Is danshen (Salvia miltiorrhiza) dripping pill more effective than isosorbide dinitrate in treating angina pectoris? A systematic review of randomized controlled trials

Jia, Yongliang; Huang, Fang-Yi; Zhang, Shikai; Leung, Siu-wai

doi:10.1016/j.ijcard.2010.12.073

Cited by 87 publications

(56 citation statements)

References 20 publications

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“…Emerging antianginal therapies are facilitating its long-term use as they appear to have a low incidence of side effects (Jia et al, 2012). Danshen therapies are given orally or intravenously.…”

Section: Introductionmentioning

confidence: 99%

Renal Tubular Secretion of Tanshinol: Molecular Mechanisms, Impact on Its Systemic Exposure, and Propensity for Dose-Related Nephrotoxicity and for Renal Herb-Drug Interactions

Jia

et al. 2015

Drug Metab Dispos

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Tanshinol has desirable antianginal and pharmacokinetic properties and is a key compound of Salvia miltiorrhiza roots (Danshen). It is extensively cleared by renal excretion. This study was designed to elucidate the mechanism underlying renal tubular secretion of tanshinol and to compare different ways to manipulate systemic exposure to the compound. Cellular uptake of tanshinol was mediated by human organic anion transporter 1 (OAT1) (K m , 121 mM), OAT2 (859 mM), OAT3 (1888 mM), and OAT4 (1880 mM) and rat Oat1 (117 mM), Oat2 (1207 mM), and Oat3 (1498 mM [BCRP], and rat Oct1, Oct2, Octn1, Octn2, Mate1, Mrp2, Mrp4, and Bcrp) showed either ambiguous ability to transport tanshinol or no transport activity. Rats may be a useful model, to investigate the contribution of the renal transporters on the systemic and renal exposure to tanshinol. Probenecid-induced impairment of tubular secretion resulted in a 3-to 5-fold increase in the rat plasma area under the plasma concentration-time curve from 0 to infinity (AUC 0-' ) of tanshinol. Tanshinol exhibited linear plasma pharmacokinetic properties over a large intravenous dose range (2-200 mg/kg) in rats. The dosage adjustment could result in increases in the plasma AUC 0-' of tanshinol of about 100-fold. Tanshinol exhibited very little doserelated nephrotoxicity. In summary, renal tubular secretion of tanshinol consists of uptake from blood, primarily by OAT1/Oat1, and the subsequent luminal efflux into urine mainly by passive diffusion. Dosage adjustment appears to be an efficient and safe way to manipulate systemic exposure to tanshinol. Tanshinol shows low propensity to cause renal transporter-mediated herb-drug interactions.

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Section: Introductionmentioning

confidence: 99%

Renal Tubular Secretion of Tanshinol: Molecular Mechanisms, Impact on Its Systemic Exposure, and Propensity for Dose-Related Nephrotoxicity and for Renal Herb-Drug Interactions

Jia

et al. 2015

Drug Metab Dispos

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“…Many herbal products are used as medicines in China, because they exert therapeutic actions in clinics [5][6][7][8][55][56][57][58] . Further analysis of the therapeutic actions of an herbal medicine provides the basis for both the rational therapeutic use of the medicine and the design of new and superior therapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and disposition of monoterpene glycosides derived from Paeonia lactiflora roots (Chishao) after intravenous dosing of antiseptic XueBiJing injection in human subjects and rats

Cheng

Lin

et al. 2016

Acta Pharmacol Sin

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Aim: Monoterpene glycosides derived from Paeonia lactiflora roots (Chishao) are believed to be pharmacologically important for the antiseptic herbal injection XueBiJing. This study was designed to characterize the pharmacokinetics and disposition of monoterpene glycosides. Methods: Systemic exposure to Chishao monoterpene glycosides was assessed in human subjects receiving an intravenous infusion and multiple infusions of XueBiJing injection, followed by assessment of the pharmacokinetics of the major circulating compounds. Supportive rat studies were also performed. Membrane permeability and plasma-protein binding were assessed in vitro. Results: A total of 18 monoterpene glycosides were detected in XueBiJing injection (content levels, 0.001-2.47 mmol/L), and paeoniflorin accounted for 85.5% of the total dose of monoterpene glycosides detected. In human subjects, unchanged paeoniflorin exhibited considerable levels of systemic exposure with elimination half-lives of 1.2-1.3 h; no significant metabolite was detected. Oxypaeoniflorin and albiflorin exhibited low exposure levels, and the remaining minor monoterpene glycosides were negligible or undetected. Glomerular-filtration-based renal excretion was the major elimination pathway of paeoniflorin, which was poorly bound to plasma protein. In rats, the systemic exposure level of paeoniflorin increased proportionally as the dose was increased. Rat lung, heart, and liver exposure levels of paeoniflorin were lower than the plasma level, with the exception of the kidney level, which was 4.3-fold greater than the plasma level; brain penetration was limited by the poor membrane permeability. Conclusion: Due to its significant systemic exposure and appropriate pharmacokinetic profile, as well as previously reported antiseptic properties, paeoniflorin is a promising XueBiJing constituent of therapeutic importance.

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“…In 1997, Compound Danshen dripping pill (CDDP) as a Chinese medicinal product was unprecedentedly listed as an investigational new drug (IND No. 56956) by the United States Food and Drug Administration (FDA) (Jia et al, 2012b). Then in 2010, as the major preparation of this herb pair, CDDP stepped into phase III clinical trial in US, which was an important milestone in the process of TCM modernization.…”

Section: Danqi Fangmentioning

confidence: 99%

“…DBD also has an anti-tumor action and can accelerate hematopoiesis, protect the function of essential organs, promote post-operation recovery, thus elevate a patient's living quality and personal confidence in rehabilitation (Du et al, 2009). Recently, a systematic summation of randomized controlled trials of CDDP was accomplished by our institute (Jia et al, 2012b). By analyzing the 60 randomized controlled trials published between 1994 (i.e., year of DSP launch) and 2009, we found that CDDP is apparently more effective than isosorbide dinitrate (a drug routinely prescribed in conventional medicine) in treating angina pectoris, which further confirmed the great potentials of herb pair prescriptions in clinic.…”

Section: Clinical Study Of Herb Pairsmentioning

confidence: 99%

Compatibility art of traditional Chinese medicine: From the perspective of herb pairs

Sheng-peng

Tan

et al. 2012

Journal of Ethnopharmacology

273

158

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Is danshen (Salvia miltiorrhiza) dripping pill more effective than isosorbide dinitrate in treating angina pectoris? A systematic review of randomized controlled trials

Cited by 87 publications

References 20 publications

Renal Tubular Secretion of Tanshinol: Molecular Mechanisms, Impact on Its Systemic Exposure, and Propensity for Dose-Related Nephrotoxicity and for Renal Herb-Drug Interactions

Renal Tubular Secretion of Tanshinol: Molecular Mechanisms, Impact on Its Systemic Exposure, and Propensity for Dose-Related Nephrotoxicity and for Renal Herb-Drug Interactions

Pharmacokinetics and disposition of monoterpene glycosides derived from Paeonia lactiflora roots (Chishao) after intravenous dosing of antiseptic XueBiJing injection in human subjects and rats

Compatibility art of traditional Chinese medicine: From the perspective of herb pairs

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