Drug & supplement interaction

Danshen + Perindopril Arginine, Amlodipine

Perindopril Arginine, Amlodipine brand name: Prestalia.

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

Perindopril Arginine, Amlodipine falls into 3 drug categories that Danshen can interact with; the most serious is rated moderate. Theoretically, taking danshen with antihypertensive drugs might increase the risk of hypotension.

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

Danshen and Perindopril Arginine, Amlodipine

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. Perindopril Arginine, Amlodipine 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

ANTIHYPERTENSIVE DRUGS

1 of 3

Why this applies to Perindopril Arginine, Amlodipine

Perindopril Arginine, Amlodipine falls under ANTIHYPERTENSIVE DRUGS — the group Danshen interacts with.

Theoretically, taking danshen with antihypertensive drugs might increase the risk of hypotension.
Animal research suggests that danshen can produce dose-dependent hypotensive effects. Furthermore, concomitant use with captopril appears to potentiate this effect.
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

Prestalia is a two-in-one blood pressure pill: perindopril (an ACE inhibitor) paired with amlodipine (a calcium channel blocker). Both already work to relax your blood vessels and lower your blood pressure. Danshen has shown its own blood-pressure-lowering effects in lab and animal studies, so stacking it on top could theoretically push your numbers down too far.

If that happened, you might feel dizzy, lightheaded, tired, or even faint, especially when standing up quickly. Keep in mind this concern comes from animal research only, not solid human studies, so it's more of a caution than a proven problem. Still, since you're already on two blood pressure medicines, please check with your pharmacist or doctor before adding Danshen.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Li CP, Yung KH, and Chiu KW. Hypotensive action of Salvia miltiorrhiza cell culture extract. American Journal of Chinese Medicine 1990;18(3-4):157-166.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Perindopril Arginine, Amlodipine 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 piece that matters with Prestalia: the amlodipine half is cleared by an enzyme called CYP3A4, and Danshen seems to nudge that enzyme. When taken regularly for a week or two, Danshen tends to speed up CYP3A4, which could lower amlodipine levels and make it work less well. That might show up as your blood pressure creeping back up. Oddly, a single dose of Danshen can do the reverse and raise levels briefly, which could mean more dizziness, flushing, or ankle swelling.

This is based on small studies using a different test drug, so it's only a possible effect, not a sure thing. Danshen can also thin the blood. Please check with your pharmacist or doctor before pairing the two, and don't change your medicine on your own.

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

AMLODIPINE (Norvasc)

3 of 3
Theoretically, taking danshen in combination with amlodipine may decrease the clinical effects of amlodipine.
In animal research, taking danshen orally in combination with amlodipine reduced blood levels of amlodipine by about 52%. This may have been due to induction of cytochrome P450 3A4 (CYP3A4) by danshen, which has been demonstrated in vitro. 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

Prestalia combines two blood pressure medicines: perindopril and amlodipine. The concern here is mostly with the amlodipine half. Your liver clears amlodipine using an enzyme called CYP3A4, and lab and animal studies suggest danshen may speed that enzyme up. In one animal study, danshen dropped amlodipine blood levels by about half. If that happened in people, amlodipine could become less effective, meaning your blood pressure might not be controlled as well as it should be.

Keep in mind this is theoretical, based on lab and animal work, and has not actually been reported in humans. Still, since good blood pressure control matters, I'd check with your pharmacist or doctor before pairing danshen with Prestalia rather than guessing.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhang H, Han X, Li Y, Li H, Guo X. Effects of danshen tablets on pharmacokinetics of amlodipine in rats. Pharm Biol. 2019;57(1):306-309. 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 123 major, 935 moderate known drug interactions in our database — the Perindopril Arginine, Amlodipine 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. Perindopril Arginine, Amlodipine)
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 Perindopril Arginine, Amlodipine

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Perindopril Arginine, Amlodipine page lists 243 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Coleus (major).

By severity: 9 major · 189 moderate · 45 minor.

From our pharmacist’s overview on the Perindopril Arginine, Amlodipine page

“People taking Prestalia (perindopril arginine with amlodipine) for blood pressure are often the same people reaching for heart-healthy supplements, and this particular list calls for genuine care. Of the 243 ingredients on file, 9 carry a major rating, and those deserve attention first.”

Reviewed by 2 · Jul 18, 2026

Open the Perindopril Arginine, Amlodipine 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 Perindopril Arginine, Amlodipine 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 Perindopril Arginine, Amlodipine 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

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

29 days ago today
Medication Perindopril Arginine, Amlodipine
Top 10%

#221 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 Perindopril Arginine, Amlodipine, 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 Perindopril Arginine, Amlodipine supplement interactions › Every supplement checked against Perindopril Arginine, Amlodipine, 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 Perindopril Arginine, Amlodipine Together: Common Questions

Can you take Danshen with Perindopril Arginine, Amlodipine?
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 Perindopril Arginine, Amlodipine?
Perindopril Arginine, Amlodipine 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 Perindopril Arginine, Amlodipine 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

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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.