Herb-drug interactions with Danshen (Salvia miltiorrhiza): a review on the role of cytochrome P450 enzymes.
Drug Metabol Drug Interact. 2012;27(1):9-18
Authors: Zhou X, Chan K, Yeung JH
Danshen, the dried root and rhizome of Salvia miltiorrhiza
Bunge, is a widely used medicinal plant for the treatment of
cardiovascular diseases in China and a complementary medicine in the
West. Danshen is indexed in the 2010 Chinese Pharmacopoeia, with more
than 35 formulations and concoctions containing Danshen water-extracts,
ethanolic extracts or their combination, which are rich in phenolic
acids and different levels of tanshinones.
There are rare reports on the
adverse effects of Danshen preparations. It is, however, well-known
that Danshen leads the anticoagulation failure of warfarin. The
Danshen-warfarin interaction may be mediated via both pharmacodynamic
and pharmacokinetic mechanisms. This review does not summarize recent
progress, but the effects of Danshen and its active ingredients on the
interactions of cytochrome P450 (CYP450) and drug transporters, as well
as the analysis of ingredients, and the metabolism and pharmacokinetics
that are related to these interactions. Tanshinones play significant
roles in the inhibition and induction of several CYP450 isozymes. It can
be concluded that precautions should be taken when using Danshen
preparations rich in tanshinones for CYP-related herb-drug interactions.
PMID: 22718621 [PubMed - indexed for MEDLINE]