Herb & supplement monograph

Blue Cohosh Drug Interactions, Uses, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Blue Cohosh interacts with medications. The heart of this page is the interaction list — every drug Blue Cohosh is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Blue Cohosh is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Blue Cohosh Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Blue Cohosh drug interaction appears low for most people, though a few medication groups deserve caution. None of the listed interactions are rated major, and all of them rest on theoretical or laboratory findings rather than well-documented effects in people.

Interactions deserving the most attention

The concerns that stand out most involve medicines where a small shift can matter. Blue cohosh might raise blood sugar, which could theoretically make diabetes medications such as insulin, glyburide, or glipizide work less well. Its constituents may also tighten blood vessels, which could work against blood pressure medications and drugs used for angina. It may also strengthen the effects of nicotine, something to keep in mind for anyone using nicotine replacement products.

What the rest of the list means

The long list of medications here reflects a few broad drug categories rather than hundreds of separate proven problems. Every interaction on the list is rated moderate, and each is based on how blue cohosh might act in theory, not on confirmed harm in people. That means we treat these as sensible cautions rather than established dangers.

Check your medications against Blue Cohosh

Based on HelloPharmacist’s Blue Cohosh interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Blue Cohosh

259 medications have a known interaction with Blue Cohosh, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AcarboseGlucobay, Prandase, Precose› AcebutololRhotral, Sectral› AcetazolamideAk-Zol, Diamox› AcetohexamideDymelor› AlbiglutideTanzeum› AliskirenTekturna› AlogliptinNesina› Alogliptin, MetforminKazano› Alogliptin, PioglitazoneOseni› AmbrisentanLetairis, Volibris› AmilorideAmilamont, Midamor› Amiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic› AmlodipineNorliqva› Amlodipine BenzoateKaterzia› Amlodipine BesilateIstin› Amlodipine BesylateNorvasc› Amlodipine Besylate, BenazeprilLotrel› Amlodipine, CelecoxibConsensi› Ammonium ChlorideAmmonium Chloride› Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi› AprocitentanTryvio› AtenololAtenix, Tenormin› Atenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic› Atenolol, ChlorthalidoneTenoretic› AzilsartanEdarbi› Azilsartan, ChlorthalidoneEdarbyclor› BenazeprilLotensin› Benazepril, HydrochlorothiazideLotensin HCT› BendroflumethiazideAprinox, Naturetin, Neo-NaClex› Bendroflumethiazide, NadololCorzide›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Blue Cohosh combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Blue Cohosh affects

Every type of medication (drug category) Blue Cohosh is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 3 drug categories Blue Cohosh interacts with
Antidiabetes DrugsAntihypertensive DrugsNicotine
Antidiabetes Drugs

There is some concern that blue cohosh might increase blood glucose levels. Theoretically, it might decrease the effectiveness of medicines used for diabetes. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Likelihood Possible Evidence D
Antihypertensive Drugs

Constituents in blue cohosh might increase blood pressure by causing coronary vasoconstriction. Theoretically, concomitant use might decrease the effectiveness of drugs used for angina and high blood pressure; use with caution. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Likelihood Possible Evidence D
Nicotine

Blue cohosh can increase the effects of nicotine.

Likelihood Possible Evidence D
Monograph

Blue Cohosh: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Blue cohosh is a traditional herb historically used by Native Americans and midwives to bring on labor or menstruation, but it carries serious safety concerns, especially for the heart and during pregnancy. There is very little reliable human evidence that it works, and reports of harm—including serious problems in newborns—make it an herb most people should avoid without close professional supervision.

Scientific name
Caulophyllum thalictroides
Family
Berberidaceae
Part used
Root and rhizome
Common forms
Capsules, tinctures, dried root, tea, liquid extracts
People commonly use it for
  • Inducing labor or starting menstruation
  • Menstrual cramps and irregular periods
  • Symptoms of menopause
  • Pelvic or uterine discomfort
  • Traditional Native American remedy

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Blue cohosh contains compounds that can affect the heart and has been linked to serious adverse events.

PregnancyLikely Unsafe

When used orally. Blue cohosh is a uterine stimulant and can induce labor. Several blue cohosh constituents, such as anagyrine and N-methylcytisine, a...

Read the full pregnancy detail
BreastfeedingLikely Unsafe

When used orally. Blue cohosh is a uterine stimulant and can induce labor. Several blue cohosh constituents, such as anagyrine and N-methylcytisine, a...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Blue cohosh (Caulophyllum thalictroides) is a flowering plant native to woodland areas of eastern North America. The root and underground stem (rhizome) are the parts traditionally used in herbal medicine.

It has a long history of use among Native American peoples and later among midwives, who used it mainly to try to start labor, bring on menstruation, or ease menstrual discomfort. Despite the similar name, blue cohosh is a different plant from black cohosh (Actaea racemosa), and the two should not be confused.

Today blue cohosh is sold as capsules, tinctures, teas, and liquid extracts. Because of safety concerns, many health professionals advise against using it.

Uses & effectiveness

People have traditionally used blue cohosh to induce labor, start a delayed menstrual period, ease menstrual cramps, and help with menopause symptoms. It has also been used historically for other complaints such as joint pain.

The honest summary is that high-quality human evidence is very limited. Most of what is known comes from traditional use, laboratory studies, and animal research rather than well-designed clinical trials. There is not enough reliable evidence to say that blue cohosh works for any of these uses.

Importantly, the historical use for inducing labor is now considered risky. Case reports have described serious problems—including heart and other complications—in newborns after mothers used blue cohosh near the end of pregnancy. Because of this, the potential harms appear to outweigh any unproven benefit.

How it works

Blue cohosh contains several active plant compounds, including saponins (such as caulosaponin) and alkaloids (such as methylcytisine, sometimes called caulophylline). These are thought to be responsible for its effects.

In laboratory and animal studies, some of these compounds appear to stimulate the muscle of the uterus and may affect blood vessels and the heart. Methylcytisine is chemically related to nicotine-like substances and may act on certain nerve receptors and raise blood pressure.

It is important to understand that these mechanisms are based largely on lab and animal research. They help explain why blue cohosh may be harmful, but they do not prove it is effective or safe in people.

Safety & precautions

Blue cohosh is one of the more concerning herbal products from a safety standpoint. Its compounds can affect the heart and blood vessels and may stimulate the uterus.

Pregnancy: Avoid blue cohosh during pregnancy. It may cause uterine contractions, and case reports have linked its use near delivery to serious harm in newborns, including heart problems and stroke-like injury. Do not use it to try to start labor.

Breastfeeding: There is not enough reliable safety information, so it is best to avoid blue cohosh while breastfeeding.

People with heart disease, high blood pressure, diabetes, or a history of stroke, as well as children, should not use blue cohosh. Because of the lack of safety data and the risk of serious effects, talk with a pharmacist or doctor before considering this herb.

Side effects

Reported side effects include stomach upset, nausea, vomiting, diarrhea, headache, and high blood pressure. Some people may notice chest discomfort or a fast heartbeat.

More serious effects have been reported, especially with larger amounts or near pregnancy. These include heart-related problems and dangerous reactions in newborns when used by mothers before delivery. The seeds and berries of the plant are considered poisonous if eaten.

If you take blue cohosh and develop chest pain, an irregular or racing heartbeat, severe stomach symptoms, or any signs of a serious reaction, seek medical care right away.

Blue Cohosh: Reported Adverse Effects

Documented safety reports on Blue Cohosh from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, blue cohosh can cause significant adverse effects including mucous membrane irritation, stomach upset including diarrhea and cramping, chest pain (angina), hypertension, and hyperglycemia.

Neonatal acute myocardial infarction (MI), congestive heart failure (CHF), and shock has occurred following maternal use of a blue cohosh combination product one month before delivery. There is also a case report of severe complications, including seizures, renal failure, and respiratory distress, in an infant whose mother was given an unknown dose of black and blue cohosh at 42 weeks gestation to induce labor. In another case, a mother was advised to drink a blue cohosh tea to induce labor. The infant experienced a seizure during delivery, and 2 days later it was discovered that the infant was experiencing an evolving ischemic stroke. In another case, nicotinic toxicity characterized by tachycardia, sweating, abdominal pain, vomiting, and muscle twitching and weakness was reported for a woman taking blue cohosh to induce abortion.

Due to these life-threatening side effects pregnant women should be advised not to ingest any blue cohosh product during pregnancy.

  1. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  2. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2.
  3. Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int Midwife 1999;52:34-5.
  4. Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73.
  5. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16.
  6. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  7. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3.
  8. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
Reports by condition
Angina Cardiovascular

Orally, blue cohosh can cause tachycardia, hypertension, and chest pain (angina). Neonatal acute myocardial infarction (MI), congestive heart failure (CHF), myocardial toxicity, and shock has occurred following maternal use of a blue cohosh combination product one month before delivery.

  1. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
  2. Scott, C. C. and Chen, K. K. The pharmacological action of N-methylcytisine. The Journal of Pharmacology and Experimental Therapuetics 1943;79:334-339.
  3. Sirtori CR, Triolo M, Bosisio R, et al. Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals. Br J Nutr 2012;107:1176-83.
  4. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2.
  5. Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int Midwife 1999;52:34-5.
  6. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3.
  7. Gunn, T. R. and Wright, I. M. The use of black and blue cohosh in labour. N.Z Med J 10-25-1996;109(1032):410-411.
  8. Low, D. T. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
Diarrhea Gastrointestinal

Orally, blue cohosh can cause mucous membrane irritation, stomach upset including diarrhea and cramping, nausea, vomiting, and abdominal pain.

  1. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
Epilepsy Neurologic/CNS

In one case, a mother was advised to drink a blue cohosh tea to induce labor. The infant experienced a seizure during delivery and 2 days later it was discovered that the infant was experiencing an evolving ischemic stroke. There is also another case report of severe complications, including seizures, in an infant whose mother was given an unknown dose of black and blue cohosh at 42 weeks gestation to induce labor.

  1. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3.
  2. Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73.
  3. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16.
  4. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  5. Sirtori CR, Triolo M, Bosisio R, et al. Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals. Br J Nutr 2012;107:1176-83.
Kidney failure Renal

There is a case report of severe complications, including renal failure, in an infant whose mother was given an unknown dose of black and blue cohosh at 42 weeks gestation to induce labor.

  1. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16.
  2. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  3. Sirtori CR, Triolo M, Bosisio R, et al. Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals. Br J Nutr 2012;107:1176-83.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no well-established, standardized safe dose for blue cohosh. Products vary widely in strength, and the herb's safety concerns make general dosing recommendations inappropriate.

Because of the risk of serious side effects, we do not provide specific amounts. If you are considering any product that contains blue cohosh, follow the product label and—more importantly—check first with a pharmacist or doctor, who may recommend a safer alternative.

Pregnancy & Breastfeeding

Blue Cohosh & Pregnancy

Likely Unsafe

When used orally. Blue cohosh is a uterine stimulant and can induce labor. Several blue cohosh constituents, such as anagyrine and N-methylcytisine, are potentially teratogenic and might cause congenital malformations in newborns. Use of blue cohosh near term can cause life-threatening toxicity in the infant, as well as severe toxicity in the mother. Many midwives still use blue cohosh to facilitate delivery. This dangerous practice should be avoided.

  1. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3.
  2. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16.
  3. Irikura B, Kennelly E. American Health Consultants. Blue Cohosh: a word of caution. 1999. Available at: http://www.ahcmedia.com/articles/50424-blue-cohosh-a-word-of-caution.
  4. Kennelly, E. J., Flynn, T. J., Mazzola, E. P., Roach, J. A., McCloud, T. G., Danford, D. E., and Betz, J. M. Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. J.Nat.Prod. 1999;62(10):1385-1389.
  5. Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73.
  6. Wright IM. Neonatal effects of maternal consumption of blue cohosh. J Pediatr 1999;134:384-5.
  7. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  8. Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
  9. Low, D. T. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
  10. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.

Blue Cohosh & Breastfeeding

Likely Unsafe

When used orally. Blue cohosh is a uterine stimulant and can induce labor. Several blue cohosh constituents, such as anagyrine and N-methylcytisine, are potentially teratogenic and might cause congenital malformations in newborns. Use of blue cohosh near term can cause life-threatening toxicity in the infant, as well as severe toxicity in the mother. Many midwives still use blue cohosh to facilitate delivery. This dangerous practice should be avoided.

  1. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3.
  2. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16.
  3. Irikura B, Kennelly E. American Health Consultants. Blue Cohosh: a word of caution. 1999. Available at: http://www.ahcmedia.com/articles/50424-blue-cohosh-a-word-of-caution.
  4. Kennelly, E. J., Flynn, T. J., Mazzola, E. P., Roach, J. A., McCloud, T. G., Danford, D. E., and Betz, J. M. Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. J.Nat.Prod. 1999;62(10):1385-1389.
  5. Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73.
  6. Wright IM. Neonatal effects of maternal consumption of blue cohosh. J Pediatr 1999;134:384-5.
  7. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  8. Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
  9. Low, D. T. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
  10. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 16 references that drive our Blue Cohosh monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2. PubMed
  2. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16. PubMed
  3. Wright IM. Neonatal effects of maternal consumption of blue cohosh. J Pediatr 1999;134:384-5. DOI
  4. Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int Midwife 1999;52:34-5.
  5. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  6. Irikura B, Kennelly E. American Health Consultants. Blue Cohosh: a word of caution. 1999. Available at: http://www.ahcmedia.com/articles/50424-blue-cohosh-a-word-of-caution.
  7. Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  8. Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
  9. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3. PubMed
  10. Kennelly, E. J., Flynn, T. J., Mazzola, E. P., Roach, J. A., McCloud, T. G., Danford, D. E., and Betz, J. M. Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. J.Nat.Prod. 1999;62(10):1385-1389. PubMed
  11. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
  12. Gunn, T. R. and Wright, I. M. The use of black and blue cohosh in labour. N.Z Med J 10-25-1996;109(1032):410-411.
  13. Scott, C. C. and Chen, K. K. The pharmacological action of N-methylcytisine. The Journal of Pharmacology and Experimental Therapuetics 1943;79:334-339. DOI
  14. Low, D. T. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
  15. Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73.
Keep reading

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.

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

Brand directory

Brands that make products with Blue Cohosh

35 brands in our database make a supplement containing Blue Cohosh.

Product directory

Supplement products with Blue Cohosh

127 products in our database contain Blue Cohosh. Open any to see its full ingredient list and every drug interaction we check.

#10-FEM by Nutri-West Herbals Tablet Or Pill 100 Tablet(s) View ingredients & interactions B&B-W by Pure Herbs Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions B&B-W by Pure Herbs Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Black Cohosh by Oregon's Wild Harvest Capsule 90 Vegan Capsule(s) View ingredients & interactions Blood Grail by Tonic Tinctures Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions Blue Cohosh by Herbs Etc. Liquid 8 fl. Oz. · 236 mL View ingredients & interactions Blue Cohosh by Herb Pharm Liquid 1 fl. Oz. · 30 mL View ingredients & interactions Blue Cohosh by Herb Pharm Liquid 1 Fluid Ounce(s) · 30 Milliliter(s) View ingredients & interactions Blue Cohosh by Herb Pharm Liquid 4 fl. Oz. · 120 mL View ingredients & interactions Blue Cohosh by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Blue Cohosh by Herbal Terra Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Blue Cohosh by Village Vitality Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Blue Cohosh by Hawaii Pharm Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Blue Cohosh by Pure Herbs Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Blue Cohosh by Pure Herbs Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Blue Cohosh by TerraVita Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Blue Cohosh by Herbal Terra Liquid 2 Fluid Ounce(s) · 60 mL View ingredients & interactions Blue Cohosh by Hawaii Pharm Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Blue Cohosh by Hawaii Pharm Liquid 4 Fluid Ounce(s) · 120 mL View ingredients & interactions Blue Cohosh 1,000 mg by Nature's Answer Liquid 1 fl. Oz. · 30 mL View ingredients & interactions Blue Cohosh 1,000 mg by Nature's Answer Liquid 1 Fluid Ounce(s) · 30 mL View ingredients & interactions Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection Powder 4 Ounce(s) View ingredients & interactions Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection Powder 1 Ounce(s) View ingredients & interactions Blue Cohosh 450 mg by TerraVita Capsule 100 Capsule(s) View ingredients & interactions
Pharmacist Counseling Corner

Blue Cohosh: Common Questions

Does Blue Cohosh interact with prescription medications?
Yes. We list 259 medications with a known interaction with Blue Cohosh. Use the checker above to see how Blue Cohosh interacts with a specific drug.
How are Blue Cohosh interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Blue Cohosh with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Blue Cohosh interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Blue Cohosh used for?
It has traditionally been used to try to start labor or menstruation and to ease menstrual cramps. However, there is little reliable evidence that it works, and it carries serious safety risks.
Is Blue Cohosh the same as black cohosh?
No. Despite the similar name, Blue Cohosh (Caulophyllum thalictroides) and black cohosh (Actaea racemosa) are different plants with different effects and safety profiles. Do not substitute one for the other.
Can I use Blue Cohosh to bring on labor?
No. Using Blue Cohosh to induce labor is not safe—case reports have linked it to serious harm in newborns. Never use it for this purpose; talk to your obstetrician about safe options.
Is Blue Cohosh safe to take?
Blue Cohosh has notable safety concerns, including effects on the heart and blood pressure, and there is little proof it works. Most people should avoid it, and you should speak with a pharmacist or doctor before using it.

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

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