Drug & supplement interaction

Black Cohosh + Cisplatin

Cisplatin brand name: Platinol-AQ.

Moderate Interaction
The bottom line Moderate

Black Cohosh has a moderate interaction with Cisplatin. Theoretically, black cohosh may reduce the clinical effects of cisplatin.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Black Cohosh and Cisplatin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CISPLATIN (Platinol-AQ)

Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with black cohosh and cisplatin: the concern is that black cohosh might make cisplatin work less well. Cisplatin is a chemotherapy drug that kills cancer cells directly (it isn't a prodrug that needs activating), and some lab and animal studies hint that black cohosh could blunt how strongly it attacks cancer cells. The worry isn't more side effects, it's potentially weaker treatment.

I want to be honest about the evidence though: this comes only from cell and animal research, not from people, so it's theoretical. Still, when you're going through cancer treatment, you don't want to risk anything working against it. Please loop in your oncologist or pharmacist before adding black cohosh or any supplement during cisplatin therapy.

References
  1. Rockwell S, Liu Y, Higgins SA. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 2005;90:233-9. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Black Cohosh Also Interacts With Other Medications

Black Cohosh has 635 moderate, 16 minor known drug interactions in our database — the Cisplatin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Black Cohosh

Covers the 2,830 medications we’ve checked against Black Cohosh. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Cisplatin

This page covers Black Cohosh only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cisplatin page lists 90 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Acerola (moderate) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 3 major · 75 moderate · 12 minor.

From our pharmacist’s overview on the Cisplatin page

“Kidney damage is the risk I would flag first for anyone receiving cisplatin (Platinol-AQ). Cisplatin is a chemotherapy drug that already stresses the kidneys, and two of the three major-rated interactions on this list, Siberian cocklebur and asarabacca, involve herbs that can injure the kidneys on their own, stacking harm on an organ t…”

Reviewed by 2 · Jul 18, 2026

Open the Cisplatin interaction page

One more smart check

Taking Black Cohosh as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,472 real supplement products containing Black Cohosh, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Black Cohosh. Your product may carry other ingredients that interact with Cisplatin too, on top of Black Cohosh — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Black Cohosh and Cisplatin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Black Cohosh
Top 25%

#156 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cisplatin
Top half

#1,176 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Black Cohosh

What is Black Cohosh?

Black Cohosh
  • Hot flashes and night sweats
  • Other menopause symptoms
  • Mood changes during menopause
  • Premenstrual syndrome (PMS)
  • Menstrual cramps

Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It is generally well tolerated for short-term use, though rare reports of liver problems mean you should talk with your pharmacist or doctor before trying it, especially if you have liver disease.

Read the full Black Cohosh monograph & all interactions
Medication

About Cisplatin Injection

What Is Cisplatin Injection Used For?

Brand name: Platinol-AQ

Cisplatin Injection is used to treat three types of cancer. For metastatic testicular tumors and metastatic ovarian tumors, it is used as part of combination chemotherapy — alongside other approved cancer medicines — in patients who have already had surgery and/or radiation therapy. For metastatic ovarian tumors, it can also be used alone as a second-line treatment when standard chemotherapy has stopped working and cisplatin has not been tried before.

For advanced bladder cancer (specifically transitional cell bladder cancer) that can no longer be treated with surgery or radiation, Cisplatin Injection is used as a single agent.

See full Cisplatin Injection drug information
Keep checking

Other Drugs & Black Cohosh

Browse every other medication we’ve checked against Black Cohosh — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
635Moderate
16Minor
2,178No known interaction
Moderate

635 interactions

Showing 60 of 635 moderate interactions — see all 635 on the Black Cohosh page.

Minor

16 interactions

No interaction 2,178 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Black Cohosh and Cisplatin Together: Common Questions

Can you take Black Cohosh with Cisplatin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Black Cohosh and Cisplatin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Cisplatin and Black Cohosh?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.