Danshen (Salvia Miltiorrhiza)
A traditional Chinese root used for angina and circulation. Hundreds of Chinese trials look positive, but they are of poor methodological quality, and the one rigorous Western trial found nothing.
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What the science says
- Angina pectoris Limited evidence
A meta-analysis of 109 randomised trials with 11,973 participants found danshen dripping pills better than isosorbide dinitrate for symptoms and ECG changes (odds ratios around 2.4–2.9), but the authors judged the risk of bias high for randomisation and blinding across almost all included studies, and the comparator was an active drug rather than placebo.
- Cardiovascular risk factors Limited evidence
A randomised, double-blind crossover trial in 20 hyperlipidaemic, hypertensive adults in the Netherlands found danshen root water extract had no beneficial effect on blood pressure, endothelial function or lipids, and LDL was slightly higher on danshen than placebo.
- Circulation and blood flow Limited evidence
Much of the Chinese evidence comes from intravenous danshen injections given in hospital, which say nothing about what an oral capsule does; oral supplement data are sparse.
Dosage & safety
How to take it
Interactions
With medications
- warfarin
Danshen potentiates anticoagulation and has caused bleeding and dangerously high INR. do not combine
- aspirin, clopidogrel and other antiplatelets
Additive antiplatelet effect and bleeding risk. avoid, and stop danshen at least two weeks before surgery
- digoxin
Danshen interferes with digoxin immunoassays and can make measured levels read falsely high or low. tell your doctor and the laboratory that you take it
With other supplements
- fish oil, garlic, ginkgo and other blood-thinning supplements
Additive effect on platelet function. avoid stacking, and stop before surgery
Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.
Frequently asked questions
Does danshen work for angina?
Danshen has limited evidence for angina: a meta-analysis of 109 Chinese trials found danshen dripping pills beat isosorbide dinitrate on symptoms, but risk of bias was high in almost all studies and there was no placebo comparison. The one rigorous Western trial of danshen found no benefit on cardiovascular risk factors.
Can I take danshen with warfarin?
No, do not combine danshen with warfarin: danshen potentiates anticoagulation and has caused bleeding and dangerously high INR. Danshen also adds to aspirin, clopidogrel and blood-thinning supplements such as fish oil, garlic and ginkgo.
Does danshen lower blood pressure or cholesterol?
In a double-blind crossover trial in 20 hyperlipidaemic, hypertensive Dutch adults, danshen root extract had no beneficial effect on blood pressure, endothelial function or lipids, and LDL was slightly higher than on placebo. The evidence that danshen helps cardiovascular risk factors is limited.
Is danshen safe before surgery?
Stop danshen at least two weeks before any surgery or dental extraction, because it increases bleeding risk. Avoid danshen in pregnancy and with bleeding disorders, and tell your doctor if you take digoxin, since danshen distorts digoxin blood tests.
Scientific references
- How Efficacious is Danshen (Salvia miltiorrhiza) Dripping Pill in Treating Angina Pectoris? Evidence Assessment for Meta-Analysis of Randomized Controlled Trials
- Salvia Miltiorrhiza Root Water-Extract (Danshen) Has No Beneficial Effect on Cardiovascular Risk Factors. A Randomized Double-Blind Cross-Over Trial
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