Danshensu

Danshensu at a Glance

Danshensu is the smallest and least impressive-looking molecule in danshen’s water-soluble family, and it is the only one that reliably turns up in human blood. That single asymmetry is the whole page.

Chemically it is 3-(3,4-dihydroxyphenyl)lactic acid — a catechol ring on a three-carbon lactic-acid tail, C₉H₁₀O₅, 198.17 Da, roughly a quarter the mass of salvianolic acid B ^{3Reference 3PubChemCompound record for danshensu (CID 11600642) — (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, C9H10O5, MW 198.17, CAS 76822-21-4; synonyms tanshinol, salvianic acid A, dan shen suan AView study →}. It occupies two positions in danshen’s chemistry at once, and they are the same position seen from opposite ends of the pathway:

It is the building block. Rosmarinic acid is an ester of one caffeic-acid unit and one danshensu unit. Salvianolic acid A is a danshensu unit esterified to a doubled caffeic-acid moiety. Salvianolic acid B is three danshensu units and one caffeic acid, condensed around a benzofuran ring. Danshensu is the tyrosine-derived monomer the plant keeps adding; every member of the salvianolic acid family is built partly out of it.

It is the metabolite. Because the salvianolic acids are large, polar and hardly absorbed — salvianolic acid B’s absolute oral bioavailability is 1-4% depending on the study, salvianolic acid A’s is under 1% — the question five of our danshen pages had to leave open is what actually gets into the blood. The answer is danshensu. When rats were given a whole danshen extract by gastric tube and the contents of gut, mucosa, plasma, bile and urine were quantified together, every salvianolic acid except protocatechuic aldehyde and danshensu itself was cleaved to danshensu and caffeic acid in the gastrointestinal tract before absorption, and only free and glucuronidated protocatechuic aldehyde, caffeic acid and danshensu appeared in plasma at meaningful concentrations ^{19Reference 19Liu Z et al. · 2016AnimalQuantitatively metabolic profiles of salvianolic acids in rats after gastric-administration of Salvia miltiorrhiza extractView study →}.

So the molecule the plant builds up into oligomers is the molecule the gut takes those oligomers back apart into. Danshensu is the entry and the exit of the same pathway, and it is the reason a danshen decoction is not pharmacologically empty despite salvianolic acid B’s terrible absorption. Danshen is a herb whose cardiovascular reputation rests on its water-soluble fraction ^{5Reference 5Li ZM et al. · 2018Salvia miltiorrhiza Burge (danshen) — a golden herbal medicine in cardiovascular therapeuticsView study →}; this is the piece of that fraction which demonstrably arrives.

One Molecule, Four Names

This compound has the worst synonym problem in the danshen literature, and the split is bigger than the one that cost half the salvianolic acid B evidence base.

Name	PubMed records	With Salvia miltiorrhiza
danshensu	550	231
tanshinol	123	50
3,4-dihydroxyphenyllactic acid	332	132
salvianic acid A	91	34
Union of all four	802	321

PubMed counts, August 2026. The systematic name runs ahead of the informal ones partly because it is also the working name in the rosmarinic acid biosynthesis literature — hornworts, lavender, self-heal, engineered E. coli, a Lactobacillus reuteri dehydrogenase — where the molecule is the tyrosine-derived half of an ester rather than a danshen constituent. Only 52 of those 332 records mention neither Salvia nor danshen.

The arithmetic that matters: 252 of the 802 records — 31% — never use the word “danshensu” at all. Of those, 138 use only the systematic name or “salvianic acid A”, and 114 use only “tanshinol”. Searching the primary name alone loses nearly a third of the literature.

And the lost third is not redundant. The tanshinol slice is a largely separate bone-biology tradition, centred on glucocorticoid-induced osteoporosis and osteoblast differentiation, with its own systematic review and meta-analysis of nine animal studies ^{40Reference 40Wang S et al. · 2022Meta-analysisAntiosteoporosis effect of tanshinol in osteoporosis animal models — a systematic review and meta-analysisView study →}. The salvianic acid A slice is where much of the analytical and human-plasma work sits ^{17Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →}, and where the sodium salt is studied as a candidate injectable ^{37Reference 37Zeng M et al. · 2023Sodium danshensu stabilizes atherosclerotic vulnerable plaques by targeting IKKβ-mediated inflammation in macrophagesView study →}. This is the third time this campaign has hit the pattern — tellimagrandin II / eugeniin, salvianolic acid B / lithospermic acid B, and now this — and it is the largest split of the three.

A fourth trap is stereochemical rather than lexical. The natural compound is the (R)-(+) enantiomer, listed in PubChem as (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, CAS 76822-21-4 ^{3Reference 3PubChemCompound record for danshensu (CID 11600642) — (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, C9H10O5, MW 198.17, CAS 76822-21-4; synonyms tanshinol, salvianic acid A, dan shen suan AView study →}, and the bone literature writes it as D-(+)-β-3,4-dihydroxyphenyllactic acid ^{40Reference 40Wang S et al. · 2022Meta-analysisAntiosteoporosis effect of tanshinol in osteoporosis animal models — a systematic review and meta-analysisView study →}. But several pharmacology and ADME studies used the racemic sodium salt — the definitive rat ADME paper states its test article as “sodium DL-β-(3,4-dihydroxyphenyl)lactate” ^{15Reference 15Meng X et al. · 2019AnimalPreclinical absorption, distribution, metabolism, and excretion of sodium danshensu, one of the main water-soluble ingredients in Salvia miltiorrhiza, in ratsView study →}. Half of a racemate is not the natural product, and nobody appears to have compared the enantiomers.

The Monomer the Salvianolic Acids Are Built From

Danshensu’s structural role is settled and easy to state precisely, because the whole family is defined against it.

Compound	Formula (MW)	Composition	Danshensu units
Danshensu	C₉H₁₀O₅ (198.17)	Monomer — catechol + lactic acid tail	1 (it is the unit)
Rosmarinic acid	C₁₈H₁₆O₈ (360.3)	Dimer — 1 caffeic + 1 danshensu	1
Salvianolic acid A	C₂₆H₂₂O₁₀ (494.4)	Trimer-level — danshensu + doubled caffeoyl	1
Salvianolic acid B	C₃₆H₃₀O₁₆ (718.6)	Tetramer, benzofuran-cyclised	3

Biosynthetically the two halves of rosmarinic acid come from different amino acids: the caffeic acid half from phenylalanine via the phenylpropanoid pathway, and the danshensu half from tyrosine, by transamination to 4-hydroxyphenylpyruvate, reduction to 4-hydroxyphenyllactate and meta-hydroxylation to the catechol. That route is reproducible in a test tube — a three-enzyme cascade converting L-DOPA to danshensu with a tyrosine aminotransferase and a D-specific 2-hydroxyacid dehydrogenase reached 98.3% yield ^{9Reference 9Han R et al. · 2023In vitroSelf-sufficient in vitro multi-enzyme cascade for efficient synthesis of danshensu from L-DOPAView study →}, which is a clean demonstration of where the molecule comes from.

The structural relationship also runs in reverse, and our own pages already document it. The industrial conversion of salvianolic acid B into salvianolic acid A under high temperature, pressure and humidity proceeds by hydrolysis with loss of one danshensu unit, then decarboxylation ^{6Reference 6Xia H et al. · 2014Conversion of salvianolic acid B into salvianolic acid A in tissues of Radix Salviae Miltiorrhizae using high temperature, high pressure and high humidityView study →}. Danshen’s chemistry assembles and disassembles along the same seam.

One consequence deserves stating plainly. Because the oligomers can be hydrolysed back to their monomers, any measurement of “danshensu content” is partly a measurement of how the sample was handled. Fresh danshen root is low in free phenolic acids and high in bound ones — esterified to cell-wall polysaccharides — and drying and dehydration release them enzymatically; danshensu is one of the four principal hydrolysis products identified in that work ^{8Reference 8Zhou T et al. · 2020Comparative study on free and bound phenolic acids before and after drying of Salvia miltiorrhiza [in Chinese]View study →}. This is the same post-harvest story that governs salvianolic acid B ^{7Reference 7Zhou GJ et al. · 2014Post-harvest induced production of salvianolic acids and significant promotion of antioxidant properties in roots of Salvia miltiorrhiza (danshen)View study →}, reaching danshensu from the other direction.

The Metabolite That Actually Circulates

This is the section the rest of the danshen cluster has been waiting for.

Five of our danshen pages state, correctly, that the salvianolic acids are barely absorbed. None of them could say what is. The gastrointestinal-fate study answers it directly: after gastric administration of danshen extract to rats, salvianolic acids other than protocatechuic aldehyde and danshensu were metabolised into danshensu and caffeic acid in the gut before absorption, and it was “the free and glucuronidated” protocatechuic aldehyde, caffeic acid and danshensu — “rather than the prototypes of other salvianolic acids” — that appeared in plasma at considerable concentrations ^{19Reference 19Liu Z et al. · 2016AnimalQuantitatively metabolic profiles of salvianolic acids in rats after gastric-administration of Salvia miltiorrhiza extractView study →}.

The intravenous route reaches the same conclusion by a different road. In a study that dosed Danhong injection into human subjects, rats and dogs and tracked 28 danshen catechols, tanshinol, salvianolic acid D and lithospermic acid showed considerable exposure in humans and rats; in dogs, only tanshinol did. Salvianolic acids A and B showed low plasma levels, with their human plasma metabolites “little or not detected” ^{18Reference 18Li M et al. · 2015Clinical trialSystemic exposure to and disposition of catechols derived from Salvia miltiorrhiza roots (danshen) after intravenous dosing DanHong injection in human subjects, rats, and dogsView study →}. Even when you inject the oligomers, the monomer is what you can measure.

And it works in the other direction too: give salvianolic acid B, and danshensu appears. In mice dosed with Sal B or with a danshen depside-salt injection, danshensu was measured as Sal B’s active metabolite, and in unilateral-ureteric-obstruction kidneys the AUC of Sal B fell by 71% while the AUC of danshensu rose by 61-178% relative to sham ^{20Reference 20Lin P et al. · 2025AnimalComparative study of pharmacokinetics and renal exposure of salvianolic acid B and its metabolite danshensu in normal and renal fibrosis miceView study →} — the parent disappears, the metabolite accumulates.

The practical upshot for anyone reading a danshen label: the salvianolic-acid-B number on a certificate of analysis is a quality marker, not a bioavailability statement. What that Sal B becomes on the way in is largely this molecule.

What It's Used For

Evidence by IndicationStrength of support · Beta

Support is an experimental score — weighted by study type (human > animal > in vitro) and volume, then tempered for how well the thing studied matches the molecule named. A beta, not a validated metric. Every row here is capped by the same two facts: no controlled efficacy trial has ever given isolated danshensu to a person for any endpoint, and most animal work dosed it intravenously or intraperitoneally. The “Rests on” column names what each row actually stands on.

01Myocardial ischaemia & cardioprotectionShaky42%Systematic review + meta-analysis of 32 studies, 473 animals, 134 cell experiments ^{24Reference 24Bao XY et al. · 2018Danshensu for myocardial ischemic injury — preclinical evidence and novel methodology of quality assessment toolView study →}

02Antiplatelet & antithromboticShaky38%Two independent rat in-vivo mechanisms (COX-2/TXA2-PGI2 and SIRT1/mtDNA), plus 1980s rabbit work ^{28,29,31Reference 28Yu C et al. · 2014AnimalEffects of danshensu on platelet aggregation and thrombosis — in vivo arteriovenous shunt and venous thrombosis models in ratsView study →Reference 29Xue Y et al. · 2022Danshensu prevents thrombosis by inhibiting platelet activation via SIRT1/ROS/mtDNA pathways without increasing bleeding riskView study →Reference 31Zhu L et al. · 1986Effects of sodium beta-3,4-dihydroxyphenyl lactate and beta-phenyl lactic acid on prostacyclin and thromboxane A2 contents in the plasma of rabbits after coronary artery occlusion [in Chinese]View study →}

03Vascular, endothelial & blood pressureShaky34%Isolated-artery, HUVEC and spontaneously-hypertensive-rat data; identified as the marker of danshen water extract’s vasorelaxation ^{25,26,32,34Reference 25Dong ZT · 1982Effect of danshensu on isolated swine coronary artery perfusion preparation [in Chinese]View study →Reference 26Zhou X et al. · 2012Danshensu is the major marker for the antioxidant and vasorelaxation effects of danshen (Salvia miltiorrhiza) water-extracts produced by different heat water-extractionsView study →Reference 32Chan K et al. · 2004Protective effects of danshensu from the aqueous extract of Salvia miltiorrhiza (danshen) against homocysteine-induced endothelial dysfunctionView study →Reference 34Tang Y et al. · 2011AnimalCardiovascular protection with danshensu in spontaneously hypertensive ratsView study →}

04Cerebral ischaemia & neuroprotectionShaky28%Mouse MCAO with a defined 6-hour therapeutic window and Nrf2-knockout confirmation ^{38Reference 38Guo C et al. · 2025Therapeutic time window of sodium danshensu on cerebral ischemia and its mechanism of inhibiting oxidative stress and ferroptosis through the Nrf2 pathwayView study →}

05Homocysteine metabolismShaky26%Rat trans-sulphuration studies with a PK/PD model; a genuinely unusual and specific finding ^{32,33Reference 32Chan K et al. · 2004Protective effects of danshensu from the aqueous extract of Salvia miltiorrhiza (danshen) against homocysteine-induced endothelial dysfunctionView study →Reference 33Cao Y et al. · 2009AnimalBeneficial effects of danshensu, an active component of Salvia miltiorrhiza, on homocysteine metabolism via the trans-sulphuration pathway in ratsView study →}

06Bone formation & osteoporosisShaky24%Nine-study animal meta-analysis under the tanshinol name; large heterogeneity and publication bias ^{40Reference 40Wang S et al. · 2022Meta-analysisAntiosteoporosis effect of tanshinol in osteoporosis animal models — a systematic review and meta-analysisView study →}

07Atherosclerosis & lipid handlingShaky20%Single-laboratory macrophage and plaque studies ^{36,37Reference 36Gao H et al. · 2016Danshensu promotes cholesterol efflux in RAW264.7 macrophagesView study →Reference 37Zeng M et al. · 2023Sodium danshensu stabilizes atherosclerotic vulnerable plaques by targeting IKKβ-mediated inflammation in macrophagesView study →}

Mechanisms

Pharmacokinetics

This is the section that justifies the page existing, so it is worth being precise.

Oral bioavailability. The cleanest number is a head-to-head. In rats, absolute oral bioavailability was 11.09% for danshensu and 3.90% for salvianolic acid B, measured in the same laboratory with the same design; both showed very limited intestinal permeability, and sodium caprate improved both ^{14Reference 14Zhou L et al. · 2009Effect of sodium caprate on the oral absorptions of danshensu and salvianolic acid BView study →}. A dedicated ADME study of the sodium salt reported 13.72% in rats, comparing 180 mg/kg orally against 30 mg/kg intravenously ^{15Reference 15Meng X et al. · 2019AnimalPreclinical absorption, distribution, metabolism, and excretion of sodium danshensu, one of the main water-soluble ingredients in Salvia miltiorrhiza, in ratsView study →}.

Two caveats keep this honest. First, 11-14% is poor — the ADME authors’ own conclusion was that “sodium danshensu can be developed as an injection because of its poor oral bioavailability” ^{15Reference 15Meng X et al. · 2019AnimalPreclinical absorption, distribution, metabolism, and excretion of sodium danshensu, one of the main water-soluble ingredients in Salvia miltiorrhiza, in ratsView study →}. Second, the 3.90% figure for Sal B in that study is higher than the 2.3% reported elsewhere in rats, so the ratio (roughly 3×) is more robust than either absolute number. Against salvianolic acid A’s 0.39-0.52% in rats, the gap is more like 25-30×.

Disposition. After intravenous dosing in rats, danshensu shows linear kinetics from 15-60 mg/kg, distributes widest to kidney (then lung, stomach, muscle, uterus, heart), and is cleared overwhelmingly renally: 46.99% of the dose was recovered unchanged in urine within 96 hours, against 1.16% in faeces and 0.83% in bile. Metabolism is phase II — methylation, sulfation, combined methylation-and-sulfation, and acetylation ^{15Reference 15Meng X et al. · 2019AnimalPreclinical absorption, distribution, metabolism, and excretion of sodium danshensu, one of the main water-soluble ingredients in Salvia miltiorrhiza, in ratsView study →}. The major urinary metabolite was isolated and identified as 4-hydroxy-3-methoxyphenyllactic acid, i.e. the O-methylated catechol ^{21Reference 21Wang X et al. · 2015AnimalIdentification of a major metabolite of danshensu in rat urine and simultaneous determination of danshensu and its metabolite in plasma — application to a pharmacokinetic study in ratsView study →} — the COMT product, and the same reaction that makes danshensu a homocysteine substrate ^{33Reference 33Cao Y et al. · 2009AnimalBeneficial effects of danshensu, an active component of Salvia miltiorrhiza, on homocysteine metabolism via the trans-sulphuration pathway in ratsView study →}.

In humans. Rare for this database, there is real human pharmacokinetic data:

Setting	What was measured	Result	Source
6 healthy volunteers, oral danshen decoction containing 20 mg danshensu	urinary recovery, t½	14 ± 4% of dose in urine in 8 h; t½ 0.94 ± 0.21 h	16Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →
Same volunteers, compound granule preparation, 20 mg	urinary recovery	6.2 ± 2.8% in 8 h; t½ 0.92 ± 0.16 h	16Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →
Healthy Chinese subjects, oral Qishenyiqi dropping pills	plasma, as salvianic acid A	Cmax 21.1 ± 3.92 ng/mL, Tmax 1.33 h, t½ 1.76 h	17Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →
Healthy subjects, rats and dogs, intravenous Danhong injection	28 danshen catechols	tanshinol had considerable exposure in all three species; Sal A and Sal B low, human metabolites little/not detected	18Reference 18Li M et al. · 2015Clinical trialSystemic exposure to and disposition of catechols derived from Salvia miltiorrhiza roots (danshen) after intravenous dosing DanHong injection in human subjects, rats, and dogsView study →
Healthy volunteers, oral Compound Danshen Dripping Pills	danshensu + 3 related catechols in plasma	validated method, clinical PK performed	22Reference 22Li W et al. · 2017Simultaneous determination and pharmacokinetics of danshensu, protocatechuic aldehyde, 4-hydroxy-3-methyloxyphenyl lactic acid and protocatechuic acid in human plasma by LC-MS/MS after oral administration of Compound Danshen Dripping PillsView study →

Two things follow. The decoction delivered more than twice the urinary recovery of the proprietary granule from the same danshensu dose ^{16Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →} — a rare direct comparison favouring the traditional preparation. And the plasma concentration achieved from an oral proprietary product, 21 ng/mL ≈ 0.11 µM ^{17Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →}, is roughly 300-fold below the 35 µM CYP2C9 inhibition constant ^{43Reference 43Qiu F et al. · 2008Inhibitory effects of seven components of danshen extract on catalytic activity of cytochrome P450 enzyme in human liver microsomesView study →}. That single comparison does more work here than any efficacy study.

Route matters as much as it does for the parents. After pulmonary administration of a S. miltiorrhiza polyphenolic-acid solution to rats, danshensu was tracked in plasma alongside Sal B and rosmarinic acid, whose bioavailabilities by that route were 50.4% and 89.6% ^{23Reference 23Lu P et al. · 2019AnimalPharmacokinetics of salvianolic acid B, rosmarinic acid and danshensu in rat after pulmonary administration of Salvia miltiorrhiza polyphenolic acid solutionView study →}. And when Sal B or a danshen depside-salt injection was given to mice, danshensu appeared as the active metabolite, accumulating in obstructed kidneys as the parent’s exposure collapsed ^{20Reference 20Lin P et al. · 2025AnimalComparative study of pharmacokinetics and renal exposure of salvianolic acid B and its metabolite danshensu in normal and renal fibrosis miceView study →}.

Clinical Trials

There are none of the isolate. No randomised controlled trial has given purified danshensu to human beings for any clinical endpoint. "danshensu" AND (clinical trial[pt] OR randomized controlled trial[pt]) returns 2 PubMed records, neither of which tests the molecule alone.

What exists instead is a human pharmacokinetic record — five studies measuring danshensu in the plasma or urine of healthy volunteers after danshen decoctions, dripping pills, granules and intravenous injectables ^{16,17,18,22Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →Reference 18Li M et al. · 2015Clinical trialSystemic exposure to and disposition of catechols derived from Salvia miltiorrhiza roots (danshen) after intravenous dosing DanHong injection in human subjects, rats, and dogsView study →Reference 22Li W et al. · 2017Simultaneous determination and pharmacokinetics of danshensu, protocatechuic aldehyde, 4-hydroxy-3-methyloxyphenyl lactic acid and protocatechuic acid in human plasma by LC-MS/MS after oral administration of Compound Danshen Dripping PillsView study →} — plus one human drug-interaction study in which danshensu was the marker component (see below) ^{44Reference 44Zhang Y et al. · 2020Clinical trialIs it safe to take Radix Salvia miltiorrhiza – Radix Pueraria lobata product with warfarin and aspirin? A pilot study in healthy human subjectsView study →}. That is the reverse of the usual pattern here: we know a fair amount about what happens to this molecule in a person, and nothing about what it does to one.

Last checked: August 2026.

Isolate vs. Plant Studies

Danshensu sits in an unusual position: the pharmacology is almost entirely isolate work, and the human evidence is almost entirely plant work — but for once the two halves connect, because the plant work measured the isolate in plasma.

• Traditional decoction. Danshen’s water decoction extracts the hydrophilic fraction, and danshensu is both directly present in it and generated from the larger salvianolic acids in the gut ^{19Reference 19Liu Z et al. · 2016AnimalQuantitatively metabolic profiles of salvianolic acids in rats after gastric-administration of Salvia miltiorrhiza extractView study →}. The vasorelaxant and antioxidant activity of danshen water extracts tracks danshensu content better than any other marker ^{26Reference 26Zhou X et al. · 2012Danshensu is the major marker for the antioxidant and vasorelaxation effects of danshen (Salvia miltiorrhiza) water-extracts produced by different heat water-extractionsView study →}, and a decoction delivered better danshensu absorption than a proprietary granule in the same volunteers ^{16Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →}.
• Chinese injectables. Danshensu has been an assay marker for Salvia miltiorrhiza injections since at least 1988 ^{13Reference 13Ni KY · 1988Reversed-phase HPLC determination of three components in Salvia miltiorrhiza injections [in Chinese]View study →}, and it is a quantified constituent of Danhong injection ^{18Reference 18Li M et al. · 2015Clinical trialSystemic exposure to and disposition of catechols derived from Salvia miltiorrhiza roots (danshen) after intravenous dosing DanHong injection in human subjects, rats, and dogsView study →}, danshen depside salt injection ^{20Reference 20Lin P et al. · 2025AnimalComparative study of pharmacokinetics and renal exposure of salvianolic acid B and its metabolite danshensu in normal and renal fibrosis miceView study →} and other hospital products. In Danhong, tanshinol is the catechol with the highest dose in the formulation and the greatest systemic exposure ^{18Reference 18Li M et al. · 2015Clinical trialSystemic exposure to and disposition of catechols derived from Salvia miltiorrhiza roots (danshen) after intravenous dosing DanHong injection in human subjects, rats, and dogsView study →}. Clinical outcomes for those products belong to the mixtures, not to this molecule.
• Oral proprietary products. Compound Danshen Dripping Pills and Qishenyiqi dropping pills both deliver measurable plasma danshensu ^{17,22Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →Reference 22Li W et al. · 2017Simultaneous determination and pharmacokinetics of danshensu, protocatechuic aldehyde, 4-hydroxy-3-methyloxyphenyl lactic acid and protocatechuic acid in human plasma by LC-MS/MS after oral administration of Compound Danshen Dripping PillsView study →}. Their efficacy literature is formula-level; crediting it to danshensu would be the same category error the salvianolic acid pages warn about.
• Danshen tablets. In one quantified commercial sample, sodium danshensu was present at 0.81 mg/g against salvianolic acid B at 6.04 mg/g and rosmarinic acid at 0.52 mg/g ^{12Reference 12Peng LQ et al. · 2017Graphene nanoplatelets based matrix solid-phase dispersion microextraction for phenolic acids by ultrahigh performance liquid chromatography with electrochemical detectionView study →} — the mass hierarchy of the root, preserved into the product.

Within this database, danshensu’s legitimate role is as a genuine minor constituent of dan shen, as the shared monomer of rosmarinic acid and the salvianolic acids, and as the circulating species that follows from taking any of them by mouth.

Prevalence in Nature

Danshensu is not a food compound and has no meaningful dietary exposure. Its commercially relevant source is the dried root of Salvia miltiorrhiza; the attribution is solid, with 231 of 550 PubMed records for “danshensu” co-mentioning the binomial (321 of 802 across all four synonyms).

By mass it is a minor phenolic. A survey of 58 Salvia species found phenolic-acid content in most of them followed the pattern salvianolic acid B > rosmarinic acid > danshensu > caffeic acid, in roots and leaves alike, with leaf content generally exceeding root. Danshensu was widely distributed across the genus but never abundant: the highest root content across all 58 species was 0.172% in S. sinica, against rosmarinic acid reaching 5.3% in S. daiguii and salvianolic acid B 11.8% in S. paramiltiorrhiza ^{10Reference 10Wang F et al. · 2024Content determination and chemical clustering analysis of tanshinone and salvianolic acid in Salvia sppView study →}. Danshensu content was, however, discriminating enough to drive part of the chemical clustering — species distributed across central China carried more of it ^{10Reference 10Wang F et al. · 2024Content determination and chemical clustering analysis of tanshinone and salvianolic acid in Salvia sppView study →}.

One outlier is worth recording: Salvia clandestina shoots contained 4.96 mg/g dry weight, which the authors described as considerable relative to published S. miltiorrhiza figures and proposed as an unexploited source ^{11Reference 11Nicolì F et al. · 2019Salvia clandestina L. — unexploited source of danshensuView study →}.

Beyond Salvia, danshensu occurs implicitly wherever rosmarinic acid does — the Lamiaceae and Boraginaceae — because it is one of that ester’s two halves, and it is released by hydrolysis. Whether it accumulates free in those plants at meaningful levels is a separate question, and the drying study suggests the answer depends heavily on processing: fresh root is low in free and high in bound phenolic acids, and dehydration converts one into the other enzymatically ^{8Reference 8Zhou T et al. · 2020Comparative study on free and bound phenolic acids before and after drying of Salvia miltiorrhiza [in Chinese]View study →}.

Discovery & Synthesis

Danshensu was isolated from danshen root by Chinese workers in the late 1970s, and the earliest PubMed-indexed pharmacology is Dong and Jiang’s 1982 study of its effect on an isolated swine coronary artery perfusion preparation in Acta Pharmaceutica Sinica ^{25Reference 25Dong ZT · 1982Effect of danshensu on isolated swine coronary artery perfusion preparation [in Chinese]View study →}. Work on the anticoagulant action followed in 1983 ^{30Reference 30Li CZ · 1983Experimental study on the anticoagulative action of danshensu [in Chinese]View study →}, and on the sodium salt’s effects on prostacyclin and thromboxane A2 in rabbits after coronary occlusion in 1986 ^{31Reference 31Zhu L et al. · 1986Effects of sodium beta-3,4-dihydroxyphenyl lactate and beta-phenyl lactic acid on prostacyclin and thromboxane A2 contents in the plasma of rabbits after coronary artery occlusion [in Chinese]View study →}. By 1988 it had a formal analytical identity: a reversed-phase HPLC method determined danshensu as one of three components assayed in Salvia miltiorrhiza injections ^{13Reference 13Ni KY · 1988Reversed-phase HPLC determination of three components in Salvia miltiorrhiza injections [in Chinese]View study →}. I could not verify the specific primary isolation paper in this pass.

Chemically it is (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, C₉H₁₀O₅, 198.17 Da, CAS 76822-21-4, PubChem CID 11600642 ^{3Reference 3PubChemCompound record for danshensu (CID 11600642) — (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, C9H10O5, MW 198.17, CAS 76822-21-4; synonyms tanshinol, salvianic acid A, dan shen suan AView study →}. It is a small, water-soluble, weakly acidic catechol, and it is handled commercially as the sodium salt (“sodium danshensu”, “salvianic acid A sodium”) because that is stable, soluble and injectable. The molecule’s own instability — an ortho-diphenol plus an α-hydroxy carboxylic acid — is the explicit motive for a large medicinal-chemistry literature on danshensu derivatives, hybrids and prodrugs (danshensu-tetramethylpyrazine conjugates, ADTM, danshensu methyl ester and others) aimed at better stability, lipophilicity and bioavailability ^{2Reference 2Yang Y et al. · 2025Danshensu derivatives — a series of promising drugs with protective effects against cardiocerebrovascular diseases and cancersView study →}.

Supply does not depend on the plant. Danshensu is made enzymatically from L-DOPA by a self-sufficient three-enzyme cascade — a tyrosine aminotransferase from E. coli, a D-specific 2-hydroxyacid dehydrogenase from Lactobacillus frumenti, and a glutamate dehydrogenase to recycle cofactors — reaching 98.3% yield and a space-time yield of 6.61 g/L/h ^{9Reference 9Han R et al. · 2023In vitroSelf-sufficient in vitro multi-enzyme cascade for efficient synthesis of danshensu from L-DOPAView study →}. Chemical synthesis of racemic material is also straightforward, which is how several pharmacology studies came to use the DL form ^{15Reference 15Meng X et al. · 2019AnimalPreclinical absorption, distribution, metabolism, and excretion of sodium danshensu, one of the main water-soluble ingredients in Salvia miltiorrhiza, in ratsView study →}.

Patents: not yet researched.

Toxicity & Safety

Danshensu has something almost nothing else here has: a real, published toxicology package on the isolated molecule.

Acute. Intravenous danshensu given to rats produced no signs of toxicity or mortality up to a maximum practical dose of 1,500 mg/kg. In mice, acute dosing produced dose-dependent behavioural effects and mortality with a median lethal dose of 2,356 mg/kg, a no-observed-adverse-effect level of 1,835 mg/kg and a lowest-observed-adverse-effect level of 2,000 mg/kg ^{42Reference 42Gao Y et al. · 2009AnimalAcute and subchronic toxicity of danshensu in mice and ratsView study →}.

Subchronic. Rats received daily intraperitoneal danshensu at 50, 150 and 450 mg/kg for 90 days. There was no mortality and no change in body weight, food consumption, haematology, serum chemistry, organ weights, gross pathology or histopathology. The only treatment-related finding was a transient writhing response at 450 mg/kg immediately after dosing ^{42Reference 42Gao Y et al. · 2009AnimalAcute and subchronic toxicity of danshensu in mice and ratsView study →}.

That is a genuinely clean 90-day record at doses far above anything achievable from a plant preparation, and it is the basis for the low grading here. Two limits: there is no genotoxicity, carcinogenicity or reproductive-toxicity study on the isolate, and no human safety study designed as one. Human exposure data exist only as pharmacokinetic measurements in small volunteer groups ^{16,17,22Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →Reference 22Li W et al. · 2017Simultaneous determination and pharmacokinetics of danshensu, protocatechuic aldehyde, 4-hydroxy-3-methyloxyphenyl lactic acid and protocatechuic acid in human plasma by LC-MS/MS after oral administration of Compound Danshen Dripping PillsView study →}.

Reproductive data are limited but not absent, and they point the opposite way to the herb’s traditional contraindication. In a phosphatidylserine/phosphatidylcholine-induced preeclampsia model in 66 pregnant mice, danshensu lowered blood pressure and proteinuria, improved antithrombin III activity and platelet counts, reduced placental fibrin deposition and thrombomodulin expression, and improved fetal weight, nose-breech length and brain weight — with the authors noting no side effects in the danshensu groups, against bleeding complications in the heparin and aspirin comparators ^{49Reference 49Shen Y et al. · 2011AnimalFavorable maternal and fetal effects of danshensu in an experimental mice model of preeclampsiaView study →}. That is one mouse model, from one group, and it does not license use in human pregnancy; danshen as a herb remains conventionally avoided, and that judgement belongs on the dan shen monograph where dose and preparation are decided.

Where Danshensu Sits in the Danshen-Warfarin Split

The danshen–warfarin interaction is one of the best-documented herb–drug interactions in the materia medica — case reports of raised INR, over-anticoagulation and bleeding ^{48Reference 48Chan TY · 2001Case reportInteraction between warfarin and danshen (Salvia miltiorrhiza) — review of case reportsView study →}. Our salvianolic acid pages divide it: the pharmacokinetic half traces to the lipophilic tanshinones, because a danshen ethyl acetate extract inhibited warfarin hydroxylation in rat liver microsomes while the aqueous extract had no effect at all ^{46Reference 46Wu WW · 2010In vitroInhibition of warfarin hydroxylation by major tanshinones of danshen (Salvia miltiorrhiza) in the rat in vitro and in vivoView study →}; the pharmacodynamic half belongs to the antiplatelet salvianolic fraction.

Danshensu is the constituent that complicates that split, and it should be stated rather than smoothed over.

It has a documented CYP2C9 mechanism. In a panel of seven danshen constituents tested against probe substrates in human liver microsomes, the tanshinones were potent CYP1A2 inhibitors as expected — but danshensu was a competitive inhibitor of CYP2C9 with a Ki of 35 µM ^{43Reference 43Qiu F et al. · 2008Inhibitory effects of seven components of danshen extract on catalytic activity of cytochrome P450 enzyme in human liver microsomesView study →}. CYP2C9 clears S-warfarin. Salvianolic acid B produced no comparable finding in that panel.

And it is the marker in a human study that found a real interaction. In a 5-day, five-session crossover in 14 healthy volunteers, a danshen–kudzu product co-administered with warfarin reduced the AUC of 7-hydroxywarfarin — the CYP2C9 metabolite — and significantly increased systemic danshensu exposure; with aspirin it raised aspirin AUC and lowered systemic thromboxane B2, which the authors attributed partly to danshensu’s own COX-2 inhibition acting synergistically ^{44Reference 44Zhang Y et al. · 2020Clinical trialIs it safe to take Radix Salvia miltiorrhiza – Radix Pueraria lobata product with warfarin and aspirin? A pilot study in healthy human subjectsView study →}. The rat version of the same experiment had shown the same direction of travel ^{45Reference 45Zhou L et al. · 2012Pharmacokinetic and pharmacodynamic interaction of danshen-gegen extract with warfarin and aspirinView study →}.

But the quantitative case against clinical significance is strong. The achievable oral plasma concentration is about 0.11 µM ^{17Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →} — roughly 300-fold below the 35 µM Ki. A standardised water-type danshen product added to stable warfarin in 24 volunteers produced no increase in INR, with R- and S-warfarin exposure ratios inside bioequivalence bounds ^{47Reference 47Wang P et al. · 2014Absence of an effect of T89 on the steady-state pharmacokinetics and pharmacodynamics of warfarin in healthy volunteersView study →}. And the rat and human danshen–kudzu studies both found warfarin’s effect reduced, not enhanced ^{44,45Reference 44Zhang Y et al. · 2020Clinical trialIs it safe to take Radix Salvia miltiorrhiza – Radix Pueraria lobata product with warfarin and aspirin? A pilot study in healthy human subjectsView study →Reference 45Zhou L et al. · 2012Pharmacokinetic and pharmacodynamic interaction of danshen-gegen extract with warfarin and aspirinView study →} — the opposite direction to the case reports.

The honest reading: the metabolic interaction still belongs mainly to the tanshinones, but danshensu is not innocent of it, and the “the aqueous fraction does nothing” shorthand is too clean. What danshensu does own outright is a pharmacodynamic contribution — COX-2 inhibition, thromboxane suppression and platelet inhibition ^{28,29,44Reference 28Yu C et al. · 2014AnimalEffects of danshensu on platelet aggregation and thrombosis — in vivo arteriovenous shunt and venous thrombosis models in ratsView study →Reference 29Xue Y et al. · 2022Danshensu prevents thrombosis by inhibiting platelet activation via SIRT1/ROS/mtDNA pathways without increasing bleeding riskView study →Reference 44Zhang Y et al. · 2020Clinical trialIs it safe to take Radix Salvia miltiorrhiza – Radix Pueraria lobata product with warfarin and aspirin? A pilot study in healthy human subjectsView study →}. That is additive with aspirin and clopidogrel regardless of warfarin.

Safety at a Glance

✅ Low / no toxicityBleeding risk

• A real 90-day repeat-dose toxicology study on the isolate found no changes in body weight, haematology, serum chemistry, organ weights or histopathology at up to 450 mg/kg/day in rats ^{42Reference 42Gao Y et al. · 2009AnimalAcute and subchronic toxicity of danshensu in mice and ratsView study →}.
• Wide acute margin — no toxicity in rats intravenously to 1,500 mg/kg; mouse LD50 2,356 mg/kg ^{42Reference 42Gao Y et al. · 2009AnimalAcute and subchronic toxicity of danshensu in mice and ratsView study →}.
• Substantial human exposure without a safety signal in the record, via decoctions, dripping pills and hospital injectables where danshensu is a quantified marker ^{13,16,17,18,22Reference 13Ni KY · 1988Reversed-phase HPLC determination of three components in Salvia miltiorrhiza injections [in Chinese]View study →Reference 16Liu Q · 2003Determination of danshensu in urine and its pharmacokinetics in human [in Chinese]View study →Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →Reference 18Li M et al. · 2015Clinical trialSystemic exposure to and disposition of catechols derived from Salvia miltiorrhiza roots (danshen) after intravenous dosing DanHong injection in human subjects, rats, and dogsView study →Reference 22Li W et al. · 2017Simultaneous determination and pharmacokinetics of danshensu, protocatechuic aldehyde, 4-hydroxy-3-methyloxyphenyl lactic acid and protocatechuic acid in human plasma by LC-MS/MS after oral administration of Compound Danshen Dripping PillsView study →}.
• Genuine antiplatelet activity of its own — selective COX-2 inhibition and thromboxane suppression ^{28Reference 28Yu C et al. · 2014AnimalEffects of danshensu on platelet aggregation and thrombosis — in vivo arteriovenous shunt and venous thrombosis models in ratsView study →}, SIRT1-mediated platelet inhibition ^{29Reference 29Xue Y et al. · 2022Danshensu prevents thrombosis by inhibiting platelet activation via SIRT1/ROS/mtDNA pathways without increasing bleeding riskView study →}. Additive with aspirin, clopidogrel, NSAIDs and anticoagulants; relevant before surgery. One mouse study found no prolongation of bleeding time ^{29Reference 29Xue Y et al. · 2022Danshensu prevents thrombosis by inhibiting platelet activation via SIRT1/ROS/mtDNA pathways without increasing bleeding riskView study →}, which is reassuring but not a clearance.
• CYP2C9 competitive inhibition in human liver microsomes (Ki 35 µM) ^{43Reference 43Qiu F et al. · 2008Inhibitory effects of seven components of danshen extract on catalytic activity of cytochrome P450 enzyme in human liver microsomesView study →}, and a human crossover study in which a danshen-containing product shifted 7-hydroxywarfarin exposure and raised danshensu exposure when combined with warfarin ^{44Reference 44Zhang Y et al. · 2020Clinical trialIs it safe to take Radix Salvia miltiorrhiza – Radix Pueraria lobata product with warfarin and aspirin? A pilot study in healthy human subjectsView study →}. Achievable plasma levels are ~300× below the Ki ^{17Reference 17Feng L et al. · 2015Validation and application of a rapid HPLC-MS method for the determination of salvianic acid A in human plasmaView study →}, and a water-type danshen product did not move INR ^{47Reference 47Wang P et al. · 2014Absence of an effect of T89 on the steady-state pharmacokinetics and pharmacodynamics of warfarin in healthy volunteersView study →} — but this is the one water-soluble danshen constituent with a metabolic mechanism on paper.
• No genotoxicity, carcinogenicity or reproductive toxicology on the isolate. A preeclampsia mouse model reported benefit and no adverse effects ^{49Reference 49Shen Y et al. · 2011AnimalFavorable maternal and fetal effects of danshensu in an experimental mice model of preeclampsiaView study →}; that is not a reproductive-safety dataset.
• No human efficacy trial of any kind, so there is no clinical dose at which safety has been characterised.
• Much of the pharmacology used the racemic sodium salt ^{15Reference 15Meng X et al. · 2019AnimalPreclinical absorption, distribution, metabolism, and excretion of sodium danshensu, one of the main water-soluble ingredients in Salvia miltiorrhiza, in ratsView study →} rather than the natural (R)-(+) enantiomer ^{3Reference 3PubChemCompound record for danshensu (CID 11600642) — (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, C9H10O5, MW 198.17, CAS 76822-21-4; synonyms tanshinol, salvianic acid A, dan shen suan AView study →}; the enantiomers have not been compared.

Dosage

There is no dose of danshensu, and no product is standardised to it as an active. The figures below are what the research used, and they are for orientation only — most are animal doses given intravenously or intraperitoneally, because that is what the 11-14% oral bioavailability forces.

The last row is the practical one and it cannot be converted. Danshensu is a minor constituent of the root by mass ^{10Reference 10Wang F et al. · 2024Content determination and chemical clustering analysis of tanshinone and salvianolic acid in Salvia sppView study →}, no pharmacopoeia sets a specification for it, and a large and variable share of what reaches the blood comes not from the root’s free danshensu but from gut cleavage of the salvianolic acids ^{19Reference 19Liu Z et al. · 2016AnimalQuantitatively metabolic profiles of salvianolic acids in rats after gastric-administration of Salvia miltiorrhiza extractView study →}. So the ingested dose is unknown even in principle from a label. These are research figures, not recommendations, and anyone on anticoagulant or antiplatelet medication should not add danshen or any isolate from it without medical supervision.

References

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3. PubChem, National Library of Medicine. Compound record for danshensu (CID 11600642) — (2R)-3-(3,4-dihydroxyphenyl)-2-hydroxypropanoic acid, C9H10O5, MW 198.17, CAS 76822-21-4; synonyms tanshinol, salvianic acid A, dan shen suan A. [Database — no per-record PMID.] https://pubchem.ncbi.nlm.nih.gov/compound/11600642
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