Drug & supplement interaction

Danshen + Pitavastatin

Pitavastatin brand names: Zypitamag, Nikita.

Moderate Interaction
The bottom line Moderate

Pitavastatin falls into 2 drug categories that Danshen can interact with; the most serious is rated moderate. Theoretically, danshen may increase the levels and clinical effects of drugs metabolized by CYP2C9.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Danshen and Pitavastatin

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. Pitavastatin 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 (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 2

Why this applies to Pitavastatin

Pitavastatin falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Danshen interacts with.

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 with Danshen and pitavastatin. Pitavastatin is an active drug (not a prodrug), so anything that slows its breakdown can let more of it linger in your body. Danshen has shown, in test-tube studies, that it may block a liver enzyme called CYP2C9, which plays a small role in clearing pitavastatin. In theory, that could nudge your statin levels up and raise the odds of side effects like muscle aches, soreness, or weakness.

I want to be honest about the strength of this: it's based only on lab data and has never actually been reported in people, so this is more caution than alarm. Still, if you'd like to use Danshen, run it by your pharmacist or doctor first so they can keep an eye on you.

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

2 of 2

Pitavastatin 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 situation with Danshen and pitavastatin. Pitavastatin is unusual among statins because your body mostly clears it through a process called glucuronidation rather than the usual liver enzymes. Danshen, in lab studies, can tug on those glucuronidation enzymes in both directions, sometimes blocking them and sometwise speeding them up depending on how the root was processed. If it slowed pitavastatin's breakdown, the drug could build up and raise your odds of muscle aches or weakness. If it sped things up, your cholesterol numbers might not improve as well.

Honestly, this is all theoretical right now, seen only in test tubes and animals, never in real patients. So I wouldn't lose sleep over it. Still, since Danshen also thins the blood, please run it past your pharmacist or doctor before combining them.

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 Pitavastatin 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.

Everything else you take

See Every Supplement That Interacts With Pitavastatin

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pitavastatin page lists 126 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 Wine (major).

By severity: 5 major · 98 moderate · 23 minor.

From our pharmacist’s overview on the Pitavastatin page

“Liver strain runs through the serious end of pitavastatin's (Zypitamag, Nikita) supplement interactions, and this list deserves real care rather than a quick skim. The biggest cluster of worrisome entries is herbs and ingredients with their own record of liver injury, and alcohol belongs to that group too, with beer and wine both carry…”

Reviewed by 2 · Jul 18, 2026

Open the Pitavastatin 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 Pitavastatin 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 Pitavastatin 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

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

29 days ago today
Medication Pitavastatin
Steady interest

#2,243 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 Pitavastatin

What Is Pitavastatin Used For?

Brand names: Zypitamag, Nikita

Pitavastatin tablets are used alongside a cholesterol-lowering diet to reduce LDL-C (low-density lipoprotein, or "bad" cholesterol) in adults with primary hyperlipidemia (high cholesterol not caused by another disease).

Livalo, Pitavastatin Calcium (tablet), and some other pitavastatin tablet products are also approved for adults and children aged 8 years and older with heterozygous familial hypercholesterolemia (HeFH) — an inherited condition that causes very high LDL-C from birth. Zypitamag is labeled only for adults with primary hyperlipidemia; its labeling does not include the pediatric HeFH indication.

See full Pitavastatin 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.

123Major
935Moderate
0Minor
1,771No known 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
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

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Pharmacist Counseling Corner

Taking Danshen and Pitavastatin Together: Common Questions

Can you take Danshen with Pitavastatin?
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 2 interactions listed for Danshen and Pitavastatin?
Pitavastatin 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 Pitavastatin 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.