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Dietary supplement

Black Cohosh 80 mg extract Ingredients & Drug Interactions

by herbscience

Black Cohosh 80 mg extract label
See full label image
Other (e.g. Tea Bag) Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Black Cohosh 80 mg extract against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Black Cohosh 80 mg extract is a dietary supplement by herbscience with 2 active ingredients. Its ingredients are commonly taken for hot flashes and night sweats, other menopause symptoms, mood changes during menopause.Based on those ingredients, 704 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Cohosh root extract, Chaste tree berry extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Black Cohosh 80 mg extract by herbscience

Ask about any prescription or over-the-counter medication and we check it for interactions with Black Cohosh 80 mg extract by herbscience — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Black Cohosh 80 mg extract by herbscience

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

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 12, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 2 active ingredients: black cohosh root extract and chaste tree berry extract. Black cohosh has been studied mainly for menopausal hot flashes, while chaste tree berry is used for hormone-related issues like premenstrual syndrome and breast tenderness.

The inactive ingredients are dicalcium phosphate, microcrystalline cellulose, croscarmellose sodium, stearic acid, silica, magnesium stearate, and pharmaceutical glaze—these are standard tablet binders and fillers.

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: menopausal and menstrual health support.
  • We looked for evidence on: Menopausal symptoms, Premenstrual syndrome (PMS), Dysmenorrhea, Amenorrhea, Mastalgia, Premenstrual dysphoric disorder (PMDD) — and 3 related terms.
  • The strongest evidence on file: Black Cohosh is rated "Possibly Effective" for Menopausal symptoms (Natural Medicines).
  • Also on file: Vitex Agnus-castus is rated "Possibly Effective" for Mastalgia, Premenstrual syndrome (PMS).
  • Also on file: Black Cohosh is rated "Insufficient Reliable Evidence To Rate" for Breast cancer-related hot flashes, Premenstrual syndrome (PMS), Dysmenorrhea.

Black cohosh is possibly effective for menopausal symptoms, though the evidence isn't conclusive. For other uses listed—acne, sexual dysfunction, anxiety, and breast cancer-related hot flashes—we don't have enough reliable evidence to rate how well it works.

Chaste tree berry is possibly effective for premenstrual syndrome and breast tenderness, but possibly ineffective for fractures. Evidence is insufficient for anxiety, skin aging, and premenstrual dysphoric disorder.

The evidence, ingredient by ingredient Black Cohosh Vitex Agnus-castus

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 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Both ingredients are generally well tolerated in typical short-term use. Black cohosh's most common side effects are breast tenderness, dizziness, gastrointestinal upset, headache, irritability, rash, and tiredness.

Rare serious concerns include liver problems and endometrial hyperplasia (thickening of the uterine lining). Chaste tree berry commonly causes diarrhea, fatigue, headache, insomnia, irregular menstruation, nausea, skin irritation, stomach pain, and vomiting.

There's also been a report of irregular or prolonged menstrual bleeding. Black cohosh is rated possibly unsafe in pregnancy and lactation due to lack of safety data and potential effects on the uterus and hormones.

Chaste tree berry is also rated possibly unsafe during pregnancy and lactation because of possible hormonal effects and unclear safety.

Side effects, ingredient by ingredient Black Cohosh Vitex Agnus-castus

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?
  • 2 of the 2 matched ingredients can interact with medications — Black Cohosh, Vitex Agnus-castus.
  • The most serious interaction on file is rated Moderate.
  • For scale: 705 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.

Check with your pharmacist before using this if you take serotonergic drugs (antidepressants like sertraline or duloxetine)—black cohosh may increase serotonin syndrome risk. Also double-check if you're on estrogen therapy, oral contraceptives, antipsychotic drugs, dopamine agonists, drugs metabolized by the liver enzyme CYP2D6, metoclopramide (Reglan), cancer drugs like cisplatin, or any drugs that can harm the liver.

No interactions are documented for the inactive ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

If you take serotonergic drugs like antidepressants, estrogen therapy, metoclopramide, oral contraceptives, antipsychotic medications, or dopamine agonists, you'll want to check with your pharmacist before using this product. Anyone pregnant or breastfeeding should avoid it.

The safety data for both ingredients during these times isn't solid enough, and the hormonal effects could be a concern.

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

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Mar 23, 2012.

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 Black Cohosh 80 mg extract, straight from the product label.

Brand herbscience
Barcode (UPC) 035046043094
Net contents 60 Caplet(s)
Market status On market
Date entered into DSLD Mar 23, 2012
DSLD ID 7112
Product type Botanical
Supplement form Other (e.g. Tea Bag)
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult Female (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 Black Cohosh 80 mg extract by herbscience, 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 Caplet(s)
Maximum serving Sizes:
1 Caplet(s)
Servings per container
60
UPC/BARCODE
035046043094
IngredientAmount% DV
Black Cohosh root extract80 mg--
Chaste tree berry extract200 mg--

Other ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Croscarmellose Sodium, Stearic Acid, Silica, Magnesium Stearate, Pharmaceutical Glaze

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.
Precautions

Do not use if seal is broken.

WARNING: Pregnant or lactating women should consult with their physician prior to taking this product.

Keep out of reach of children.

General Statements

A Division of Vitaquest Ind., Inc.

STANDARDIZED-FULL POTENCY

support FEMALE BALANCE

Brand IP Statement(s)

(C) Copyright 1998 Windmill Consumer Products(TM)

BLUEPRINT BOTANICALS(TM)

At herbscience(TM), we have found a way to combine high technology with age-old herbal tradition. The Blueprint Botanicals(TM) system begins with select herbs gathered from all over the world. Pre-tested, using advanced analytical methods, our herbal extracts are patiently concentrated utilizing time-tested methods. Once we have attained the highly standardized levels recommended by leading herbalists, our finished products are packaged and double-sealed for optimal freshness. This is your assurance of potency and purity. Blueprint Botanicals(TM) for herbscience(TM)- Perfecting the Science of Nature(TM).

FDA Disclaimer Statement

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

General

TC# 59050602 ITEM# N4309

Seals/Symbols

(BB) BLUEPRINT BOTANICALS(TM)

FDA Statement of Identity

herbal supplement

Storage

DIRECTIONS: Take two caplets daily as a dietary supplement or as recommended by a healthcare professional.

Protect from heat, light and moisture.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Black Cohosh 80 mg extract by herbscience label

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

Black Cohosh 80 mg extract label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Black Cohosh 80 mg extract by herbscience

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Caplet(s) Dosage formOther (e.g. Tea Bag) Servings per container60 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.

Black Cohosh root extract

Interacts with
652 drugs
80 mg per serving Form: Triterpene Glycosides

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...

Black Cohosh root extract monograph & interactions

Chaste tree berry extract

Interacts with
121 drugs
200 mg per serving Form: Vitexicarpin, Vitricin

Vitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS sympto...

Chaste tree berry extract monograph & interactions

Other (inactive) ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Croscarmellose Sodium, Stearic Acid, Silica, Magnesium Stearate, Pharmaceutical Glaze. These complete the product’s ingredient list but are not active constituents.

Interaction report

Black Cohosh 80 mg extract by herbscience Drug Interactions

Want to check YOUR meds against Black Cohosh 80 mg extract?

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
704Drugs
688 Moderate 16 Minor

Ingredients driving the most interactions

Black Cohosh root extract 652
Chaste tree berry extract 121

Individual Drug Interactions

The ingredients in Black Cohosh 80 mg extract interact with 704 drugs. Click any drug to see the details.

2 of the 2 ingredients in Black Cohosh 80 mg extract interact with drugs. Each result below shows which ingredient is responsible. Black Cohosh root extract Chaste tree berry extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Black Cohosh 80 mg extract with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Black Cohosh root extract7 drug types · 652 drugs

Atorvastatin (Lipitor)

Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.

Likelihood Possible Evidence B
Estrogens

Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.

Likelihood Possible Evidence D
Serotonergic Drugs

Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.

Likelihood Possible Evidence D
Black Cohosh root extract full monograph & interactions

Chaste tree berry extract5 drug types · 121 drugs

Antipsychotic Drugs

Theoretically, vitex agnus-castus could interfere with the activity of antipsychotic drugs.
Vitex agnus-castus might interfere with the action of dopamine antagonists such as antipsychotic drugs due to its dopamine agonist effects.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, vitex agnus-castus could interfere with oral contraceptives.
Vitex agnus-castus might interfere with the efficacy of oral contraceptives due to possible hormone modulating activity.

Likelihood Possible Evidence B
Dopamine Agonists

Theoretically, vitex agnus-castus could interfere with dopamine agonists.
Vitex agnus-castus might potentiate the actions of dopaminergic agonists due to possible dopaminergic effects.

Likelihood Possible Evidence D
Estrogens

Theoretically, vitex agnus-castus could interfere with the activity of estrogens.
Vitex agnus-castus has hormone modulating activity that can interfere with the efficacy of hormone replacement therapy.

Likelihood Probable Evidence D
Metoclopramide (Reglan)

Theoretically, dopaminergic effects of vitex agnus-castus could interfere with metoclopramide.
Vitex agnus-castus might interfere with the action of dopamine antagonists such as metoclopramide due to its possible dopaminergic effects.

Likelihood Possible Evidence D
Chaste tree berry extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Black Cohosh 80 mg extract, from the product label.

herbscience

See all herbscience products
Name
Windmill Consumer Products
City
West Caldwell
State
NJ
ZipCode
07006
Pharmacist Counseling Corner

Black Cohosh 80 mg extract by herbscience: Common Questions

Does Black Cohosh 80 mg extract by herbscience interact with any medications?
Yes. Based on its ingredients, Black Cohosh 80 mg extract has a known interaction with 704 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Black Cohosh 80 mg extract contains 2 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.
Is black cohosh safe to take while I'm pregnant or breastfeeding?
Both black cohosh and chaste tree berry are rated possibly unsafe during pregnancy and breastfeeding. There isn't enough safety data, and both may have effects on hormones and the uterus. Talk with your doctor or pharmacist for personalized advice before using this product.
What are the most common side effects?
Black cohosh most often causes breast tenderness, dizziness, gastrointestinal upset, headache, irritability, rash, and tiredness. Chaste tree berry commonly causes diarrhea, fatigue, headache, insomnia, irregular menstruation, nausea, stomach pain, and vomiting. Both are generally well tolerated, but side effects vary person to person.
Does black cohosh really help with hot flashes?
Black cohosh is rated possibly effective for menopausal symptoms. The evidence suggests it may help, but it's not definitive. Results vary, and it's not guaranteed to work for everyone.
What is chaste tree berry used for?
Chaste tree berry is possibly effective for premenstrual syndrome and breast tenderness. The evidence supports use for these hormone-related conditions, though again results can vary between individuals.
Can this product interfere with my birth control pill?
Yes, chaste tree berry may interfere with oral contraceptives due to its hormone-modulating activity. Talk with your pharmacist or doctor before starting this product if you're taking birth control to make sure they work together safely.
Why does this product interact with so many medications?
Both ingredients affect how the body handles hormones and certain brain chemicals, and they're processed by the liver. That's why they can interfere with a wide range of drugs—from antidepressants to contraceptives to cancer medications. That's also why checking your specific medications is so important.

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

Not sure if Black Cohosh 80 mg extract is safe with your meds?

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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.

Black Cohosh 80 mg extract label
Go deeper

The Full Monographs Behind Black Cohosh 80 mg extract’s Ingredients

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

Herb & supplement monograph

Black Cohosh

Interacts with 652 drugs

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-t...

Read the full Black Cohosh monograph → Herb & supplement monograph

Vitex Agnus-castus

Interacts with 121 drugs

Vitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS symptoms. It is generally well tolerated by ma...

Read the full Vitex Agnus-castus monograph →
Sources

Sources & How We Checked

Black Cohosh 80 mg extract'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 91 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.

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
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See these in context on the Black Cohosh monograph →

Vitex Agnus-castus 23 references
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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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