Salvia miltiorrhiza Bunge (Danshen)

Reduce Platelet Aggregation

Quellenbefund mit unverändertem Untersuchungskontext. Klinischer Schweregrad: nicht bewertet.

Salvia miltiorrhiza Bunge (Danshen): The dried radix et rhizome of Salvia miltiorrhiza Bunge has the functions of promoting blood circulation and removing blood stasis, relieving pain by dredging meridians, clearing heart fire, relieving restlessness, and cooling blood to diminish carbuncle. Modern pharmacological effects are anti-coagulation, anti-thrombosis, improvement of microcirculation, improvement of blood rheology, anti-myocardial ischemia, anti-cerebral ischemia, anti-oxidation, etc. In vivo (Fan et al., 2010), salvianolic acid A (SAA) did not affect coagulation parameters in rats after intravenous administration for five successive days. In vitro, pretreatment with SAA on washed rat and human platelets significantly inhibited various agonists, stimulated platelet aggregation and caused an increase in cyclic adenosine monophosphate (cAMP) level in platelets activated by adenosine diphosphate (ADP). SAA possesses antithrombotic activities. The antithrombotic effect might be related to its antiplatelet action and ability to modulate hemorheology without affecting the coagulation system. The mechanisms underlying such activities may involve the induction of cAMP. Li Le reported that Salvia miltiorrhiza can increase the activity of coagulation factor Ⅲ and fibrinolysis by inhibiting platelet aggregation, and can reduce the clearance rate of warfarin to enhance its anticoagulant effect (Li L. et al., 2016). A pharmacological study by Xie H.J. et al. showed that Salvia miltiorrhiza has the effect of anti-platelet aggregation, but does not affect blood coagulation function in rats (Xie et al., 2009). When combined with warfarin, it can increase the steady-state blood concentration and INR of warfarin in rats, and enhance the anticoagulation of warfarin.

Befund HOS-368740 · warfarin · HOS-085950 · Originalquelle ↗

Reduction of Warfarin Metabolism

Quellenbefund mit unverändertem Untersuchungskontext. Klinischer Schweregrad: nicht bewertet.

Salvia miltiorrhiza Bunge (Danshen): Wang et al. (2010a) studied human cells and showed that tanshinone I, tanshinone IIA and cryptotanshinone strongly inhibited CYP1A2, moderately inhibited CYP2C9, tanshinone I and cryptotanshinone, weakly inhibited CYP3A4, dihydrotanshinone and competitively inhibited CYP1A2 and CYP2C9, but had no effect on CYP3A4. Qiu et al. (2008), Wang (2015) investigated the effects of various components of Salvia miltiorrhiza Bunge on the activity of cytochrome P450s (CYPs) in humans and found that cryptotanshinone, tanshinone I and tanshinone IIA competitively inhibited CYP1A2, cryptotanshinone and tanshinin moderately inhibited CYP2C9, protocatechualdehyde slightly inhibited CYP3A4, while the lipid soluble components of Salvia miltiorrhiza Bunge could induce CYP3A4. Wang et al. (2009), Wang et al. (2010b) showed in both in vivo and ex vivo experiments in rats that tanshinones inhibited the activity of CYP2C11, but had fewer pharmacodynamic effects on the CYP2C11-specific substrate toluene sulfonylurea, which had the same specific metabolic substrate as human CYP2C9, therefore it can be concluded that various components of Salvia miltiorrhiza Bunge may affect the anticoagulant effect of warfarin by inhibiting CYP2C9 and CYP1A2, inhibiting or inducing CYP3A4, and competitively binding to human albumin and other ways. Wu and Yeung (2010) also found that tanshinone reduced CYP1A1, CYP2C6 and CYP2C11 mediated 4-, 6- and 7-hydroxywarfarin hydroxylation reactions in rats, thereby inhibiting warfarin metabolism. Zhou et al. (2012) also concluded that Salvia miltiorrhiza Bunge affected the anticoagulant effect of warfarin in relation to CYP450 enzyme metabolism.

Befund HOS-368741 · warfarin · HOS-085950 · Originalquelle ↗

Reduction of Warfarin Metabolism

Quellenbefund mit unverändertem Untersuchungskontext. Klinischer Schweregrad: nicht bewertet.

Salvia miltiorrhiza Bunge (Danshen): Lo et al. (1992) studied the effect of Salvia miltiorrhiza Bunge on warfarin metabolism in rats. It was found that Salvia miltiorrhiza Bunge decreased the absorption rate, apparent volume of distribution and clearance half-life of warfarin, and increased the peak concentration and time to peak thereby enhancing the anticoagulant effect of warfarin.

Befund HOS-368742 · warfarin · HOS-085950 · Originalquelle ↗

Competitive Binding to Plasma Proteins Increases Free State Warfarin Concentration

Quellenbefund mit unverändertem Untersuchungskontext. Klinischer Schweregrad: nicht bewertet.

Salvia miltiorrhiza Bunge (Danshen): Wang Q. et al. (Tan et al., 2002; Liu et al., 2008; Guo and Zheng, 2009; Wang, 2013) concluded that the binding rate of Salvia miltiorrhiza Bunge and tanshinone IIa to human serum proteins was comparable to that of warfarin, and could replace warfarin in warfarin-albumin complexes, which could significantly reduce the plasma protein binding rate of warfarin, increase the free warfarin concentration in blood, and enhance the anticoagulant effect. Wang (2013) also found that tanshinone IIa and oleanolic acid in Salvia miltiorrhiza Bunge also have certain inhibitory effects on coagulation factor Xa. When Salvia miltiorrhiza Bunge is used in combination with warfarin, the anticoagulant effect is enhanced, which may lead to bleeding adverse reactions.

Befund HOS-368743 · warfarin · HOS-085950 · Originalquelle ↗

Interaction Between Chinese Medicine and Warfarin: Clinical and Research Update ↗

Copyright © 2021 Zhuang, Liu, Zhao, Sun, He, Wang, Jia, Lin, Chu and Xi. Interaction Between Chinese Medicine and Warfarin: Clinical and Research Update. DOI: 10.3389/fphar.2021.751107 · CC BY 4.0

Quellen-Hash: b46c221ac01dd09600094fcfc243f39e7e1846720f413ea49157075cd642ed78

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