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“Danshen” the Night Away

Fatal Forty DDI: Salvia miltiorrhiza, warfarin, CYP2C9, CYP1A2

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A Case Approach to Perioperative Drug-Drug Interactions

Abstract

This case discusses a mixed pharmacodynamic and pharmacokinetic drug interaction between warfarin and danshen resulting in increased anticoagulation.

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References

  1. Kam PC, Liew S. Traditional Chinese herbal medicine and anaesthesia. Anaesthesia. 2002;57(11):1083–9.

    Article  PubMed  CAS  Google Scholar 

  2. Cheng TO. Warfarin danshen interaction. Ann Thorac Surg. 1999;67(3):894.

    Article  PubMed  CAS  Google Scholar 

  3. Chan TY. Interaction between warfarin and danshen (Salvia miltiorrhiza). Ann Pharmacother. 2001;35(4):501–4.

    Article  PubMed  CAS  Google Scholar 

  4. Izzat MB, Yim AP, El-Zufari MH. A taste of Chinese medicine! Ann Thorac Surg. 1998;66(3):941–2.

    Article  PubMed  CAS  Google Scholar 

  5. Tam LS, Chan TY, Leung WK, et al. Warfarin interactions with Chinese traditional medicines: danshen and methyl salicylate medicated oil. Aust N Z J Med. 1995;25(3):258.

    Article  PubMed  CAS  Google Scholar 

  6. Yu CM, Chan JC, Sanderson JE. Chinese herbs and warfarin potentiation by ‘danshen’. J Intern Med. 1997;241(4):337–9.

    Article  PubMed  CAS  Google Scholar 

  7. Chan K, Lo AC, Yeung JH, et al. The effects of Danshen (Salvia miltiorrhiza) on warfarin pharmacodynamics and pharmacokinetics of warfarin enantiomers in rats. J Pharm Pharmacol. 1995;47(5):402–6.

    Article  PubMed  CAS  Google Scholar 

  8. Hirsh J, Dalen J, Anderson DR, et al. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest. 2001;119(1 Suppl):8S–21.

    Article  PubMed  CAS  Google Scholar 

  9. Kaminsky LS, Zhang ZY. Human P450 metabolism of warfarin. Pharmacol Ther. 1997;73(1):67–74.

    Article  PubMed  CAS  Google Scholar 

  10. Hirsh J, Fuster V, Ansell J, et al. American Heart Association/American College of Cardiology Foundation guide to warfarin therapy. J Am Coll Cardiol. 2003;41(9):1633–52.

    Article  PubMed  CAS  Google Scholar 

  11. Wang CM, Cheung WY, Lee PM, et al. Major tanshinones of Danshen (Salvia miltiorrhiza) exhibit different modes of inhibition on human CYP1A2, CYP2C9, CYP2E1 and CYP3A4 activities in vitro. Phytomedicine. 2010;17:868–75.

    Article  PubMed  CAS  Google Scholar 

  12. Qiu F, Zhang R, Sun J, et al. Inhibitory effects of seven components of danshen extract on catalytic activity of cytochrome P450 enzyme in human liver microsomes. Drug Metab Dispos. 2008;36(7):1308–14. Epub 2008 Apr 14.

    Article  PubMed  CAS  Google Scholar 

  13. Zhou L, Zuo Z, Chow MS. Danshen: an overview of its chemistry, pharmacology, pharmacokinetics, and clinical use. J Clin Pharmacol. 2005;45(12):1345–59.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Tara C. Carey BA, MD .

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Carey, T.C., Lalwani, K. (2015). “Danshen” the Night Away. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_217

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_217

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

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