Drug & supplement interaction

Danshen + Treprostinil

Major Interaction
The bottom line Major

Treprostinil 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?
Know someone taking this? Share
Interaction report

Danshen and Treprostinil

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. Treprostinil 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 Treprostinil

Treprostinil 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 about combining Danshen with Treprostinil (Orenitram). Treprostinil is a prostacyclin medicine used for pulmonary arterial hypertension, and on top of relaxing blood vessels, it also acts on platelets and can slow down clotting on its own. Danshen has been reported to thin the blood too, so stacking the two together could nudge your bleeding risk higher.

What that might look like in real life is easier bruising, nosebleeds, bleeding gums, or cuts that take longer to stop. I'll be honest with you though, the evidence here is mostly theoretical and based on animal and case reports, so we don't know how strong it really is. Please don't start or stop anything on your own. Loop in your pharmacist or doctor first so they can keep an eye on you.

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

ANTIHYPERTENSIVE DRUGS

2 of 2

Treprostinil also falls under ANTIHYPERTENSIVE DRUGS.

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

Treprostinil (Orenitram) is a medicine that opens up blood vessels to ease the workload on your heart and lungs in pulmonary hypertension. One of its built-in side effects is lowering blood pressure, which can leave you feeling dizzy, lightheaded, flushed, or headachy. Danshen may also gently lower blood pressure on its own, based mostly on lab and animal studies.

So the concern here is simple: stacking the two together could push your blood pressure down a little more than expected. Keep in mind this is theoretical and comes from weak evidence, not human trials, so it may not be a big deal for everyone. Still, before adding Danshen, check with your pharmacist or doctor, and let them know if you feel faint or unusually woozy.

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.

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 Treprostinil 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 Treprostinil

This page covers Danshen only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Treprostinil page lists 291 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), Piracetam (major) and Tyramine (major).

By severity: 6 major · 258 moderate · 27 minor.

Open the Treprostinil 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 Treprostinil 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 Treprostinil 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

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

29 days ago today
Medication Treprostinil
Steady interest

#2,208 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 Treprostinil

What Is Treprostinil Used For?

Treprostinil treats pulmonary arterial hypertension (PAH; WHO Group 1) — high blood pressure in the arteries of the lungs. Depending on the product and route, it is used to improve exercise ability, delay disease progression, or reduce symptoms tied to physical activity. Remodulin and treprostinil injection products are also indicated for patients who need to transition away from another PAH medicine called epoprostenol.

Tyvaso, Tyvaso DPI, and Yutrepia (inhaled forms) are additionally approved to treat pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) — lung-pressure problems caused by scarring or inflammation in the lung tissue itself. Orenitram (extended-release oral tablet) is specifically indicated to delay disease progression and improve exercise capacity in PAH.

See full Treprostinil 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 Treprostinil Together: Common Questions

Can you take Danshen with Treprostinil?
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 Treprostinil?
Treprostinil 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 Treprostinil 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 Treprostinil and Danshen?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.