Paeonia lactiflora

Used by 2 traditions1 compound

Common Names

tcm: 白芍 (Bai Shao), 赤芍 (Chi Shao)

kampo: Shakuyaku

korean: 작약 (Jakyak)

english: Chinese Peony, White Peony

japanese: 芍薬 (Shakuyaku)

latin_pharmaceutical: Paeoniae Radix Alba / Paeoniae Radix Rubra

Geographic Range: East Asia — China, Japan, Korea, Mongolia, Siberia.

Known Contraindications

• Long-term use without monitoring (pseudoaldosteronism risk from Kanzo)
• Hypokalemia
• Hypertension
• Concurrent aldosterone-affecting drugs
• Kyo-Sho (deficiency pattern) without Oketsu signs
• Pregnancy (blood-moving formula)
• Concurrent anticoagulant therapy (additive blood-moving effect)
• Jitsu-Sho (excess pattern) with heat signs
• Blood excess with Oketsu (use Keishi-Bukuryo-Gan instead for strong Oketsu)
• No major contraindications — one of the safest Kampo formulas; widely used during pregnancy in Japan under physician supervision
• Yang deficiency without blood stasis
• Concurrent anticoagulants (mild blood-moving)

Compounds

Traditions

Treatments

Conditions

CAS: 23180-57-6

SMILES: O=C(OC[C@]12C[C@@H](OC(=O)c3ccccc3)[C@H](O1)[C@@H]1OC(CO)[C@@H](O)[C@H](O)[C@@H]1O)C2

CYP Interaction Profile

Enzyme	Interaction
CYP1A2	no significant interaction
CYP2C9	no significant interaction
CYP2D6	no significant interaction
CYP3A4	weak substrate (minor hepatic metabolism)
CYP2C19	no significant interaction
clinical_note	Gut flora-dependent activation. Antibiotic co-administration may reduce therapeutic effect. Low direct CYP interaction risk.
gut_flora_note	Primary metabolism via gut flora hydrolysis to paeonimetabolin I/II. Concurrent antibiotic use may significantly reduce efficacy.