“Danshen” the Night Away

Fatal Forty DDI: Salvia miltiorrhiza, warfarin, CYP2C9, CYP1A2
  • Tara C. CareyEmail author
  • Kirk Lalwani


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


Pharmacodynamic Pharmacokinetic Inhibitor Inhibition Danshen Danshensu Tanshinone I Tanshinone IIA Cryptotanshinone Protocatechuic aldehyde Protocatechuic acid Salvianolic acid B Salvia miltiorrhiza Herb Herb-drug interaction Anticoagulation Warfarin Coumadin International Normalized Ratio INR Pharmacokinetic Pharmacodynamics Digoxin Bioavailability Elimination Albumin Platelet Platelet adhesion Platelet aggregation Protein binding Potentiation 


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Anesthesiology and Perioperative MedicineBrigham and Women’s HospitalBostonUSA
  2. 2.Department of Anesthesiology & Perioperative MedicineOregon Health and Science UniversityPortlandUSA

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