Danshen (Salvia miltiorrhiza)

Also called dan shen, Salvia miltiorrhiza, red sage root, Chinese sage root, Salviae miltiorrhizae radix, tanshinones.

The short answer

From 16 sources

Danshen is a Chinese red sage root. Most positive evidence comes from Chinese trials of multi-herb pills or hospital injections. In a Dutch placebo-controlled trial, an oral water extract did not lower blood pressure and slightly raised LDL. Two Korean trials with industry ties report better urinary symptoms in men. Danshen has caused serious bleeding when combined with warfarin.

Key facts

Warfarin
Published cases describe gross over-anticoagulation and bleeding when danshen was added to warfarin, and a review advises people on warfarin to avoid it; one manufacturer-run study of a danshen-sanqi pill found no INR change786
Clopidogrel
7 days of Danshen capsules cut clopidogrel exposure by about half (AUC down 49.3%) and weakened its antiplatelet effect in 20 healthy men13
Oral extract alone
4 weeks of danshen water extract did not lower blood pressure and raised LDL to 3.82 vs 3.52 mmol/l on placebo in 20 adults2
Angina pills
93 Chinese-led RCTs (10,208 people) of compound danshen dripping pills added to standard care; certainty moderate to very low1
Urinary symptoms
400-800 mg/day of a root extract (SAGX) improved prostate symptom scores vs placebo in 136 men over 12 weeks; the trial had industry-employed authors4
Multi-herb products
The dripping pill T89 combines danshen with sanqi (notoginseng), so its results cannot be credited to danshen alone6

What it is

Danshen is the root of Salvia miltiorrhiza (red sage), a Chinese medicine herb used for heart conditions and sold as extracts.

How it works

Proposed

Reviews describe danshen affecting blood clotting in several ways: blocking platelet aggregation, interfering with the extrinsic coagulation pathway, antithrombin III-like activity and promoting fibrinolysis. Its tanshinones inhibit and induce several liver CYP450 enzymes. These actions, mostly shown in lab and animal work, underpin both its traditional cardiovascular use and its warfarin interaction.712

Forms, side by side

3 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.

Danshen (Salvia miltiorrhiza) forms compared

3 forms
Danshen (Salvia miltiorrhiza) forms compared: 3 forms by 3 attributes. Empty cells are labelled No data yet, or Not graded in the evidence row.
3 formsOral root extract (e.g., SAGX, water extracts)Compound danshen dripping pill (danshen plus sanqi)Intravenous danshen injection
Absorption in peopleNot measured in the cited abstracts.42Not reported in the meta-analysis abstract.16Given directly into a vein in hospital.3
GI toleranceNo serious adverse events led to discontinuation in the 12-week SAGX trial.42Adverse events not increased vs conventional therapy.16Mild gastrointestinal discomfort and dizziness.3
Studied forUrinary symptoms, cardiovascular risk markersStable angina (with standard care)Hypertension (hospital use)
  1. Oral root extract (e.g., SAGX, water extracts)
    Absorption in people
    Not measured in the cited abstracts.42
    GI tolerance
    No serious adverse events led to discontinuation in the 12-week SAGX trial.42
    Studied for
    Urinary symptoms, cardiovascular risk markers
  2. Compound danshen dripping pill (danshen plus sanqi)
    Absorption in people
    Not reported in the meta-analysis abstract.16
    GI tolerance
    Adverse events not increased vs conventional therapy.16
    Studied for
    Stable angina (with standard care)
  3. Intravenous danshen injection
    Absorption in people
    Given directly into a vein in hospital.3
    GI tolerance
    Mild gastrointestinal discomfort and dizziness.3
    Studied for
    Hypertension (hospital use)
Every cell holds data from a cited page; citation numbers link to the page that holds them.Scroll the table for every column

What the human research says

Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.

Trial map

6 graded outcomes, largest study first

6 graded outcomes: 5 improved, 1 worsened. The largest, a 2026 meta-analysis of 10,208 people on angina symptoms and ECG response when added to standard care, found an improvement. One outcome found a worsening: LDL cholesterol, blood pressure and other cardiovascular risk markers (20 people).

1Angina symptoms and ECG response when added to standard care

Improved · Grade C · Meta-analysis, 10,208 people, 2026

People with stable angina in 93 RCTs (mostly Chinese databases)

Dose, result and source
Every graded outcome on this page, largest study first
OutcomeFoundPeopleStudyWho was studied
Angina symptoms and ECG response when added to standard careImproved10,208Grade C · Meta-analysis, 2026People with stable angina in 93 RCTs (mostly Chinese databases)
Heart function in heart failure when added to standard careImproved855Grade C · Meta-analysis, 2023People with heart failure in 9 RCTs
24-hour blood pressure in primary hypertensionImproved320Grade C · RCT, 2025Adults aged 30-75 with primary hypertension (China)
Lower urinary tract symptoms (IPSS) in menImproved136Grade C · RCT, 2024Men with lower urinary tract symptoms (Korea, multicentre)
Urinary symptoms vs saw palmettoImproved30Grade D · Pilot RCT, 2026Men with lower urinary tract symptoms (Korea)
LDL cholesterol, blood pressure and other cardiovascular risk markersWorsened20Grade C · Crossover RCT, 2015Adults aged 40-70 with high cholesterol and high blood pressure (Netherlands)
Each circle is one graded outcome on this page, numbered from the largest study down, and placed by how many people it studied (log scale). It shows who was studied and what was found, not advice about your dose.

Every graded row

6 rows

Showing 6 of 6 outcomes. Human trials only.

Grade CAngina symptoms and ECG response when added to standard careAnginaRR 1.26 angina responseMeta-analysis · 93 studies
n 10,208 · 2026

Improved Angina efficacy RR 1.26 (95% CI 1.19-1.33) and ECG efficacy RR 1.34 vs conventional therapy alone; angina frequency and duration fell and LVEF rose. Adverse events were not increased. Certainty ranged from moderate to very low.

Design
Meta-analysis, 93 studies, n = 10,208, 2026
Population
People with stable angina in 93 RCTs (mostly Chinese databases)
Form
Compound danshen dripping pills (multi-herb) plus conventional therapy vs conventional therapy alone or with nitrates
Dose
As used in each trial
Duration
Varied
Source
Reference 1 · PubMed 42851529 (opens PubMed)
Grade CHeart function in heart failure when added to standard careHeart failureLVEF +5.5 pointsMeta-analysis · 9 studies
n 855 · 2023

Improved Left ventricular ejection fraction rose by a mean 5.46 percentage points (95% CI 5.32-5.60), BNP fell by 88.61 pg/mL and hs-CRP by 2.73 mg/L vs conventional treatment alone, and heart chamber diameters shrank. GRADE certainty was moderate to low; no trial reported adverse events.

Design
Meta-analysis, 9 studies, n = 855, 2023
Population
People with heart failure in 9 RCTs
Form
Danshen decoction plus conventional heart-failure treatment vs conventional treatment alone
Dose
As used in each trial
Duration
Varied
Source
Reference 16 · PubMed 37146072 (opens PubMed)
Grade C24-hour blood pressure in primary hypertensionBlood pressureLower BP (IV only)RCT
n 320 · 2025

Improved Systolic and diastolic pressure fell from week 4 to 136.78 and 85.36 mmHg by week 12, both lower than control (p < 0.01). Adverse events were mild gastrointestinal discomfort and dizziness.

Design
RCT, n = 320, 2025
Population
Adults aged 30-75 with primary hypertension (China)
Form
Intravenous Salvia miltiorrhiza injection vs matching placebo infusion
Dose
20 ml in 200 ml 5% glucose daily
Duration
12 weeks
Source
Reference 3 · PubMed 40658027 (opens PubMed)
Grade CLower urinary tract symptoms (IPSS) in menProstateBetter IPSSRCT
n 136 · 2024

Improved Both doses improved total IPSS and several secondary outcomes vs placebo; erectile function (IIEF) improved, especially at 400 mg. PSA and testosterone did not change; no serious adverse events led to discontinuation.

Design
RCT, n = 136, 2024
Population
Men with lower urinary tract symptoms (Korea, multicentre)
Form
Salvia miltiorrhiza root extract (SAGX) vs placebo
Dose
400 or 800 mg/day
Duration
12 weeks
Source
Reference 4 · PubMed 39796461 (opens PubMed)
Grade CLDL cholesterol, blood pressure and other cardiovascular risk markersCholesterol and BPLDL slightly higher, BP unchangedCrossover RCT
n 20 · 2015

Worsened LDL was 3.82 mmol/l after danshen vs 3.52 after placebo (p < 0.05). 24-hour blood pressure did not change (138/84 vs 136/87), nor did endothelial function, inflammation, glucose or clotting markers.

Design
Crossover RCT, n = 20, 2015
Population
Adults aged 40-70 with high cholesterol and high blood pressure (Netherlands)
Form
Danshen water extract of Salvia miltiorrhiza root vs placebo
Dose
Not stated in the abstract
Duration
4 weeks per arm (4-week washout)
Source
Reference 2 · PubMed 26192328 (opens PubMed)
Grade DUrinary symptoms vs saw palmettoProstateBeat saw palmetto (pilot)Pilot RCT
n 30 · 2026

Improved Total IPSS fell more with SAGX than saw palmetto (p = 0.031), with better storage symptoms (p = 0.003), quality of life (p = 0.035) and erectile function (p = 0.005).

Design
Pilot RCT, n = 30, 2026
Population
Men with lower urinary tract symptoms (Korea)
Form
SAGX 400 mg vs saw palmetto extract 320 mg
Dose
400 mg/day
Duration
12 weeks
Source
Reference 5 · PubMed 42280395 (opens PubMed)

What the numbers add up to

Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.

The best-controlled oral trial was negative

The only Western placebo-controlled crossover trial of a danshen-only oral extract found no blood pressure benefit and a small LDL rise, while positive cardiovascular results come from multi-herb pills or injections.213

How we got this: Comparison of heart rows by form on this page

Interaction risk is clearer than benefit

Bleeding with warfarin is documented in case reports, while a manufacturer-run study of one multi-herb pill found no warfarin change, so the risk varies by product and is hard to predict.786

How we got this: Interaction sources on this page

Studied doses

Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.

Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.

Doses studied in human trials

Doses studied in human trials ranged from 400 to 800 mg/day of a standardised root extract for 12 weeks in men with urinary symptoms; a Dutch trial gave a water extract for 4 weeks, and Chinese trials used multi-herb pills or a 20 ml daily infusion. These are research doses, not recommendations.423

Interactions and safety

Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.

What Danshen meets

5 cited rows

Medicines 5

Danshen5 medicines · 0 supplements

Supplements and foods 0

No supplement rows in our sources.

  • Measured in a human study
  • Reference summary
  • Case reports
Rows as our evidence profiles cite them; links stay on this site. Line weight shows what backs a row, not how serious an interaction is. No line means none was found in our sources, not that a combination is safe. Not medical advice: ask your pharmacist.

Interactions

5 agents
Published interactions, grouped by kind
AgentWhat the source saysEvidence
Medicines5
Warfarine.g. warfarin (Coumadin)Case reports describe gross over-anticoagulation and bleeding after danshen was added to stable warfarin therapy, and a review concluded people on warfarin should avoid danshen. A 1-week study of the danshen-sanqi pill T89, run by its manufacturer Tasly, found no change in INR or warfarin levels in 23 healthy volunteers. In heart patients taking compound danshen dripping pills with warfarin, the warfarin dose did not change and no bleeding occurred, although S-warfarin peak levels changed in patients with one CYP4F2 genotype. A 2023 study in healthy volunteers with the EPHX1 A/A genotype found the dripping pill only slightly changed warfarin's levels and effect. These results cover specific multi-herb products and do not show that other danshen products are safe with warfarin.78961015Case report
Clopidogrele.g. clopidogrel (Plavix)In 20 healthy men, 7 days of Danshen capsules lowered exposure (AUC0-∞) to clopidogrel by 49.3% and to its metabolite by 41.5%, and weakened clopidogrel's antiplatelet effect. The authors attribute this to CYP enzyme induction and advise caution with drugs metabolized by CYP3A4.13PK study
Aspirin and other antiplatelet drugse.g. aspirinIn 14 healthy adults, a danshen-gegen product moderately raised aspirin exposure (AUC) and altered warfarin metabolism; danshen also inhibits platelet aggregation, so bleeding risk may add up.117PK study
Rosuvastatine.g. rosuvastatin (Crestor)In a 6-person crossover study, a tanjin (danshen)-containing product lowered rosuvastatin peak level by 26.85% and exposure (AUC0-12) by 19.43%, apparently by reducing its absorption.14PK study
Drugs cleared by CYP450 enzymese.g. many prescription drugs (inferred)Tanshinones inhibit and induce several CYP450 isozymes; a review advises caution with tanshinone-rich danshen products.12Review

Check with what you take

Kept on this device only

Add what you take. We list every interaction our evidence profiles cite between Danshen and your picks, and between your picks.

Most cited:

Add a supplement or medicine you take to check it against Danshen.

Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.

Not medical advice, and no dosing advice. An empty result means no row we cite names that pair, by name or through a drug class we can link the medicine to, not that a combination is safe. Where our sources name only a group of medicines we cannot match, the cabinet says so. Ask your pharmacist before you combine supplements and medicines.

Who should be careful

5 groups
People taking warfarin
Serious over-anticoagulation and bleeding have been reported when danshen was added to warfarin; a review says to avoid the combination.78
People taking clopidogrel or statins
In healthy-volunteer studies, danshen products lowered blood levels of clopidogrel (with a weaker antiplatelet effect) and of rosuvastatin.1314
Bleeding disorders and surgery
Danshen affects platelets, clotting and fibrinolysis, which could add to bleeding risk; this has not been studied around surgery.7
People on heart or blood pressure medicines
The positive heart trials added danshen products to standard care under medical supervision; they do not support replacing prescribed drugs.13
Pregnancy and breastfeeding
LactMed and LiverTox have no danshen entry, and none of the trials on this page included pregnant or breastfeeding women, so safety is unknown. Danshen's effects on platelets and clotting add a theoretical bleeding concern.47
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.

How to read the label

What to check on the Supplement Facts panel.

How to read the label

2 checks
Single herb or formula

Many danshen products are multi-herb formulas. The dripping pill T89 contains danshen plus sanqi, and its results do not transfer to a danshen-only capsule.61

Extract type matters

Danshen products may be water extracts, ethanol extracts or both, with differing levels of phenolic acids and tanshinones; a review advises particular caution with tanshinone-rich products because of CYP450 effects.12

Frequently asked questions

Short answers to common questions; the numbers link to the sources below.

Common questions

7 answers
Does danshen lower blood pressure?

A 4-week oral water-extract trial found no change. A Chinese trial of a daily intravenous danshen infusion did lower blood pressure, but that is a hospital product, not a supplement.23

Does danshen help angina?

A meta-analysis of 93 trials found better angina scores when compound danshen dripping pills were added to standard care, but the pill also contains sanqi and certainty was moderate to very low.16

Is danshen good for prostate symptoms?

Two Korean trials of the SAGX root extract report better urinary symptom scores, one vs placebo and one vs saw palmetto. Both had industry ties.45

What are the side effects of danshen?

Trials report few: no serious adverse events led to stopping in the 12-week SAGX trial, and the angina meta-analysis found no increase in adverse events. Hospital injections caused mild stomach discomfort and dizziness. The main documented harm is bleeding when danshen is combined with warfarin.41378

Can I use danshen with warfarin?

Published cases describe dangerous over-anticoagulation and bleeding when danshen was added to warfarin, and a review advises avoiding the combination. Anyone on warfarin should talk to their prescriber before any danshen product.78

Does danshen interact with clopidogrel or statins?

In 20 healthy men, 7 days of Danshen capsules lowered clopidogrel exposure by 49.3% and weakened its antiplatelet effect. In a 6-person study, a danshen product lowered rosuvastatin exposure by 19.43%. Lower levels could make these drugs work less well, but neither study tested patients.1314

Is danshen the same as garden sage?

No. Danshen is the root of Salvia miltiorrhiza; culinary sage is Salvia officinalis, a different species.

Sources

16 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.

Sources cited on this page

16 sources
  1. 1Efficacy and safety of Compound Danshen Dripping Pills as an adjunct to conventional therapy for stable angina pectoris: an updated systematic review and meta-analysis of randomized controlled trials.Meta-analysis Front Pharmacol, 2026 · PMID 42851529
  2. 2Salvia Miltiorrhiza Root Water-Extract (Danshen) Has No Beneficial Effect on Cardiovascular Risk Factors. A Randomized Double-Blind Cross-Over Trial.Crossover RCT PLoS One, 2015 · PMID 26192328
  3. 3Effects of Dan Shen (Salvia miltiorrhiza) on blood pressure management in hypertensive patients: a randomized controlled trial.RCT Blood Press, 2025 · PMID 40658027
  4. 4Salvia miltiorrhiza Root Extract for Men with Lower Urinary Tract Symptoms: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.RCT Nutrients, 2024 · PMID 39796461
  5. 5Efficacy and Safety of Salvia miltiorrhiza Extract (SAGX) Compared with Saw Palmetto in Men with Lower Urinary Tract Symptoms: A 12-Week, Randomized, Double-Blind, Parallel-Group Pilot Study.Pilot RCT Nutrients, 2026 · PMID 42280395
  6. 6Absence of an effect of T89 on the steady-state pharmacokinetics and pharmacodynamics of warfarin in healthy volunteers.PK study J Clin Pharmacol, 2014 · PMID 24142885
  7. 7Interaction between warfarin and danshen (Salvia miltiorrhiza).Review Ann Pharmacother, 2001 · PMID 11302416
  8. 8Chinese herbs and warfarin potentiation by 'danshen'.Observational J Intern Med, 1997 · PMID 9159606
  9. 9Systematic overview of warfarin and its drug and food interactions.Systematic review Arch Intern Med, 2005 · PMID 15911722
  10. 10The Effect of Compound Danshen Dripping Pills on the Dose and Concentration of Warfarin in Patients with Various Genetic Polymorphisms.Observational Clin Ther, 2019 · PMID 31053296
  11. 11Is it safe to take Radix Salvia Miltiorrhiza - Radix Pueraria Lobate product with warfarin and aspirin? A pilot study in healthy human subjects.PK study J Ethnopharmacol, 2020 · PMID 32736050
  12. 12Herb-drug interactions with Danshen (Salvia miltiorrhiza): a review on the role of cytochrome P450 enzymes.Review Drug Metabol Drug Interact, 2012 · PMID 22718621
  13. 13Effects of Danshen capsules on the pharmacokinetics and pharmacodynamics of clopidogrel in healthy volunteers.PK study Food Chem Toxicol, 2018 · PMID 29496531
  14. 14Pharmacokinetic Drug Interaction Between Rosuvastatin and Tanjin in Healthy Volunteers and Rats.PK study Yonago Acta Med, 2019 · PMID 30962748
  15. 15Evaluation and clinical implications of interactions between compound Danshen dropping pill and warfarin associated with the epoxide hydrolase gene.PK study Front Pharmacol, 2023 · PMID 37214448
  16. 16Clinical effect of Danshen decoction in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials.Meta-analysis PLoS One, 2023 · PMID 37146072

What changed

Every dated change to this page: what changed, who made it and why.

Change log

3 entries
Dated changes to this page
DateChangeWho and why
evidence; interactions; key facts; who should avoid; FAQ; questions; relatedAdded a 2023 meta-analysis of danshen decoction in heart failure (9 RCTs, 855 people; PMID 37146072). Added two human interaction studies: Danshen capsules roughly halved clopidogrel exposure in 20 healthy men (PMID 29496531) and a danshen product lowered rosuvastatin levels in 6 volunteers (PMID 30962748), plus a 2023 warfarin study of the dripping pill in EPHX1 A/A volunteers (PMID 37214448). Pregnancy and breastfeeding note rewritten: LactMed, LiverTox and NCCIH have no danshen entry (offline NCBI archive and NCCIH site searched). Added FAQ on clopidogrel/statins and side effects, questions this page answers and a heart goal-hub link. Injection-only meta-analyses (lipids, stroke) were left out as hospital products.Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md
allInitial editorial evidence review (first draft). Every PMID checked against NCBI E-utilities esummary (titles and years taken from the record, none retracted) and the abstract read for each cited row. Studied doses are reported as research doses, not dosing advice.Writer: Kymata Health EditorialTrigger: new page
allAdversarial review: disclosed that the T89 warfarin study (PMID 24142885) was run by the manufacturer Tasly, added the CYP4F2-genotype change in S-warfarin peaks from the CDDP patient study (PMID 31053296), and balanced the warfarin key fact with that product-specific null result.Writer: Kymata Health EditorialTrigger: adversarial review

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