Danning Tablet

What It Is

Danning Tablet (胆宁片) is a Chinese patent (traditional herbal) medicine formulated for hepatobiliary and gallbladder/gallstone-related conditions.

Its constituents include a combination of herbal ingredients (in classical Chinese medicine theory) such as:

• Radix et Rhizoma Rhei (rhubarb)
• Rhizoma/Root of Polygonum cuspidatum (Japanese knotweed)
• Pericarpium Citri Reticulatae (peel of mandarin orange) or its green variant
• Rhizoma Curcumae (turmeric)
• Fructus Crataegi (hawthorn fruit)
• Rhizoma Imperatae (sometimes used in formulations)
• Other adjunct herbal or “synergistic” ingredients, possibly including artificial bezoar, silibinin, berberine, Corydalis, dandelion, loosestrife, peppermint oil, etc.

Analytically, modern studies have identified polydatin and resveratrol as detectable active constituents in Danning Tablets.

It is often marketed in tablet form (coated) with a typical per-tablet mass of ~0.25 g (or equivalent to ~0.66 g of “original drug” per some references). Danning Tablet is used (in the Chinese medical / integrative medicine setting) for conditions involving the liver, gallbladder, bile ducts, and cholestasis or inflammation of the biliary system.

In some jurisdictions (e.g. Canada), Danning has been registered as a “natural product” with a Natural Product Number (NPN: 80073325) for traditional Chinese medicine use. hmeonlineglobal.com

How It Works

Because Danning Tablet is a multi-herb formulation, its mechanisms are likewise multifactorial. Several pharmacological and mechanistic studies (mostly in animals, cell systems, or preclinical settings) shed light on how it might act:

Choleretic / Bile-promoting effect

• Danning Tablet has been found to increase bile secretion (i.e. promote cholagogue / stimulate hepatic bile flow) by enhancing the activity of hepatic Na⁺–K⁺ ATPase, improving the function of sodium pumps in hepatocyte membranes, thereby increasing bile formation and excretion.
• In cholestasis models in rats (e.g., induced by α-naphthylisothiocyanate, ANIT), Danning mitigated bile stasis by modulating transporter proteins (e.g. Bsep, Mdr2, Mrp2) and metabolic enzymes (e.g. CYP2b1, UGT1A1) to help eliminate bile acids and bilirubin via hepatic and renal routes.

Anti-inflammatory and hepatoprotective effects

• It attenuates liver injury under cholestatic stress, likely through reducing oxidative stress, neutrophil infiltration, and inflammation in hepatic tissue. BioMed Central
• In the context of gallbladder inflammation, Danning appears to reduce inflammatory markers (e.g. IL-6) locally and systemically in experimental animals, thereby decreasing wall thickness of the gallbladder and alleviating cholecystitis symptoms. pjps.pk
• Some of the herbal constituents (quercetin, luteolin, aloe-emodin, rhein, etc.) have known anti-inflammatory, antioxidant, or cell signaling effects (e.g. via NF-κB inhibition) that may contribute synergistically. pjps.pk

Modulation of gene expression / aquaporin regulation

• A more specific mechanistic insight: Danning might upregulate hepatic aquaporin 7 (AQP7) expression (a water channel) via regulation mediated by estrogen receptor 1 (ESR1). This helps facilitate water movement and “flushing” of bile through the gallbladder, thereby aiding in the “rinsing” effect of bile flow. pjps.pk
• Through network pharmacology, various active compounds in Danning have been predicted to bind to ESR1, modulating transcriptional regulation relevant to biliary function. pjps.pk

Potential anti-stone / lithostatic effects

• Some claims (in traditional medicine literature) suggest that Danning may reduce stone formation by increasing lecithin secretion (a component that helps solubilize cholesterol in bile), reducing nucleation factors, or lowering β-glucuronidase activity in liver/bile.
• However, in newer experimental work, the influence on cholesterol saturation index or bile composition was modest and often not statistically significant in animal models, suggesting that the anti-stone effect may be secondary or marginal. pjps.pk

Metabolic / systemic effects (e.g. addressing liver fat)

• In nonalcoholic fatty liver disease (NAFLD) or obesity models, Danning has been shown to ameliorate hepatic steatosis (fat accumulation in the liver) and reduce lipid peroxidation, possibly via enhancing antioxidant enzyme activity (e.g. superoxide dismutase) and reducing oxidative stress. ScienceDirect
• Through network pharmacology approaches, Danning is predicted to act on multiple molecular targets (e.g. lipid metabolism, inflammatory signaling, oxidative stress pathways) in treatment of NAFLD. Europe PMC

Because most of the robust mechanistic data come from animal or in vitro studies, human-level mechanistic certainty is still limited.

Why It’s Important

Understanding Danning Tablet is important for several reasons:

Clinical demand in biliary / gallbladder disorders

• Gallbladder inflammation (cholecystitis), gallstones, biliary stasis, and gallbladder polyps are fairly common hepatobiliary conditions. Therapies that can non-invasively aid bile flow, reduce inflammation, and possibly slow polyp growth are appealing, especially in patients not eligible or willing for surgery.
• A registered clinical trial (Phase 4) is underway to assess its effect on gallbladder polyp shrinkage compared with lifestyle intervention in 336 patients. ICHGCP
• Another real-world observational study is evaluating its effect on dyspepsia (indigestion, upper abdominal discomfort, bloating) in 4,500 patients. ctv.veeva.com

Potential as adjunct or alternative to more invasive treatments

• If Danning tablets can meaningfully reduce gallbladder inflammation or polyp size, they might reduce the need for surgical interventions or delay progression to more serious disease. Icahn School of Medicine at Mount Sinai
• For patients with cholestasis (i.e. impaired bile flow), adjunctive therapies that promote bile excretion may protect against bile acid accumulation, liver injury, or progression to fibrosis. BioMed Central

Bridging traditional and modern medicine

• Danning is an example of a traditional Chinese medicine that is being subjected to modern pharmacological, biochemical, and clinical research. It exemplifies the trend of integrating herbal formulas with evidence-based medicine.
• Identifying its active constituents (e.g. polydatin, resveratrol) and clarifying molecular targets helps in standardization, quality control, and possibly deriving new drug leads. RSC Publishing

Safety / tolerability profile (in theory)

• Because it is an herbal formula (rather than a potent synthetic drug), it may offer a relatively milder side effect profile in some compare to stronger pharmaceuticals — though this depends heavily on dose, purity, interactions, and individual susceptibility.
• Its registration in certain markets (e.g. Canada) under natural product regulations suggests regulatory acceptance of its safety and manufacturing quality (assuming compliance). hmeonlineglobal.com

Thus, Danning Tablet is clinically interesting both as a therapeutic option in hepatobiliary disease and as a model for rigorous evaluation of traditional medicines.