Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Black Cohosh Ingredients & Drug Interactions

by Nutricost Women

Capsule Category: Other Combinations
Most serious interaction: Major
The interaction bottom line Most serious interaction: Major

Black Cohosh is a dietary supplement by Nutricost Women with 4 active ingredients. Its ingredients are commonly taken for estrogen/hormone balance, acne and hormonal skin issues, prostate health support.Based on those ingredients, 892 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Black Cohosh Root Extract, Diindolylmethane, Dong Quai. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Black Cohosh by Nutricost Women

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

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 4 of its 4 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains four active ingredients. Black Cohosh Root Extract is the namesake herb, traditionally used for menopausal symptoms.

Diindolylmethane is a compound derived from cruciferous vegetables like broccoli. Dong Quai is an herbal root used in traditional Chinese medicine.

Chaste Berry Fruit Extract (also called Vitex) is a berry commonly used for menstrual and hormonal support. The product also contains two inactive ingredients — hypromellose and magnesium stearate — which are a capsule material and a lubricant.

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: Women's health and menopause symptom support.
  • We looked for evidence on: Menopausal symptoms, Premenstrual syndrome (PMS), Dysmenorrhea, Mastalgia, Amenorrhea, Fibrocystic breast disease — and 4 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 Acne, Breast cancer-related hot flashes, Premenstrual syndrome (PMS), Dysmenorrhea.

Black Cohosh is possibly effective for menopausal symptoms, which is what most people take it for. The other three active ingredients don't have established evidence in our data for the conditions they're traditionally used for — the evidence is either not yet clear or hasn't been rated.

If you're considering this product for something other than menopausal hot flashes or night sweats, talk with your pharmacist or doctor about whether the science supports your specific goal.

The evidence, ingredient by ingredient Diindolylmethane Black Cohosh Dong Quai 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 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Black Cohosh and Dong Quai are both generally well tolerated in the short term, but each comes with cautions. Black Cohosh has rare reports of liver concerns, and there's enough concern that medical guidance is wise.

Diindolylmethane is generally well tolerated, though long-term safety isn't well established. Common side effects across these ingredients include headache, nausea, dizziness, gastrointestinal upset, and rash.

Chaste Berry may cause irregular menstruation, fatigue, or skin irritation in some people. Pregnancy and breastfeeding are situations to avoid this product: Black Cohosh and Dong Quai are possibly unsafe during pregnancy, and Chaste Berry is also possibly unsafe for both pregnancy and breastfeeding.

Diindolylmethane is rated likely safe for pregnancy and lactation, but there isn't enough data on the other three ingredients to know they're safe while breastfeeding — talk with your doctor or pharmacist for personalized advice.

Side effects, ingredient by ingredient Diindolylmethane Black Cohosh Dong Quai Vitex Agnus-castus

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — Black Cohosh, Dong Quai, Vitex Agnus-castus, Diindolylmethane.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 893 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 taking this product, double-check your medications against these categories: warfarin and other blood thinners or antiplatelet drugs (Major severity risk from Dong Quai and Black Cohosh); estrogens and oral contraceptives (Moderate risk from all four ingredients); serotonergic antidepressants like sertraline and duloxetine (Moderate risk from Black Cohosh); diuretics or water pills (Moderate risk from Diindolylmethane); and antipsychotics, dopamine agonists, or metoclopramide (Reglan) (Moderate risk from Chaste Berry). Also check if you take any drug that can stress your liver or any CYP2D6 or CYP1A2 substrates — the checker will flag those.

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. Major medication interactions have been identified, and safety information is well characterized.

This product is geared toward women managing menopausal symptoms, where Black Cohosh has the most evidence. However, it contains ingredients with multiple medication interactions and hormonal effects, so it's not a casual add-on if you take any prescriptions, blood thinners, birth control, hormone therapy, or antidepressants.

Run your medication list through the checker before you start, and talk with your pharmacist if you're pregnant, breastfeeding, or have liver concerns.

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

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 23, 2024.

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, straight from the product label.

Brand Nutricost Women
Barcode (UPC) 810014674698
Net contents 120 Capsule(s)
Market status On market
Date entered into DSLD Apr 23, 2024
DSLD ID 313489
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegetarian, Adult Female (18 - 50 Years), Gluten Free
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 by Nutricost Women, 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 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
120
UPC/BARCODE
810014674698
IngredientAmount% DV
Diindolylmethane30 mg--
Black Cohosh Root Extract550 mg--
Dong Quai50 mg--
Chaste Berry Fruit Extract30 mg--

Other ingredients: Hypromellose, Magnesium Stearate

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.
Suggested/Recommended/Usage/Directions

Suggested use: As a dietary supplement, take 1 capsule daily with 8-12 oz of water or as directed by your healthcare professional.

Formulation

Third party tested

Non-GMO Gluten-free

Made and quality tested in the USA with globally sourced ingredients.

Non-GMO Product

Vegetarian product

Precautions

Warning: For healthy individuals 18 years and older. Keep out of reach of children.

Do not use if safety seal is broken or missing.

Consult a healthcare professional prior to use if you are pregnant or nursing, taking medication, or have a medical condition.

Storage

Notice: Store in a cool, dry place.

Formula

Black Cohosh with Dong Quai, DIM & Chaste Berry Extract 660 mg per serving

FDA Statement of Identity

Dietary Supplement

Seals/Symbols

Nutricost Quality Guaranteed GMP Compliant Facility Vegetarian Produce

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.

See for yourself

Black Cohosh by Nutricost Women label

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

What’s inside

The Ingredients in Black Cohosh by Nutricost Women

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container120 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.

Diindolylmethane

Interacts with
269 drugs
30 mg per serving

Diindolylmethane (DIM) is a compound made when your body digests cruciferous vegetables, and it is sold as a supplement mainly for hormone balance and...

Diindolylmethane monograph & interactions

Black Cohosh Root Extract

Interacts with
652 drugs
550 mg per serving Form: Cimicifuga racemosa Root Extract

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

Dong Quai

Interacts with
163 drugs
50 mg per serving

Dong Quai is a traditional Chinese herb often called "female ginseng" and is mostly used for menstrual and menopausal complaints. High-quality scienti...

Dong Quai monograph & interactions

Chaste Berry Fruit Extract

Interacts with
121 drugs
30 mg per serving

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 Berry Fruit Extract monograph & interactions

Other (inactive) ingredients: Hypromellose, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.

Interaction report

Black Cohosh by Nutricost Women Drug Interactions

Want to check YOUR meds against Black Cohosh?

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
892Drugs
2 Major 844 Moderate 46 Minor

Ingredients driving the most interactions

Dong Quai 163

Each ingredient & the kinds of drugs it affects

For each ingredient in Black Cohosh 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

Diindolylmethane3 drug types · 269 drugs

Diuretic Drugs

Theoretically, diindolylmethane might increase the risk of hyponatremia if used with sodium-depleting diuretics.
Large doses of diindolylmethane (600 mg daily) have been associated with two cases of asymptomatic hyponatremia in clinical research.

Likelihood Possible Evidence B
Estrogens

Theoretically, diindolylmethane might increase or decrease the effects of estrogens.
Diindolylmethane might have mild estrogenic or antiestrogenic effects. Theoretically, large amounts of diindolylmethane might interfere with hormone replacement therapy.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, diindolylmethane might lower serum levels of CYP1A2 substrates.
In vitro evidence suggests that diindolylmethane can induce CYP1A2. Theoretically, it might increase metabolism of CYP1A2 substrates and lower serum concentrations. This interaction has not been reported in humans.

Likelihood Unlikely Evidence D

Dong Quai3 drug types · 163 drugs

Warfarin (Coumadin)

Dong quai may increase the risk of bleeding when used with warfarin.
Case reports suggest that concomitant use of dong quai with warfarin can increase the anticoagulant effects of warfarin and increase the risk of bleeding. In one case, after 4 weeks of taking dong quai 565 mg once or twice daily, the international normalized ratio (INR) increased to 4.9. The INR normalized 4 weeks after discontinuation of dong quai.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, dong quai may increase the risk of bleeding when used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Animal studies suggest that dong quai has antithrombin activity and inhibits platelet aggregation due to its coumarin components. Additionally, some case reports in humans suggest that dong quai can increase the anticoagulant effects of warfarin. However, clinical research in healthy adults shows that taking 1 gram of dong quai root daily for 3 weeks does not significantly inhibit platelet aggregation or cause bleeding. Until more is known, use dong quai with caution in patients taking antiplatelet/anticoagulant drugs.

Likelihood Possible Evidence D
Estrogens

Theoretically, dong quai may reduce the effects of estrogens.
Dong quai has estrogenic effects. Theoretically, concomitant use of large amounts of dong quai might interfere with hormone replacement therapy due to competition for estrogen receptors.

Likelihood Possible Evidence D

Chaste Berry Fruit 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
The maker

Brand information

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

Nutricost Women

See all Nutricost Women products
Name
Nutricost
Street Address
351 E 1750 N
City
Vineyard
State
UT
ZipCode
84059
Phone Number
(866) 438-3694
Web Address
www.nutricost.com
Pharmacist Counseling Corner

Black Cohosh by Nutricost Women: Common Questions

Does Black Cohosh by Nutricost Women interact with any medications?
Yes. Based on its ingredients, Black Cohosh has a known interaction with 892 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Black Cohosh contains 4 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.
Does this help with hot flashes and night sweats?
Black Cohosh, the main ingredient here, is possibly effective for menopausal symptoms like hot flashes. That's the strongest evidence we have for any ingredient in this product. The other three herbs don't have established evidence for the symptoms they're traditionally used for.
Is it safe to take while I'm on birth control?
No — this product contains ingredients that may interfere with how your birth control works. Dong Quai, Black Cohosh, and Chaste Berry all have theoretical interactions with estrogens and contraceptives. Don't take it without checking with your pharmacist first.
Can I take this if I'm pregnant or breastfeeding?
No, this product should be avoided during pregnancy and breastfeeding. Black Cohosh and Dong Quai are possibly unsafe in pregnancy, and we don't have enough safety data on Chaste Berry for either pregnancy or breastfeeding. Talk with your doctor about what's safe for you and your baby.
What are the most common side effects?
The most common side effects are mild: headache, nausea, dizziness, stomach upset, rash, diarrhea, and gas. Chaste Berry may also cause irregular menstruation or fatigue. Serious side effects are rare but have been reported — talk to your pharmacist if something doesn't feel right.
Does Black Cohosh interact with cholesterol medications?
There's one case report of a patient on atorvastatin (Lipitor) who developed elevated liver enzymes after starting Black Cohosh; the enzymes returned to normal when they stopped. Talk with your pharmacist before combining them.
Can I take this with an antidepressant?
It depends on your specific antidepressant. Black Cohosh has serotonergic effects and there's a case report of serotonin syndrome in someone taking it with duloxetine and sertraline. Check the medication checker on this page or ask your pharmacist before starting.

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

Not sure if Black Cohosh is safe with your meds?

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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.

Black Cohosh label
Sources

Sources & How We Checked

Black Cohosh'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 124 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.

Diindolylmethane 14 references
  1. Natl Inst Health, Natl Inst Environmental Health Sci. Indole-3-carbinol. Available at: http://ntp-server.niehs.nih.gov.
  2. Balk JL. Indole-3-carbinol for cancer prevention. Altern Med Alert 2000; 3:105-7.
  3. Riby JE, Chang GHF, Firestone GL, Bjeldanes LF. Ligand-independent activation of estrogen receptor function by 3,3'-diindolylmethane in human breast cancer cells. Biochem Pharmacol 2000;60:167-77. PubMed
  4. Lake BG, Tredger JM, Renwick AB, et al. 3'3-diindolylmethane induces CYP1A2 in cultured precision-cut human liver slices. Xenobiotica 1998;28:803-11. PubMed
  5. Dalessandri, K. M., Firestone, G. L., Fitch, M. D., Bradlow, H. L., and Bjeldanes, L. F. Pilot study: effect of 3,3'-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Canc PubMed
  6. Reed, G. A., Arneson, D. W., Putnam, W. C., Smith, H. J., Gray, J. C., Sullivan, D. K., Mayo, M. S., Crowell, J. A., and Hurwitz, A. Single-dose and multiple-dose administration of indole-3-carbinol to women: pharmacokinetics based on 3,3'-diindolylmetha
  7. Reed, G. A., Sunega, J. M., Sullivan, D. K., Gray, J. C., Mayo, M. S., Crowell, J. A., and Hurwitz, A. Single-dose pharmacokinetics and tolerability of absorption-enhanced 3,3'-diindolylmethane in healthy subjects. Cancer Epidemiol.Biomarkers Prev. 2008; PubMed
  8. Del Priore G., Gudipudi, D. K., Montemarano, N., Restivo, A. M., Malanowska-Stega, J., and Arslan, A. A. Oral diindolylmethane (DIM): pilot evaluation of a nonsurgical treatment for cervical dysplasia. Gynecol.Oncol. 2010;116(3):464-467. PubMed
  9. Heath, E. I., Heilbrun, L. K., Li, J., Vaishampayan, U., Harper, F., Pemberton, P., and Sarkar, F. H. A phase I dose-escalation study of oral BR-DIM (BioResponse 3,3'- Diindolylmethane) in castrate-resistant, non-metastatic prostate cancer. Am.J.Transl.R
  10. Jellinck, P. H., Forkert, P. G., Riddick, D. S., Okey, A. B., Michnovicz, J. J., and Bradlow, H. L. Ah receptor binding properties of indole carbinols and induction of hepatic estradiol hydroxylation. Biochem.Pharmacol. 3-9-1993;45(5):1129-1136. PubMed
  11. Bui PV, Moualla M, Upson DJ. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis. Case Rep Med. 2016;2016:7527098. PubMed
  12. Castañon A, Tristram A, Mesher D, Powell N, Beer H, Ashman S, Rieck G, Fielder H, Fiander A, Sasieni P. Effect of diindolylmethane supplementation on low-grade cervical cytological abnormalities: double-blind, randomised, controlled trial. Br J Cancer. 20 PubMed
  13. Le TM, Sanders CJ, van de Corput L, van Erpecum KJ, Röckmann H. Drug rash with eosinophilia and systemic symptoms caused by the dietary supplement diindolylmethane. J Allergy Clin Immunol Pract. 2016 Jan-Feb;4(1):175-6. PubMed
  14. Pence ST, Mehta K, Crum-Bailey J. The Serious Side of Supplements: An Ischemic Stroke in a Healthy 38-year-old Female. Mil Med 2022. PubMed

See these in context on the Diindolylmethane 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
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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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