Possible Interaction: Warfarin and Salvia Miltiorrhiza

“The combination of warfarin and Salvia miltiorrhiza is an example for synergy interaction, while the combination of guanethidine and ephedra is an example for anatagonism interaction.”

“Our results indicated that several compounds in S. miltiorrhiza were capable of decreasing the binding constant of Warfarin to HSA site I significantly, which may increase free drug concentration in vivo, contributing to the herb-drug interaction observed clinically.”

“An example of such an interaction is that of warfarin and Angelica sinensis (dong quai) or Salvia miltiorrhiza (danshen).”

“Ganoderma Japonicum, Papaw, Salvia miltiorrhiza , Ginseng, Devil's claw, Garlic, Quinine, Ginkgo, Ginger, Red Clover and Horse-Chestnut reinforce warfarin action by heterogeneous mechanisms.”

“… warfarin … ( Salvia miltiorrhiza ); mild serotonin syndrome in patients who mix St John's wort (Hypericum perforatum) with serotonin-reuptake inhibitors; decreased bioavailability of digoxin, theophylline, cyclosporin, … the Chinese herbal product xaio chai hu tang (sho-salko-to); and decreased concentrations of phenytoin when combined with the Ayurvedic syrup shankhapushpi.”

“Herbs and supplements have been associated with adverse effects and interactions; for example, garlic inhibits platelet aggregation and can cause significant anticoagulation, and the Chinese herb danshen Salvia miltiorrhiza ) appears to potentiate warfarin.”