Interactions on record — worth a quick check against your medications. Based on 1 of 3 ingredients. Check your meds →
Dietary supplement

Be Response-Able Ingredients & Drug Interactions

by Nature's Sunshine Flower Essence Formula

Liquid Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Be Response-Able is a dietary supplement by Nature's Sunshine Flower Essence Formula with 3 active ingredients. Its ingredients are commonly taken for constipation (laxative), dry skin (moisturizer), dry, irritated eyes.Based on those ingredients, 954 medications have a known interaction with it, the most serious rated moderate. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Be Response-Able by Nature's Sunshine Flower Essence Formula

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 9 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (1,000 mg) without saying how much of each component you get.
  • “Infusions of the Flowers of” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.

Be Response-Able is a liquid formula with 9 ingredients, of which several are flower extracts in a proprietary blend: black cohosh, Rudbeckia hirta (black-eyed Susan), Asclepias cordifolia (showy milkweed), California poppy, agrimony, yucca, and mullein. The formula also contains organic vegetable glycerin (a naturally derived humectant and solvent) and purified water.

There are no inactive fillers or binders listed.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: stress management and emotional balance support.
  • We looked for evidence on: Anxiety, Insomnia, Premenstrual syndrome (PMS), Menopausal symptoms, Stress, Emotional resilience — and 2 related terms.
  • The strongest evidence on file: Black Cohosh is rated "Possibly Effective" for Menopausal symptoms (Natural Medicines).
  • Also on file: California Poppy is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Insomnia.
  • Also on file: Black Cohosh is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Premenstrual syndrome (PMS).

The evidence in our data is limited for most ingredients. Black cohosh is rated possibly effective for menopausal symptoms, but evidence for anxiety, sexual dysfunction, and breast cancer-related hot flashes is insufficient.

California poppy's effectiveness for anxiety and insomnia hasn't been reliably established. Agrimony, yucca, and mullein all lack established effectiveness ratings in our data.

Glycerol shows stronger support — it's likely effective for constipation and possibly effective for athletic performance — but it's a minor ingredient here and not the product's primary purpose. The effectiveness of this formula as a whole hasn't been established in the data we hold.

The evidence, ingredient by ingredient Glycerol

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Black cohosh is generally well tolerated short-term but carries rare liver safety concerns, so medical guidance before use is wise. Common side effects of black cohosh include breast tenderness, dizziness, headache, gastrointestinal upset, and tiredness.

California poppy has limited human safety data; when combined with other ingredients in studies, it's been reported to cause nausea, muscular stiffness, and morning fatigue, though it's unclear whether those effects came from California poppy alone. Glycerol in large doses can cause stomach upset, bloating, diarrhea, nausea, vomiting, and headache.

Black cohosh is rated possibly unsafe in pregnancy and lactation. California poppy, agrimony, mullein, and yucca all lack sufficient safety data and should be avoided during pregnancy and breastfeeding.

Side effects, ingredient by ingredient Glycerol

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 4 of the 6 matched ingredients can interact with medications — California Poppy, Mullein, Agrimony, Black Cohosh.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 955 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before you start, check with your pharmacist if you take serotonergic drugs like antidepressants or SSRIs — black cohosh may increase serotonin syndrome risk. Also flag blood thinners (anticoagulants) or antiplatelet drugs, diabetes medications, estrogen therapy, cardiac or psychiatric drugs metabolized by the liver, sedative drugs, and cancer drugs like cisplatin.

These are the medication types that carry documented interactions with ingredients in this formula.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This is a flower essence formula with a mix of traditional botanicals. If you take any psychiatric medications, blood thinners, estrogen therapy, or diabetes drugs, you'll want to double-check with your pharmacist before starting — black cohosh and agrimony have documented interactions with those classes.

Anyone pregnant or breastfeeding should avoid it. It's generally mild for short-term use, but talk to your doctor or pharmacist first, especially if you have liver concerns.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 6 of 9 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2019.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Be Response-Able, straight from the product label.

Brand Nature's Sunshine Flower Essence Formula
Barcode (UPC) 099904087835
Net contents 1.9 fl. Oz.; 57 mL
Market status On market
Date entered into DSLD Oct 23, 2019
DSLD ID 208618
Product type Other Combinations
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Be Response-Able by Nature's Sunshine Flower Essence Formula, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 mL
Maximum serving Sizes:
1 mL
Servings per container
57
UPC/BARCODE
099904087835
IngredientAmount% DV
purified Water0 NP--
Proprietary Blend1000 mg--
organic Vegetable Glycerin0 NP--
Infusions of the Flowers of0 NP--
Cimicifuga racemosa0 NP--
Rudbeckia hirta0 NP--
Asclepias cordifolia0 NP--
Eschscholzia californica0 NP--
Agrimonia eupatoria0 NP--
Yucca brevifolia0 NP--
Verbascum thapsus0 NP--

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formula

Flower Essence Formulas are liquid infusions using only organic ingredients and those derived from flowers grown in organic gardens and pristine wild habitats.

Formulation

Flower Essence Formulas are liquid infusions using only organic ingredients and those derived from flowers grown in organic gardens and pristine wild habitats.

General Statements

Developed for modern issues of occasional emotional and physical stress. Formulated for direct use.

Suppressed fear formula Natural flower essence formula that may assist with: Promoting self-responsibility Self-defeating behavior Get well keep well Quality, service, integrity

010087830613

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Brand IP Statement(s)

2013

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: Take 10-15 drops under the tongue, then swallow, 4 times daily. Avoid any contact with dropper to eliminate product contamination.

Precautions

This bottle was sealed for your protection. Do not use if outer shrink band is missing or damaged.

See for yourself

Be Response-Able by Nature's Sunshine Flower Essence Formula label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Be Response-Able by Nature's Sunshine Flower Essence Formula

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 mL Dosage formLiquid Servings per container57 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Proprietary Blend

1000 mg per serving
Interaction report

Be Response-Able by Nature's Sunshine Flower Essence Formula Drug Interactions

Want to check YOUR meds against Be Response-Able?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
954Drugs
849 Moderate 105 Minor

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Be Response-Able with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

The maker

Brand information

Manufacturer and brand details for Be Response-Able, from the product label.

Nature's Sunshine Flower Essence Formula

See all Nature's Sunshine Flower Essence Formula products
Name
Nature's Sunshine Products, Inc.
City
Spanish Fork
State
UT
ZipCode
84660
Phone Number
1-800-223-8225
Web Address
www.naturessunshine.com
Pharmacist Counseling Corner

Be Response-Able by Nature's Sunshine Flower Essence Formula: Common Questions

Does Be Response-Able by Nature's Sunshine Flower Essence Formula interact with any medications?
Yes. Based on its ingredients, Be Response-Able has a known interaction with 954 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Be Response-Able contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I use this while pregnant or breastfeeding?
Black cohosh, California poppy, agrimony, mullein, and yucca all lack enough safety data — the data advises against using them during pregnancy and breastfeeding. Talk with your doctor or pharmacist about whether this formula is right for you.
What does black cohosh in this formula do?
Black cohosh is possibly effective for menopausal symptoms according to the evidence we hold. However, evidence for other uses like anxiety or sexual dysfunction is insufficient.
Will this make me drowsy?
California poppy may add to the sedative effects of sleep or anxiety medications, but the formula itself isn't advertised as a sleep aid. If you take sedative drugs, check with your pharmacist first.
What side effects might I notice from black cohosh?
The most common ones are breast tenderness, dizziness, headache, stomach upset, and tiredness. Rare but serious liver problems have been reported, so talk to your doctor if you have liver concerns or if you notice unusual fatigue, abdominal pain, or dark urine.
Is there any ingredient in here with no drug interactions?
Glycerol, yucca, and the purified water have no documented interactions in our data — though we hold no interaction data for purified water, Rudbeckia hirta, or Asclepias cordifolia at all.
Does this contain any fillers or binders?
No — there are no inactive fillers or binders listed for this product.

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

Not sure if Be Response-Able is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Be Response-Able label
Go deeper

The Full Monographs Behind Be Response-Able’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Sources

Sources & How We Checked

Be Response-Able's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 88 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Glycerol 8 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Wagner DR. Hyperhydrating with glycerol: implications for athletic performance. J Am Diet Assoc 1999;99:207-12. PubMed
  3. Yu YL, Kumana CR, Lauder IJ, et al. Treatment of acute cortical infarct with intravenous glycerol. A double-blind, placebo-controlled randomized trial. Stroke 1993;24:1119-24. PubMed
  4. Frei A, Cottier C, Wunderlich P, Ludin E. Glycerol and dextran combined in the therapy of acute stroke. A placebo-controlled, double-blind trial with a planned interim analysis. Stroke 1987;18:373-9. PubMed
  5. Balaskas E, Szepietowski JC, Bessis D, Ioannides D, Ponticelli C, Ghienne C, Taberly A, Dupuy P. Randomized, double-blind study with glycerol and paraffin in uremic xerosis. Clin J Am Soc Nephrol. 2011 Apr;6(4):748-52. PubMed
  6. Blanchet-Bardon C, Tadini G, Machado Matos M, Delarue A. Association of glycerol and paraffin in the treatment of ichthyosis in children: an international, multicentric, randomized, controlled, double-blind study. J Eur Acad Dermatol Venereol. 2012 Aug;26 PubMed
  7. Kajita N, Kanamori K, Yamamoto S, Yoshida K. Generalized Urticaria Caused by a Glycerin Enema in an Infant. J Investig Allergol Clin Immunol 2022;32(4):318-319. PubMed
  8. Suzuki R, Fukuyama K, Miyazaki Y, Namiki T. Contact urticaria syndrome and protein contact dermatitis caused by glycerin enema. JAAD Case Reports. 2016;2:108-10. PubMed

See these in context on the Glycerol monograph →

Black Cohosh 68 references
  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. PubMed
  2. Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
  3. Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
  4. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
  5. Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med 1999;65:763-4.
  6. Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 2001;19:2739-45. PubMed
  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. Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2003;179:390-1.. DOI
  10. Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 2003;44:S67-77. PubMed
  11. Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
  12. Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7. PubMed
  13. Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
  14. Thomsen M, Vitetta L, Schmidt M, Sali A. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2004;180:598-600.. DOI
  15. Cohen B, Schardt D. Center for Science in the Public Interest. Letter to Food and Drug Administration. Commissioner Mark McClellan, MD, PhD. March 4, 2004.
  16. Seidlova-Wuttke D, Hesse O, Jarry H, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol 2003;149:351-62. PubMed
  17. 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
  18. Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9. PubMed
  19. Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
  20. Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.
  21. Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
  22. Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
  23. Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Men PubMed
  24. MHRA. Black cohosh (Cimicifuga racemosa) - risk of liver problems. Herbal Safety News July 2006. Available at: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary= true&ssDocName=CON2024131&ssTargetNodeId=663.
  25. Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e257-61.
  26. Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 2006;13:678-91. PubMed
  27. Lynch CR, Folkers ME, Hutson WR. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl 2006;12:989-92. PubMed
  28. Bai W, Henneicke-von Zepelin HH, Wang S, et al. Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: A randomized, double blind, parallel-controlled study versus tibol
  29. Meyer S, Vogt T, Obermann EC, et al. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 2007;214:94-6.
  30. Gori L, Firenzuoli F. Is black cohosh a hepatotoxic medicinal herb? Forsch Komplementarmed 2007;14:109-10. PubMed
  31. Assessment of case reports connected to herbal medicinal products containing cimicifugae racemosa rhizoma (black cohosh, root). Doc. Ref. EMEA/269259/2006. Available at: www.emea.eu.int/pdfs/human/hmpc/26925806en.pdf (Accessed 30 November 2007).
  32. Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John's wort (GYNO-Plus) for climacteric symptoms. Yonsei Med J 2007;48:289-94. PubMed
  33. Chow ECY, Teo M, Ring JA, Chen JW. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust 2008;188:420-2. PubMed
  34. Mahady GB, Low Dog T, Barrett ML, et al. United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Menopause 2008;15:628-38. PubMed
  35. Hepatotoxicity with black cohosh. Australian Adv Drug Reactions Bull 2006;25:6. Available at: www.tga.gov.au/adr/aadrb/aadr0604.htm#a1.
  36. Dunbar K, Solga SF. Black cohosh, safety, and public awareness. Liver Int 2007;27:1017. PubMed
  37. Patel NM, Derkits RM. Possible increase in liver enzymes secondary to atorvastatin and black cohosh administration. J Pharm Pract 2007;20:341-6. DOI
  38. Joy D, Joy J, Duane P. Black cohosh: a cause of abnormal postmenopausal liver function tests. Climacteric 2008;11:84-8. PubMed
  39. Australian Adverse Drug Reactions Advisory Committee. Black cohosh and liver toxicity - an update. Aust Adv Drug Reactions Bull 2007;26:11.
  40. Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
  41. Spangler L, Newton KM, Grothaus LC, et al. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas 2007;57:195-204. PubMed
  42. Teschke R, Bahre R, Genthner A, et al. Suspected black cohosh hepatotoxicity - challenges and pitfalls of causality assessment. Maturitas 2009;63:302-14. PubMed
  43. Brasky TM, Lampe JW, Potter JD, et al. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) cohort. Cancer Epidemiol Biomarkers Prev 2010;19:1696-708. PubMed
  44. Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed
  45. Vermes G, Bánhidy F, Acs N. The effects of remifemin on subjective symptoms of menopause. Adv Ther 2005;22:148-54. PubMed
  46. Nuntanakorn, P., Jiang, B., Einbond, L. S., Yang, H., Kronenberg, F., Weinstein, I. B., and Kennelly, E. J. Polyphenolic constituents of Actaea racemosa. J Nat Prod 2006;69(3):314-318.
  47. Oktem M, Eroglu D, Karahan HB, Taskintuna N, Kuscu E, Zeyneloglu HB. Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial. Adv Ther 2007;24:448-61. PubMed
  48. Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HH. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study. Maturitas 2007;57:405-14. PubMed
  49. Naser, B. and Liske, E. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust. 1-19-2009;190(2):99. PubMed
  50. van de Meerendonk, H. W., van Hunsel, F. P., and van der Wiel, H. E. [Autoimmune hepatitis induced by Actaea racemosa. Side affects of an herb extract]. Ned.Tijdschr.Geneeskd. 2-7-2009;153(6):246-249.
  51. Wong, V. C., Lim, C. E., Luo, X., and Wong, W. S. Current alternative and complementary therapies used in menopause. Gynecol.Endocrinol. 2009;25(3):166-174. PubMed
  52. Pierard, S., Coche, J. C., Lanthier, P., Dekoninck, X., Lanthier, N., Rahier, J., and Geubel, A. P. Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution. Eur J Gastroenterol Hepatol. 2009;21(8):941-945 PubMed
  53. Vannacci, A., Lapi, F., Gallo, E., Vietri, M., Toti, M., Menniti-Ippolito, F., Raschetti, R., Firenzuoli, F., and Mugelli, A. A case of hepatitis associated with long-term use of Cimicifuga racemosa. Altern.Ther Health Med 2009;15(3):62-63.
  54. Zimmermann, R., Witte, A., Voll, R. E., Strobel, J., and Frieser, M. Coagulation activation and fluid retention associated with the use of black cohosh: a case study. Climacteric. 2010;13(2):187-191. PubMed
  55. Amsterdam JD, Yao Y, Mao JJ, Soeller I, Rockwell K, Shults J. Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause. J Clin Psychopharmacol 2009;29:478-83. PubMed
  56. Bai WP, Wang SY, Liu JL, Geng L, Hu LN, Zhang ZL, Chen SL, Zheng SR. [Efficacy and safety of remifemin compared to tibolone for controlling of perimenopausal symptoms]. Zhonghua Fu Chan Ke Za Zhi 2009;44:597-600.
  57. McKenzie, S. C. and Rahman, A. Bradycardia in a patient taking black cohosh. Med J Aust. 10-18-2010;193(8):479-481. PubMed
  58. Stolze H. [An alternative to treat menopausal complaints]. Gynecologie 1982;1:14-16.
  59. Guzman G, Kallwitz ER, Wojewoda C, et al. Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh. Case Rep Med. 2009;2009:918156. PubMed
  60. Enbom ET, Le MD, Oesterich L, Rutgers J, French SW. Mechanism of hepatotoxicity due to black cohosh (Cimicifuga racemosa): histological, immunohistochemical and electron microscopy analysis of two liver biopsies with clinical correlation. Exp Mol Pathol. PubMed
  61. Sen A. Orobuccolingual dyskinesia after long-term use of black cohosh and ginseng. J Neuropsychiatry Clin Neurosci 2013 Fall;25(4):E50. PubMed
  62. Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
  63. Pkhaladze L, Davidova N, Khomasuridze A, Shengelia R, Panossian AG. Actaea racemosa L. is more effective in combination with Rhodiola rosea L. for relief of menopausal symptoms: a randomized, double-blind, placebo-controlled study. Pharmaceuticals (Basel) PubMed
  64. Yalçin M, Oguz A, Bestepe EE, Saglam NGU, Ergelen M. Black cohosh associated mania in a patient with unipolar depression. Int J Psychiatry Med 2020 Sep 21:91217420961185. doi: 10.1177/0091217420961185. PubMed
  65. Brar HS, Marathi R. Case of cholestatic drug-induced liver injury (DILI) associated with black cohosh. BMJ Case Rep 2021;14(5):e240408. PubMed
  66. Castelo-Branco C, Navarro C, Beltrán E, Losa F, Camacho M; on the behalf of the Natural Products Study Group of the Spanish Menopause Society. Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. Gynecol Endoc PubMed
  67. Trant AA, Chagpar A, Wei W, et al. The Effect of Black Cohosh on Ki67 expression and Tumor Volume: A Pilot Study of Ductal Carcinoma in Situ Patients. Integr Cancer Ther 2022;21:15347354221137290. PubMed
  68. Dernbach MR, Carpenter JE, Shah N, Carter GB. Black Cohosh Interactions with Prescription Medications Associated with Serotonin Toxicity and Rhabdomyolysis: A Case Report. J Emerg Med 2024;66(5):e592-e596. PubMed

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California Poppy 3 references
  1. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate
  2. Paul LD, Springer D, Staack RF, et al. Cytochrome P450 isoenzymes involved in rat liver microsomal metabolism of californine and protopine. Eur J Pharmacol 2004;485:69-79. PubMed
  3. Paul LD, Maurer HH. Studies on the metabolism and toxicological detection of the Eschscholtzia californica alkaloids californine and protopine in urine using gas chromatography-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2003;789:43-5

See these in context on the California Poppy monograph →

Agrimony 4 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Gray AM, Flatt PR. Actions of the traditional anti-diabetic plant, Agrimony eupatoria (agrimony): effects on hyperglycaemia, cellular glucose metabolism and insulin secretion. Br J Nutr 1998;80:109-14.
  4. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. PubMed

See these in context on the Agrimony monograph →

Yucca 3 references
  1. <p><span>Kanerva, L., Estlander, T., Petman, L., Makinen-Kiljunen, S. Occupational allergic contact urticaria to yucca (Yucca aloifolia), weeping fig (Ficus benjamina), and spathe flower (Spathiphyllum wallisii). Allergy. 2001;56(10): 1008-11.</span></p>
  2. Poljacki, M., Paravina, M., Jovanovic, M., Subotic, M., and Duran, V. [Contact allergic dermatitis caused by plants]. Med Pregl. 1993;46(9-10):371-375.
  3. Mahillon, V., Saussez, S., and Michel, O. High incidence of sensitization to ornamental plants in allergic rhinitis. Allergy 2006;61(9):1138-1140. PubMed

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Mullein 2 references
  1. Castro AI, Carmona JB, Gonzales FG, Nestar OB. Occupational airborne dermatitis from gordolobo (Verbascum densiflorum). Contact Dermatitis 2006;55(5):301.
  2. Flores Echaiz C, Al Ali A, Cao AQ, Sasseville D. Simultaneous contact dermatitis caused by Asteraceae and Verbascum thapsus. Contact Dermatitis 2017;76(5):316-8.

See these in context on the Mullein monograph →

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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.

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