Danshen : Safety

by MedlinePlus

(Page 2 of 2)

Allergies

People with known allergy to danshen or its constituents (such as protocatechualdehyde, 3,4-dihydroxyphenyl-lactic acid, tanshinone I, dihydrotanshinone, cryptotanshione, miltirone, or salvianolic acid B) should avoid this herb. Danshen is often found in combination with other herbs in various formulations, and patients should read product labels carefully.

Side Effects and Warnings

Danshen may increase the risk of bleeding. This herb is reported to inhibit platelet aggregation and to increase the blood-thinning effects of warfarin in humans. Caution is advised in patients with bleeding disorders, taking drugs that may increase the risk of bleeding, or prior to some surgical procedures. Dosing adjustments may be necessary.

Some people may experience stomach discomfort, reduced appetite, or itching.

In theory, danshen may lower blood pressure and should be used cautiously by patients with blood pressure abnormalities or taking drugs that alter blood pressure.

In theory, a chemical found in danshen called miltirone may increase drowsiness. Caution is advised while driving or operating machinery.

Convulsions, mental changes, and dystonia syndrome may occur.

Pregnancy and Breastfeeding

Danshen should be avoided during pregnancy and breast-feeding. In theory, the blood-thinning properties of danshen may increase the risk of miscarriage or bleeding, and effects on the fetus or nursing infants are not known.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Danshen may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. This herb is reported to inhibit platelet aggregation and to cause over-anticoagulation (excessive "blood-thinning" effects) in patients taking the blood thinner warfarin (Coumadin®). Examples of drugs that increase the risk of bleeding include aspirin, anticoagulants such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

In theory, the risk of side effects or toxicity from digoxin (Lanoxin®) may be increased if taken with danshen. In addition, danshen may cause laboratory measurements of digoxin blood levels to be inaccurate (too high or too low).

Danshen may result in hypotension (dangerously low blood pressure) if taken with drugs that also lower blood pressure, such as ACE-inhibitors like captopril (Capoten®) or lisinopril (Prinivil®), and beta-blockers like atenolol (Tenormin®) or propranolol (Inderal®). In addition, the use of danshen with beta-blockers may cause bradycardia (dangerously slow heart rate).

In theory, a chemical found in danshen called miltirone may increase sleepiness or other side effects associated with some drugs taken for anxiety or insomnia, such as lorazepam (Ativan®), alprazolam (Xanax®), and diazepam (Valium®), or alcohol. In addition, based on animal studies, danshen may affect the absorption of alcohol into the blood.

Interactions with Herbs and Dietary Supplements

Danshen may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, EPA (eicosapentaenoic acid, found in fish oils), evening primrose oil, fenugreek, feverfew, fish oil, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), omega-3 fatty acids, onion, papain, panax ginseng, parsley, passionflower, poplar, prickly Ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric , vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

In theory, danshen may add to the effects of other herbs with potential cardiac glycoside properties, potentially resulting in slow heart rate or toxicity. Examples of other agents that may possess cardiac glycoside properties include adonis, balloon cotton, black hellebore root/melampode, black Indian hemp, bushman's poison, cactus grandifloris, convallaria, eyebright, figwort, foxglove/digitalis, frangipani, hedge mustard, hemp root/Canadian hemp root, king's crown, lily-of-the-valley, motherwort, oleander leaf, pheasant's eye plant, plantain leaf, pleurisy root; psyllium husks, redheaded cotton-bush, rhubarb root, rubber vine, sea-mango, senna fruit, squill, strophanthus, uzara, wallflower, wintersweet, yellow dock root, and yellow oleander. Notably, bufalin/Chan Suis is a Chinese herbal formula that has been reported as toxic or fatal when taken with cardiac glycosides.

Danshen should be used cautiously with herbs/supplements that may also lower blood pressure lower blood pressure, such as aconite/monkshood, arnica, baneberry, betel nut, bilberry, black cohosh, bryony, calendula, California poppy, coleus, curcumin; eucalyptol; eucalyptus oil, flaxseed/flaxseed oil, garlic, ginger, ginkgo, goldenseal, green hellebore, hawthorn, Indian tobacco, jaborandi, mistletoe, night blooming cereus, oleander, pasque flower, periwinkle, pleurisy root, Polypodium vulgare , shepherd's purse, Texas milkweed, turmeric, or wild cherry.

In theory, a chemical found in danshen called miltirone can increase the amount of drowsiness that may be caused by other herbs or supplements such as calamus, calendula, California poppy, capsicum, catnip, celery, couch grass, dogwood, elecampane, German chamomile, goldenseal, gotu kola, hops, kava (may help sleep without drowsiness), lavender aromatherapy, lemon balm, sage, sassafras, skullcap, shepherd's purse, Siberian ginseng, St. John's wort, stinging nettle, valerian, wild carrot, wild lettuce, withania root, or yerba mansa.

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