminophen

Ibuprofen, Acetaminophen brand name: Advil Dual Action.

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

Ibuprofen, Acetaminophen falls into 5 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
Interactions5
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Danshen and Ibuprofen, Acetaminophen

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

Danshen interacts with whole categories of medication. Ibuprofen, Acetaminophen falls into 5 of those categories, so it can interact with Danshen in 5 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 5

Why this applies to Ibuprofen, Acetaminophen

Ibuprofen, Acetaminophen 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 gist with Advil Dual Action, which combines ibuprofen and acetaminophen. The ibuprofen part is the piece to watch. Ibuprofen is an NSAID, and like other NSAIDs it can thin the blood a little and irritate the stomach lining. Danshen may also slow blood clotting, so pairing the two could stack those effects and raise your risk of bleeding or bruising. The acetaminophen half isn't really the concern here.

To be fair, this warning is mostly theoretical and built on animal studies and scattered reports, not strong human data. Still, watch for things like easy bruising, nosebleeds, black or tarry stools, or stomach pain. Please check with your pharmacist or doctor before combining them, and don't change anything on your own.

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 1A2 (CYP1A2) SUBSTRATES

2 of 5

Ibuprofen, Acetaminophen 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 gist with Advil Dual Action, which pairs ibuprofen and acetaminophen. In lab dishes, Danshen seems to slow down a liver enzyme called CYP1A2. If that happened in real life, drugs cleared by that enzyme could build up a bit, which in theory might mean slightly stronger effects or more side effects (think stomach upset or irritation from the ibuprofen side).

That said, I want to be honest about how thin this evidence is. It comes from test-tube and animal studies only, and when researchers tested it in actual people with another CYP1A2 drug, they did not see this effect. Neither ibuprofen nor acetaminophen is a prodrug, so nothing flips here. Still, since Danshen can affect bleeding and ibuprofen already nudges that risk, it's worth a quick chat with your pharmacist 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
  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 2C9 (CYP2C9) SUBSTRATES

3 of 5

Ibuprofen, Acetaminophen 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

Advil Dual Action combines two pain relievers, ibuprofen and acetaminophen. The ibuprofen part is partly cleared by a liver enzyme called CYP2C9. In test-tube studies, certain compounds in Danshen seem to slow that enzyme down. If that happened in your body, ibuprofen could build up a bit and its effects, both good and bad, could be stronger.

With ibuprofen, that might mean more stomach upset, heartburn, or a higher chance of stomach irritation, fluid retention, or kidney strain. There's also a separate worry: Danshen may thin the blood, and ibuprofen already nudges bleeding risk a little. That said, this is only lab evidence and hasn't been seen in real people. Still, it's worth running past 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
Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

4 of 5

Ibuprofen, Acetaminophen also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.

Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP2E1.
In vitro research shows that various constituents of danshen inhibit the activity of CYP2E1. 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 with Advil Dual Action (which combines ibuprofen and acetaminophen) and Danshen. In lab studies, certain compounds in Danshen appear to slow down a liver enzyme called CYP2E1. Acetaminophen is partly handled by this enzyme, so in theory Danshen could let a bit more acetaminophen linger in your system. That's the direction this interaction points, possibly a slightly stronger or longer effect rather than a weaker one.

I want to be honest about the strength here: this is theoretical, based only on test-tube and animal work, and it has never actually been reported in people. So I wouldn't lose sleep over it. Still, since both Danshen and ibuprofen can nudge bleeding risk, 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
Moderate

GLUCURONIDATED DRUGS

5 of 5

Ibuprofen, Acetaminophen 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 short version: Advil Dual Action is a combination of ibuprofen and acetaminophen, and your body partly clears acetaminophen by attaching a sugar molecule to it (a process called glucuronidation). Danshen, in lab and animal studies, seems to tug on that same pathway in both directions, sometimes speeding it up and sometimes slowing it down. So we honestly can't predict which way it would go in a real person.

The reassuring part: this is only a theoretical concern from test-tube and animal work, and it has never actually been reported in people. If anything tipped toward slower clearance, acetaminophen could in theory build up a bit, which matters most for your liver. To stay on the safe side, mention the Danshen to your pharmacist or doctor and don't exceed the labeled acetaminophen dose.

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 122 major, 936 moderate known drug interactions in our database — the Ibuprofen, Acetaminophen 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. Ibuprofen, Acetaminophen)
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 Ibuprofen, Acetaminophen

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ibuprofen, Acetaminophen page lists 342 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).

By severity: 7 major · 290 moderate · 45 minor.

From our pharmacist’s overview on the Ibuprofen, Acetaminophen page

“Advil Dual Action pairs ibuprofen, an NSAID with built-in stomach-bleeding risk, and acetaminophen, which the liver processes, so this interaction list deserves a careful read, not a skim. Most of the entries can add to bleeding risk, while smaller clusters put extra strain on the liver or kidneys.”

Reviewed by 2 · Jul 18, 2026

Open the Ibuprofen, Acetaminophen 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 Ibuprofen, Acetaminophen 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 Ibuprofen, Acetaminophen 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

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

29 days ago today
Medication Ibuprofen, Acetaminophen
Top 25%

#397 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 Ibuprofen, Acetaminophen, 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 Ibuprofen, Acetaminophen supplement interactions › Every supplement checked against Ibuprofen, Acetaminophen, 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 Ibuprofen, Acetaminophen Together: Common Questions

Can you take Danshen with Ibuprofen, Acetaminophen?
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 5 interactions listed for Danshen and Ibuprofen, Acetaminophen?
Ibuprofen, Acetaminophen 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 Ibuprofen, Acetaminophen 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 Ibuprofen, Acetaminophen 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.