Herb & supplement monograph

Danshen Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Danshen interacts with medications. The heart of this page is the interaction list — every drug Danshen is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Danshen is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Danshen Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Danshen drug interaction is moderate for most people, and higher for anyone taking blood thinners or certain heart medicines. None of the listed interactions are minor; all are rated moderate or major, and the best-documented ones involve bleeding risk and changes in how the body clears medications.

Interactions deserving the most attention

The biggest concern is with anticoagulant and antiplatelet drugs, since danshen itself can slow clotting and may add to their effect. With warfarin, there are several case reports of blood becoming too thin within days of starting danshen, although one clinical trial found no change, so the evidence is mixed. A human study also found danshen raised aspirin levels more than threefold. Danshen is chemically similar to digoxin, so combining them may raise the risk of side effects from that heart medicine.

What the rest of the list means

Much of the rest of this long list comes from lab or animal research suggesting danshen may affect enzymes and transporters the body uses to process many medications. These effects are largely theoretical, and at least one predicted enzyme effect did not show up when tested in people. Human studies do show danshen can meaningfully raise or lower levels of a few specific drugs, so the list is worth taking seriously without assuming every combination is harmful.

Check your medications against Danshen

Based on HelloPharmacist’s Danshen interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Danshen

1060 medications have a known interaction with Danshen, graded by severity. Select any drug for the full evidence-based detail.

123 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Danshen.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Danshen using our pharmacist-reviewed interaction data.

AI summaries are generated from our Danshen interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. 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.
Possible. 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
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Danshen combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Danshen affects

Every type of medication (drug category) Danshen is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 16 drug categories Danshen interacts with

Anticoagulant/antiplatelet DrugsDigoxin (lanoxin)Amlodipine (norvasc)Antihypertensive DrugsAspirinClopidogrel (plavix)Cytochrome P450 1a2 (cyp1a2) SubstratesCytochrome P450 2c9 (cyp2c9) SubstratesCytochrome P450 2e1 (cyp2e1) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesFexofenadine (allegra)Glucuronidated DrugsMidazolam (versed)P-glycoprotein SubstratesRosuvastatin (crestor)Warfarin (coumadin)

Anticoagulant/Antiplatelet Drugs

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.

Likelihood Probable Evidence D

Digoxin (Lanoxin)

Theoretically, using danshen with digoxin might increase the risk of adverse effects.
Danshen has structural and pharmacological similarities to cardiac glycosides.

Likelihood Probable Evidence D

Amlodipine (Norvasc)

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.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

Aspirin

Theoretically, danshen may increase the levels of aspirin and the risk of bleeding.
Research in healthy adult males shows that taking a combination of danshen and kudzu with aspirin increases plasma aspirin area under the curve by approximately 3.4-fold. Animal research also shows that taking a combination of danshen and kudzu (danshen-gegen formula) with aspirin increases maximal blood levels of aspirin and salicylic acid by approximately 4-fold and 3.7-fold, respectively, without impacting blood loss. Taking danshen increases the antiplatelet activity of aspirin and might increase the side effects of aspirin.

Likelihood Probable Evidence B

Clopidogrel (Plavix)

Theoretically, danshen may increase the risk of bleeding if taken with clopidogrel.
Clopidogrel is an antiplatelet prodrug that is metabolized by carboxyl esterase 1 (CES1) to an inactive metabolite. Animal research shows that a danshen combination formula decreases the activity of CES1, decreasing levels of the inactive metabolite in the blood and possibly increasing levels of the active metabolite. 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.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

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.

Likelihood Possible Evidence D

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%.

Likelihood Possible Evidence B

Fexofenadine (Allegra)

Danshen might increase the levels and clinical effects of fexofenadine.
Pharmacokinetic research in healthy volunteers shows that taking danshen extract 1 gram three times daily for 10 days prior to receiving fexofenadine 60 mg increases peak levels of fexofenadine, a p-glycoprotein substrate, by 27.4% and area under the curve (AUC) by 37.2%.

Likelihood Probable Evidence B

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.

Likelihood Possible Evidence D

Midazolam (Versed)

Danshen might alter the levels and clinical effects of midazolam.
Preliminary clinical research in healthy males shows that the administration of danshen for 10-14 days induces intestinal CYP3A4 and increases midazolam clearance. The maximum concentration 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%.

Likelihood Probable Evidence B

P-Glycoprotein Substrates

Danshen might alter the levels of drugs cleared by p-glycoprotein.
Pharmacokinetic research in healthy volunteers suggests that danshen might affect p-glycoprotein activity. Taking danshen extract 1 gram three times daily for 10 days prior to receiving fexofenadine 60 mg increases peak levels of fexofenadine, a p-glycoprotein substrate, by 27.4% and area under the curve (AUC) by 37.2%.

Likelihood Possible Evidence B

Rosuvastatin (Crestor)

Theoretically, danshen might increase the levels and clinical effects of rosuvastatin.
Animal research shows that a single dose of danshen increases levels of rosuvastatin at least 2-fold, possibly by increasing absorption and/or decreasing elimination. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D

Warfarin (Coumadin)

Theoretically, danshen may increase the risk of bleeding if used with warfarin.
There have been several case reports of increased international normalized ratio (INR) after concomitant use of danshen and warfarin. Elevations in INR have occurred as early as 3-5 days after start of danshen. However, a clinical trial in adults taking warfarin with stable INR found that the addition of compound danshen dripping pills, containing danshen extract, Panax notoginseng, and borneol, 270 mg three times daily for 4 weeks did not alter INR levels or the average required warfarin dose when compared to baseline. These findings are consistent with animal research, which found no change in warfarin pharmacokinetics with the use of danshen. Other research in healthy adult males also shows that taking a combination of danshen and kudzu with warfarin does not increases plasma warfarin area under the curve, but may reduce plasma soluble thrombomodulin levels. However, other research shows that danshen might increase the rate of absorption and decrease the elimination rate of warfarin. Also, research in healthy adult males shows that taking a combination of danshen and kudzu with warfarin increases plasma area under the curve of danshensu, a constituent of danshen, by approximately 29.5-fold. Danshen should be used cautiously in patients taking warfarin.

Likelihood Possible Evidence B

Monograph

Danshen: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

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.

Scientific name: Salvia miltiorrhiza
Family: Lamiaceae
Part used: Root
Common forms: Capsules, tablets, dried root, teas, tinctures, and injectable forms used in some Asian countries

People commonly use it for

Heart and circulation support
Angina (chest pain)
High blood pressure
Anxiety and stress
Liver health

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

May be used short-term by some adults, but it can affect blood clotting and quality varies between products.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail

BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Danshen comes from the root of Salvia miltiorrhiza, a plant in the mint family that is native to China and other parts of East Asia. The dried red root has been used in traditional Chinese medicine for hundreds of years.

It is best known for its traditional use in heart and circulation problems, such as chest pain (angina). People also use it for high blood pressure, liver conditions, and to help with stress. In some Asian countries it is part of combination products and is even given as an injection in hospitals, though such uses are not standard in the United States.

In the U.S., Danshen is sold as a dietary supplement, most often in capsules, tablets, teas, and tinctures.

How it works

Danshen root contains many active compounds. Two main groups are studied most: tanshinones (fat-soluble compounds) and salvianolic acids (water-soluble compounds). These are thought to act as antioxidants and to reduce inflammation.

In laboratory and animal studies, Danshen compounds appear to widen blood vessels, improve blood flow, and reduce the tendency of blood to clot. Researchers think these effects are why it has traditionally been used for heart and circulation problems.

It is important to know that much of this information comes from test-tube and animal research. How well these effects apply to people taking supplements is still not clear.

Effectiveness

Does Danshen work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 29 uses evaluated

29 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Danshen, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 29 conditions — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Acne