# Plant Monograph: Red Sage Root
**Name of plant:**
Red Sage Root
**Catch phrase (Carmina Gadelica or traditional invocation if available):**
No *Carmina Gadelica* or Gaelic invocation is recorded for Red Sage Root. Its traditional identity belongs to Chinese medicine, where the root is known as **Dān Shēn (丹参)**—literally "red ginseng" or "red root"—and is traditionally associated with the movement of blood and the restoration of circulation.
**Family:**
Lamiaceae — Mint family
**Genus and species:**
*Salvia miltiorrhiza* Bunge
**Other names:**
Red Sage; Red Sage Root; Danshen; Dan Shen; Dan Shen Root; Chinese Red Sage; Chinese Sage; Tan-shen; Tanshen; Purple Sage; Scarlet Sage Root; *Salvia miltiorrhiza*; *Salvia bowleyana* (related species sometimes encountered in Chinese materia medica)
**Brief introduction:**
Red Sage is a perennial herb native to China and parts of East Asia. It produces characteristic purple-blue flowers and a strongly reddish-brown root and rhizome, which constitute the medicinal drug known as **Danshen**. The European Medicines Agency describes the medicinal material specifically as the dried whole or fragmented root and rhizome of *Salvia miltiorrhiza*. ([European Medicines Agency (EMA)][1])
Danshen has been used in Chinese medicine for centuries, particularly for conditions traditionally described in terms of **blood stasis**, pain, menstrual disorders and cardiovascular circulation. Modern research has concentrated heavily on its effects on platelet aggregation, vascular function, inflammation and myocardial ischemia. More than 300 constituents have been identified, including tanshinones and salvianolic acids. ([PubMed][2])
**Traditional uses:**
* Traditional treatment of "blood stasis" and impaired circulation
* Traditional remedy for chest pain and cardiac complaints
* Traditional treatment of menstrual irregularity and painful menstruation
* Traditional use for abdominal pain associated with blood stasis
* Traditional treatment of inflammatory and painful conditions
**Historical use:**
* Used for centuries in Chinese traditional medicine
* Classified traditionally as a herb that **invigorates blood and dispels blood stasis**
* Used in formulas for chest pain, palpitations and other cardiovascular complaints
* Used for menstrual disorders, dysmenorrhoea and postpartum blood-stasis conditions
* Used traditionally for inflammatory disorders, pain and traumatic injuries
The modern literature confirms that Danshen has a long-established role in Chinese medicine, particularly in cardiovascular and cerebrovascular disorders. ([PubMed][3])
**Parts used and method of use:**
* Dried root
* Dried rhizome
Used as:
* Decoction
* Powder
* Tincture or liquid extract
* Standardized dry extract or pharmaceutical preparation
The pharmacopoeial drug is specifically **dried whole or fragmented root and rhizome**, traditionally collected in spring or autumn. The European Pharmacopoeia specifies quality markers including salvianolic acid B and tanshinone IIA. ([European Medicines Agency (EMA)][1])
**Use in healing (modern herbal practice):**
* Traditional cardiovascular and circulatory support
* Investigational treatment adjunct for coronary artery disease
* Traditional treatment of menstrual pain and irregular menstruation
* Experimental support for vascular endothelial function
* Investigational anti-inflammatory and neuroprotective applications
The modern evidence is extensive but heterogeneous. Danshen has been investigated particularly in ischemic heart disease, cerebrovascular disease, hypertension, inflammation and metabolic disorders. The EMA has assessed the root and rhizome, but **did not adopt an EU herbal monograph**, meaning that it should not be interpreted as having an established EU traditional-use indication. ([European Medicines Agency (EMA)][4])
**Pharmacology and biochemistry:**
* **Tanshinone IIA** — a lipophilic diterpenoid quinone and major marker constituent
* **Salvianolic acid B** — a major water-soluble phenolic compound
* **Danshensu (salvianic acid)** — a water-soluble phenolic constituent
Mechanisms:
* Tanshinones and related compounds can influence platelet aggregation, coagulation pathways, inflammatory signalling and vascular smooth-muscle/endothelial function
* Salvianolic acids demonstrate antioxidant and endothelial-protective effects in experimental models
* Danshen constituents can influence vascular tone, myocardial ischemia-reperfusion injury, inflammatory pathways and cellular oxidative stress
**Overall profile:**
Red Sage Root is a **pharmacologically active cardiovascular and anti-inflammatory medicinal plant** with an unusually extensive research literature. Its traditional "blood-moving" description has several possible modern correlates, including effects on platelet aggregation, coagulation, endothelial function and vascular inflammation. However, the complexity of Danshen extracts makes it difficult to equate traditional preparations with any single isolated constituent. ([PubMed][2])
**Common dosage:**
* **Dried root/rhizome decoction:** traditionally approximately 9–15 g/day
* **Powdered root:** approximately 1.5–3 g per dose, according to traditional preparations
* **Dry extract:** dosage varies substantially according to extraction ratio and standardization
* **Proprietary Danshen preparations:** use only according to the standardized product's instructions or professional supervision
These are traditional dosage ranges rather than universally validated therapeutic doses. Concentration of tanshinones and salvianolic acids varies greatly between preparations.
**Safety factors (including side effects):**
* Danshen has clinically important **anticoagulant and antiplatelet potential** and should not be treated as an innocuous tea herb
* Possible adverse effects include gastrointestinal upset, dizziness, headache and allergic reactions
* Avoid medicinal use with **warfarin or other anticoagulants unless specifically supervised**, because clinically significant bleeding interactions have been reported
* Caution is warranted before surgery or invasive procedures because of potential effects on haemostasis
* Safety of long-term high-dose concentrated extracts is less well established than that of traditional short-term preparations
A particularly important update for this monograph is that a 2026 real-world study involving 525 people prescribed both Danshen and oral anticoagulants found significantly increased bleeding risk during the first 28 days of combined use. ([PubMed][5])
**First aid / adverse reaction response:**
* **Unusual bruising or nosebleeds:** Stop the preparation and contact a healthcare professional, particularly if taking an anticoagulant
* **Blood in urine, stool or vomit:** Seek urgent medical assessment
* **Severe bleeding, weakness, faintness or suspected internal bleeding:** Seek emergency medical attention immediately
* **Facial swelling, hives or difficulty breathing:** Treat as a possible severe allergic reaction and seek emergency care
**Drug interactions:**
* **Warfarin:** potentially major interaction; Danshen can increase anticoagulant effects and has been associated with bleeding. ([PubMed][6])
* **Other anticoagulants:** the 2026 real-world study found increased bleeding risk when Danshen was combined with oral anticoagulants generally. ([PubMed][5])
* **Antiplatelet drugs:** theoretical and pharmacological additive effects may increase bleeding risk
* **CYP450-metabolized medicines:** Danshen constituents can affect several CYP enzymes, creating potential pharmacokinetic interactions; concentrated preparations therefore warrant professional review. ([PubMed][7])
**Horticultural requirements:**
* **USDA / Canadian zone:** USDA approximately **5–9**; perennial in milder regions but may require winter protection in colder Canadian climates
* **Soil pH:** Approximately **6.0–7.5**
* **Light requirements:** Full sun to partial shade
* **Moisture:** Moderate; prefers moist but well-drained soil
* **Other notes (growth habit, harvest timing, etc.):**
* **Growth habit:** Herbaceous perennial, generally 30–80 cm tall, with branching square stems and aromatic foliage
* **Flowering/fruiting:** Blue-violet to purple flowers appear in summer
* **Harvest timing:** Medicinal roots are traditionally harvested in spring or autumn from mature plants
* **Habitat:** Open woodland, grassy slopes, forest margins and cultivated medicinal-herb fields in its native range
* **Propagation/cultivation notes:** Can be propagated by seed, root division or cuttings. It prefers fertile, well-drained soil and adequate moisture without waterlogging. Root production is the principal horticultural objective in medicinal cultivation.
**Sampling of clinical reports / studies:**
* **Clinical cardiovascular research:** Numerous clinical investigations have examined Danshen-containing preparations in coronary heart disease and related cardiovascular conditions, but study quality and formulations vary substantially; evidence is therefore difficult to generalize to crude root preparations. ([PubMed][3])
* **Pharmacological studies:** Experimental research demonstrates effects on platelet aggregation, endothelial function, oxidative stress, inflammation and myocardial ischemia-reperfusion injury. ([PubMed][2])
* **Phytochemical studies:** More than 300 compounds have been identified, including diterpenoid quinones, phenolic acids, triterpenes, essential oils, flavonoids and other constituents. ([PubMed][2])
* **Ethnomedicinal evidence:** Danshen has centuries of documented use in Chinese medicine for blood-stasis syndromes, cardiovascular complaints, menstrual disorders, abdominal pain and other painful conditions. ([PubMed][2])
* **Overall assessment of evidence:** **Traditional evidence: very strong. Phytochemical evidence: very strong. Experimental pharmacology: extensive. Clinical evidence: substantial but heterogeneous and formulation-dependent. Safety/interactions: clinically important, particularly with anticoagulants.** The EMA has completed an assessment but did not establish an EU herbal monograph. ([European Medicines Agency (EMA)][4])
**Botanical and cultural note:**
Red Sage Root is an excellent example of why traditional herbal terminology should not be dismissed simply because it does not use modern anatomical language. The traditional Chinese concept of **"moving the blood and removing blood stasis"** is not identical to modern anticoagulation, yet modern research has found genuine effects on platelet aggregation, coagulation, vascular function and inflammation. At the same time, that correspondence is **not one-to-one**—and the newly documented bleeding risk with anticoagulants demonstrates precisely why traditional concepts and modern pharmacology should be placed beside one another rather than treated as interchangeable. ([PubMed][5])
[1]: https://www.ema.europa.eu/en/documents/herbal-report/assessment-report-salvia-miltiorrhiza-bunge-radix-et-rhizoma_en.pdf?utm_source=chatgpt.com "Salvia miltiorrhiza - AR"
[2]: https://pubmed.ncbi.nlm.nih.gov/40419206/?utm_source=chatgpt.com "Ethnomedicine, phytochemistry, pharmacology, pharmacokinetics, and clinical application of Salvia miltiorrhiza Bunge (Lamiaceae): A comprehensive review - PubMed"
[3]: https://pubmed.ncbi.nlm.nih.gov/25835361/?utm_source=chatgpt.com "Salvia miltiorrhiza: Traditional medicinal uses, chemistry, and pharmacology - PubMed"
[4]: https://www.ema.europa.eu/en/medicines/herbal/salviae-miltiorrhizae-radix-et-rhizoma?utm_source=chatgpt.com "Salviae miltiorrhizae radix et rhizoma - herbal medicinal product | European Medicines Agency (EMA)"
[5]: https://pubmed.ncbi.nlm.nih.gov/42136797/?utm_source=chatgpt.com "Increasing risk of hemorrhage following concurrent use of Salvia miltiorrhiza and oral anticoagulants: a retrospective self-controlled case series study."
[6]: https://pubmed.ncbi.nlm.nih.gov/11302416/?utm_source=chatgpt.com "Interaction between warfarin and danshen (Salvia miltiorrhiza) - PubMed"
[7]: https://pubmed.ncbi.nlm.nih.gov/22718621/?utm_source=chatgpt.com "Herb-drug interactions with Danshen (Salvia miltiorrhiza): a review on the role of cytochrome P450 enzymes - PubMed"
Educational Use Only: The information presented on this page is provided for educational, historical, and informational purposes only. ArdNemeton na Tuatha and Bhùth Draoi do not provide medical advice. Always consult your physician and pharmacist before using any herb, mushroom, supplement, or botanical product for medicinal purposes. Traditional uses described herein do not constitute medical claims.