Black Cohosh Plus Ingredients & Drug Interactions
by Metagenics
What is this page for?
First and foremost: checking Black Cohosh Plus 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
Black Cohosh Plus is a dietary supplement by Metagenics with 3 active ingredients. Its ingredients are commonly taken for anxiety and stress, sleep problems, digestive upset.Based on those ingredients, 807 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Cohosh Rhizome, Root Extract, Lemon Balm Leaf Extract, Motherwort Aerial Parts Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Black Cohosh Plus by Metagenics
Ask about any prescription or over-the-counter medication and we check it for interactions with Black Cohosh Plus by Metagenics — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Black Cohosh Plus by Metagenics
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.
What’s inside
Full disclosure
Black Cohosh Plus contains three active ingredients. Lemon Balm Leaf Extract is included for its possible effects on cold sores and stress; Motherwort Aerial Parts Extract may support bleeding management; and Black Cohosh Rhizome, Root Extract rounds out the formula.
The product also contains several inactive ingredients — microcrystalline cellulose, croscarmellose sodium, silica, stearic acid, hypromellose, medium chain triglyceride, and hydroxypropyl cellulose — that serve as fillers, binders, and capsule material.
Does it work?
Moderate evidence
The evidence supporting this product's ingredients is mixed. Lemon Balm is possibly effective for cold sores and stress.
Motherwort is possibly effective for bleeding but has insufficient evidence for anxiety, amenorrhea, asthma, or alcohol use disorder. We hold no effectiveness rating for Black Cohosh Rhizome, Root Extract in our data.
If you're considering this product for a specific condition, your pharmacist can walk you through what the science actually shows.
How safe is it?
Well-documented data
Lemon Balm is generally well tolerated for short-term use, though dizziness and sedation have been reported in rare cases — though not more often than placebo. Long-term safety at high doses hasn't been well studied.
Motherwort appears generally well tolerated in the short term but may cause diarrhea or stomach irritation. One case of uterine bleeding was reported with doses exceeding 3 grams.
Topically, motherwort leaves can cause contact dermatitis and photosensitivity. Pregnancy: Lemon Balm has not enough reliable safety data and is best avoided unless your doctor advises otherwise; Motherwort is traditionally thought to stimulate the uterus and should be avoided in pregnancy.
Breastfeeding: Lemon Balm has limited safety information — talk to your doctor before using. Motherwort has no safety data and is best avoided.
Meds to double-check
Moderate interaction found
Before taking this product, double-check with your pharmacist if you're on any CNS depressants — sedatives, sleep aids, anti-anxiety medications, or pain relievers — because both lemon balm and motherwort may boost their sedating effects (Moderate severity). Also flag it if you take thyroid hormone replacement, since lemon balm may interfere with how it works.
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.
Black Cohosh Plus may appeal to you if you're looking to address cold sores, stress, or bleeding and want a multi-ingredient approach. However, if you're on any sedating medication or thyroid hormone replacement, talk to your pharmacist before starting — the lemon balm and motherwort could interfere.
Pregnant or breastfeeding? Check with your doctor first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jan 23, 2025.
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
General information
Key facts about Black Cohosh Plus, straight from the product label.
| Brand | Metagenics |
|---|---|
| Barcode (UPC) | 755571012654 |
| Net contents | 60 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Jan 23, 2025 |
| DSLD ID | 323331 |
| Product type | Botanical |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Vegetarian, Adult Female (18 - 50 Years), Menopause, Seniors/Mature (>50 Years) - Women ONLY, Gluten Free |
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 Plus by Metagenics, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Lemon Balm Leaf Extract | 50 mg | -- |
| Triterpene Glycosides | 2 mg | -- |
| Motherwort Aerial Parts Extract | 100 mg | -- |
| Black Cohosh Rhizome, Root Extract | 80 mg | -- |
Other ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Silica, Stearic Acid, Hypromellose, Medium Chain Triglyceride, Hydroxypropyl Cellulose
Tap any ingredient to jump to its full detail below.
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
Black Cohosh Plus is a non-phytoestrogen formula designed to relieve menopausal complaints with a mood component. This formula combines herbs traditionally used to address menopausal nervousness, irritability, occasional sleep disturbances, and vasomotor symptoms, as well as help ease tension and support relaxation.
Suggested/Recommended/Usage/Directions
Directions: Take one tablet twice daily or as directed by your healthcare practitioner.
Formulation
This product is non-GMO, gluten-free, and vegetarian.
This product is non-GMO, gluten-free, and vegetarian.
Certified Gluten Free GFCO.org
Relief for menopausal mood changes
Precautions
Caution: Consult your healthcare practitioner before use if you are taking medication, have breast cancer or a history of breast cancer, or a history of breast cancer, or have a liver disorder or develop symptoms of liver trouble.
Practitioner Exclusive
Storage
Storage: Keep tightly closed in a cool, dry place.
Seals/Symbols
Certified Gluten Free GFCO.org
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.
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Black Cohosh Plus by Metagenics label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in Black Cohosh Plus by Metagenics
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill 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.
Lemon Balm Leaf Extract
Interacts with264 drugs
Lemon balm is a gentle, lemon-scented mint-family herb traditionally used to ease stress, support sleep, and calm digestion, and topically for cold so...
Lemon Balm Leaf Extract monograph & interactionsMotherwort Aerial Parts Extract
Interacts with248 drugs
Motherwort is a traditional herb in the mint family long used for anxiety, heart palpitations, and women's reproductive complaints, but solid human ev...
Motherwort Aerial Parts Extract monograph & interactionsBlack Cohosh Rhizome, Root Extract
Interacts with652 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...
Black Cohosh Rhizome, Root Extract monograph & interactions- › Triterpene Glycosides
Other (inactive) ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Silica, Stearic Acid, Hypromellose, Medium Chain Triglyceride, Hydroxypropyl Cellulose. These complete the product’s ingredient list but are not active constituents.
Black Cohosh Plus by Metagenics Drug Interactions
HelloPharmacist Interaction Report
Black Cohosh Plus by Metagenics contains three active ingredients, two of which carry documented interactions with medications.
Lemon Balm Leaf Extract poses the most serious concern: it may add to the sedating effects of CNS depressants (drugs that slow your nervous system, like sedatives, sleep aids, and some pain relievers), a Moderate-severity interaction. It may also interfere with thyroid hormone replacement therapy.
Read the full breakdown — every affected drug type, severity by severity
Motherwort Aerial Parts Extract also interacts with CNS depressants, with a Moderate-severity additive sedation risk. We hold no interaction data for Triterpene Glycosides, so we could not check it.
Altogether, these interactions span 264 individual medications. If you take any prescription medication — particularly sedatives, sleep aids, pain relievers, or thyroid hormone — use the medication checker below before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Black Cohosh Plus?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Black Cohosh Plus interact with 807 drugs. Click any drug to see the details.
3 of the 3 ingredients in Black Cohosh Plus interact with drugs. Each result below shows which ingredient is responsible. Black Cohosh Rhizome, Root Extract Lemon Balm Leaf Extract Motherwort Aerial Parts Extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + 6-mercaptopurine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Abacavir, Lamivudine interactionAbiraterone
How Abiraterone interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Abiraterone Acetate interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acebutolol interactionAcepromazineAtravet
How Acepromazine interacts with Black Cohosh Plus — through 2 ingredients. Tap an ingredient for the detail:
Motherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acepromazine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionMotherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Butalbital, Codeine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Butalbital, Codeine interactionMotherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Motherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionBlack Cohosh Rhizome, Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMotherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Caffeine, Codeine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Caffeine, Codeine interactionMotherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Motherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionBlack Cohosh Rhizome, Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionMotherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Black Cohosh Plus — through 3 ingredients. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractSerotonergic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionLemon Balm Leaf ExtractCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Read the full Lemon Balm Leaf Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionMotherwort Aerial Parts ExtractCns Depressants Moderate
Interaction Summary
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Read the full Motherwort Aerial Parts Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractSerotonergic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs, Serotonergic Drugs +1 Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractSerotonergic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with Black Cohosh Plus — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Rhizome, Root ExtractHepatotoxic Drugs, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Rhizome, Root Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Black Cohosh Plus 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 Rhizome, Root Extract
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.
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.
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.
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.
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.
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.
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.
Lemon Balm Leaf Extract
Cns Depressants
Theoretically, concomitant use of lemon balm might have additive effects with CNS depressant drugs.
Lemon balm seems to have CNS depressant activity in animals and in humans.
Thyroid Hormone
Theoretically, lemon balm might interfere with thyroid hormone replacement therapy.
In vitro, constituents of lemon balm extract bind to thyroid stimulating hormone (TSH), preventing TSH receptor-binding and leading to the inhibition of TSH-stimulated adenylate cyclase activity. In animals, lemon balm extract has been shown to decrease levels of circulating TSH and inhibit thyroid secretion.
Motherwort Aerial Parts Extract
Cns Depressants
Theoretically, taking motherwort concomitantly with other CNS depressants may increase the risk of sedation.
Motherwort has been reported to cause CNS depression and sedation.
Brand information
Manufacturer and brand details for Black Cohosh Plus, from the product label.
Metagenics
See all Metagenics products- Name
- Metagenics
- City
- Gig Harbor
- State
- WA
- ZipCode
- 98332
- Phone Number
- 800 692 9400
- Web Address
- metagenics.com
Black Cohosh Plus by Metagenics: Common Questions
Does Black Cohosh Plus by Metagenics interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Does Black Cohosh Plus work for hot flashes?
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Is it safe to use long-term?
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What's the difference between this and plain Black Cohosh?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Black Cohosh Plus’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Lemon Balm
Interacts with 264 drugsLemon balm is a gentle, lemon-scented mint-family herb traditionally used to ease stress, support sleep, and calm digestion, and topically for cold sores. Early studies are promising but gen...
Read the full Lemon Balm monograph → Herb & supplement monographMotherwort
Interacts with 248 drugsMotherwort is a traditional herb in the mint family long used for anxiety, heart palpitations, and women's reproductive complaints, but solid human evidence is very limited. It should be avo...
Read the full Motherwort monograph → Herb & supplement monographBlack Cohosh
Interacts with 652 drugsBlack 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 →Sources & How We Checked
Black Cohosh Plus'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 86 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.
Lemon Balm 12 references
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- Albrecht M, Berger W, Laux P, Schmidt U, et al. Psychopharmaka und Verkehrssicherheit. Der Einfluß von Euvegal® - Dragees forte auf die Fahrtüchtigkeit und Kombinationswirkungen mit Alkohol Z Allg Med 1995;71:1215-25.
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- Sourgens H, Winterhoff H, Gumbinger HG, et al. Antihormonal effects of plant extracts. TSH- and prolactin-suppressing properties of Lithospermum officinale and other plants. Planta Med. 1982 Jun;45:78-86. DOI
- Auf'mkolk M, Ingbar JC, Amir SM, et al. Inhibition by certain plant extracts of the binding and adenylate cyclase stimulatory effect of bovine thyrotropin in human thyroid membranes. Endocrinology. 1984 Aug;115:527-34. PubMed
- Santini F, Vitti P, Ceccarini G, et al. In vitro assay of thyroid disruptors affecting TSH-stimulated adenylate cyclase activity. J Endocrinol Invest. 2003 Oct;26:950-5. PubMed
- Alijaniha F, et al. Heart palpitation relief with Melissa officinalis leaf extract: double blind, randomized, placebo controlled trial of efficacy and safety. J Ethnopharmacol. 2015;164:378-384. doi: 10.1016/j.jep.2015.02.007. Epub 2015 Feb 11. PubMed
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Motherwort 6 references
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- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Wojtyniak K, Szymanski M, Matlawska I. Leonurus cardiaca L. (motherwort): a review of its phytochemistry and pharmacology. Phytother Res 2013;27(8):1115-20.
- Xia WT, Zhou H, Wang Y, et al. Motherwort injection in preventing post-abortion hemorrhage after induced abortion: A multi-center, prospective, randomized controlled trial. Explore (NY). 2019. pii: S1550-8307(19)30447-1. PubMed
- Cao Shan DOSOGC, Zhang W, Zhao Z, et al. Post-marketing safety surveillance and reevaluation of Motherwort injection: A clinical study of 10 094 cases. J Tradit Chin Med. 2018 Aug;38(4):625-635. DOI
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- 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
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- 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
- Meyer S, Vogt T, Obermann EC, et al. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 2007;214:94-6.
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- 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).
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC