Tian Wang Bu Xin Dan (Heavenly Emperor's Heart-Supplementing Elixir) tiān wáng bǔ xīn dān · 天王补心丹

Safety. Attribution varies between Chinese sources; the version in general use is cited to She Sheng Mi Pou (明·洪基), and alternative attributions exist. That disagreement is stated rather than hidden. - The dominant safety issue is 朱砂 (cinnabar), the mercuric sulfide used traditionally as the pill coating. Mercury is a cumulative poison with neurological and renal targets; cinnabar's mercury sulfide is far less soluble than inorganic mercury salts, which is how its traditional use is defended, but heating or incineration converts it into far more dangerous forms, and cases of mercury poisoning from cinnabar-containing preparations are published. Several jurisdictions restrict or prohibit cinnabar in medicines, and many modern manufacturers produce this formula without it. Anyone considering this product should be told plainly which version they are being offered; chronic use, use in pregnancy, and use in children are not appropriate. - 丹参 (salvia) has a well-documented interaction with warfarin, potentiating anticoagulation and raising bleeding risk; the same caution extends to other anticoagulants and antiplatelet drugs. - 五味子 (schisandra) inhibits CYP3A4 and has documented reports of altering blood levels of drugs such as tacrolimus and ciclosporin - material for transplant recipients. - 人参 interacts with warfarin, with glucose-lowering medicines, and can be overstimulating. - 当归 carries the same case-report-level warfarin caution noted elsewhere. - The pill is traditionally honey-bound, which matters for blood-sugar management. - This formula calms the spirit by traditional description; it is not a substitute for assessment of insomnia, palpitations, or low mood by a clinician, several of which have causes that this kind of remedy will not address.