Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Black Cohosh Plus Ingredients & Drug Interactions

by Metagenics

Black Cohosh Plus label
See full label image
Tablet Or Pill Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
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

The interaction bottom line Most serious interaction: Moderate

Black Cohosh Plus is a dietary supplement by Metagenics with 3 active ingredients. Its ingredients are commonly taken for hot flashes and night sweats, other menopause symptoms, mood changes during menopause.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 (Actaea racemosa) root & rhizome extract, Lemon Balm (Melissa officinalis) leaf 5:1 extract, Motherwort (Leonurus cardiaca) aerial parts 4:1 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 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.

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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.

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 3 of its 3 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Black Cohosh Plus contains three active ingredients. Black cohosh root and rhizome extract is included for its possible effectiveness in easing menopausal symptoms.

Motherwort aerial parts extract is traditionally used for bleeding and may have heart-related effects. Lemon balm leaf extract is included for its possible effectiveness in managing stress and depression, and for cold sores.

The tablet also contains several inactive ingredients — microcrystalline cellulose, croscarmellose sodium, silica, stearic acid, and a coating — which are standard binders and fillers used in tablet manufacturing.

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: relieve menopausal complaints with mood support.
  • We looked for evidence on: Menopausal symptoms, Anxiety, Insomnia, Stress, Depression, Hot flashes — and 2 related terms.
  • The strongest evidence on file: Lemon Balm is rated "Possibly Effective" for Depression (Natural Medicines).
  • Also on file: Lemon Balm is rated "Possibly Effective" for Stress.
  • Also on file: Black Cohosh is rated "Possibly Effective" for Menopausal symptoms.

Black cohosh is possibly effective for menopausal symptoms, which is the primary reason most people choose this product. The evidence for motherwort's use in bleeding is also possibly effective.

Lemon balm is possibly effective for stress, depression, and cold sores. However, the data we hold does not establish reliable evidence for black cohosh in acne, sexual dysfunction, anxiety, or breast cancer-related hot flashes, or for motherwort in amenorrhea (absent periods), anxiety, alcohol use disorder, or asthma.

The evidence, ingredient by ingredient Black Cohosh Motherwort Lemon Balm

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 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Black cohosh is generally well tolerated in short-term use, but rare cases of liver damage have been reported, so medical guidance before starting is wise. Common side effects are mild — breast tenderness, dizziness, headache, gastrointestinal upset, irritability, rash, and tiredness.

Motherwort and lemon balm are generally well tolerated for short-term use, though motherwort can cause diarrhea and stomach irritation, and lemon balm can cause dizziness and sedation (though these don't appear to be more frequent than placebo). At high doses motherwort may cause uterine bleeding.

During pregnancy, black cohosh is rated possibly unsafe due to concerns about uterine effects and insufficient data; motherwort is rated likely unsafe because it's traditionally thought to stimulate the uterus; and lemon balm lacks enough reliable safety data. During breastfeeding, black cohosh and motherwort are best avoided due to insufficient data, while lemon balm warrants caution and discussion with your doctor or pharmacist.

Side effects, ingredient by ingredient Black Cohosh Motherwort Lemon Balm

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?
  • 3 of the 3 matched ingredients can interact with medications — Motherwort, Lemon Balm, Black Cohosh.
  • The most serious interaction on file is rated Moderate.
  • For scale: 808 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 with your pharmacist or use our medication checker if you take any serotonergic antidepressants or mood stabilizers (major concern), CNS depressants like benzodiazepines or sleep aids, medications metabolized by the liver enzyme CYP2D6, hepatotoxic drugs (those that affect the liver), estrogen therapy, thyroid hormone replacement, cisplatin (a cancer drug), or OATP substrates. No interactions are documented for the inactive ingredients we could check.

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.

Black Cohosh Plus is most suitable for someone managing menopausal symptoms who has no liver concerns and is not taking antidepressants, heart medications, thyroid replacement, or sedatives. If you take any prescription medication — especially psychiatric medications, blood pressure drugs, or thyroid medication — check your exact drugs with the tool on this page before starting.

Pregnant or breastfeeding? Skip this product and talk to your doctor first.

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

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 16, 2022.

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 Plus, straight from the product label.

Brand Metagenics
Net contents 60 Tablet(s)
Market status On market
Date entered into DSLD Jun 16, 2022
DSLD ID 267973
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
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 Plus by Metagenics, 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 Tablet(s)
Maximum serving Sizes:
1 Tablet(s)
Servings per container
60
IngredientAmount% DV
Black Cohosh (Actaea racemosa) root & rhizome extract80 mg--
Motherwort (Leonurus cardiaca) aerial parts 4:1 extract100 mg--
Lemon Balm (Melissa officinalis) leaf 5:1 extract50 mg--

Other ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Silica, Stearic Acid, Coating

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.
Formulation

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.

This product is non-GMO, gluten-free and vegetarian. GF Certified Gluten-free

This product is non-GMO, gluten-free and vegetarian.

Suggested/Recommended/Usage/Directions

Directions: Take one tablet twice daily or as directed by your healthcare practitioner.

Precautions

Caution: Consult your healthcare practitioner before use if you are taking medication, have 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

GF Certified Gluten-free

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.

Formula

Relief for menopausal mood changes

FDA Statement of Identity

Dietary Supplement

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

See for yourself

Black Cohosh Plus by Metagenics label

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

Black Cohosh Plus 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 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.

Black Cohosh (Actaea racemosa) root & rhizome extract

Interacts with
652 drugs
80 mg per serving Form: Total 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 (Actaea racemosa) root & rhizome extract monograph & interactions

Motherwort (Leonurus cardiaca) aerial parts 4:1 extract

Interacts with
248 drugs
100 mg per serving

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 (Leonurus cardiaca) aerial parts 4:1 extract monograph & interactions

Lemon Balm (Melissa officinalis) leaf 5:1 extract

Interacts with
264 drugs
50 mg per serving

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 (Melissa officinalis) leaf 5:1 extract monograph & interactions

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

Interaction report

Black Cohosh Plus by Metagenics Drug Interactions

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 checker
807Drugs
791 Moderate 16 Minor

Ingredients driving the most interactions

Black Cohosh (Actaea racemosa) root & rhizome extract 652
Lemon Balm (Melissa officinalis) leaf 5:1 extract 264
Motherwort (Leonurus cardiaca) aerial parts 4:1 extract 248

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 (Actaea racemosa) root & rhizome extract Lemon Balm (Melissa officinalis) leaf 5:1 extract Motherwort (Leonurus cardiaca) aerial parts 4:1 extract

Each 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 (Actaea racemosa) root & rhizome 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 (Actaea racemosa) root & rhizome extract full monograph & interactions

Lemon Balm (Melissa officinalis) leaf 5:1 extract2 drug types · 264 drugs

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.

Likelihood Possible Evidence B
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.

Likelihood Possible Evidence D
Lemon Balm (Melissa officinalis) leaf 5:1 extract full monograph & interactions

Motherwort (Leonurus cardiaca) aerial parts 4:1 extract1 drug type · 248 drugs

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.

Likelihood Possible Evidence D
Motherwort (Leonurus cardiaca) aerial parts 4:1 extract full monograph & interactions
The maker

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
Pharmacist Counseling Corner

Black Cohosh Plus by Metagenics: Common Questions

Does Black Cohosh Plus by Metagenics interact with any medications?
Yes. Based on its ingredients, Black Cohosh Plus has a known interaction with 807 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Black Cohosh Plus contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this product really help with hot flashes?
Black cohosh is possibly effective for menopausal symptoms, which is the main use. However, we don't have reliable evidence for its use specifically for breast cancer-related hot flashes.
Can I take this while pregnant or breastfeeding?
No. Black cohosh and motherwort should be avoided in pregnancy — black cohosh is rated possibly unsafe and motherwort likely unsafe due to concerns about uterine effects and insufficient safety data. During breastfeeding, black cohosh and motherwort are best avoided, and lemon balm warrants caution. Talk with your doctor about safer options.
What are the most common side effects?
Most common are mild: breast tenderness, dizziness, headache, gastrointestinal upset, irritability, rash, and tiredness from black cohosh; diarrhea and stomach irritation from motherwort; and dizziness and sedation from lemon balm. Rare serious effects include liver damage and serotonin syndrome.
Is it safe to take this long-term?
The safety data we hold are for short-term use. Because of rare concerns about liver damage with black cohosh, medical guidance before starting is wise, and you should have periodic check-ins with your healthcare provider if you use it regularly.
Can this product make me drowsy?
Yes. Both motherwort and lemon balm can cause sedation and dizziness. If you take other sedating medications — like sleep aids, anxiety drugs, or alcohol — the effect may be stronger. Talk to your pharmacist first.
What is motherwort in this product for?
Motherwort is included for its possibly effective use in managing bleeding and is traditionally used for heart-related concerns. The evidence for anxiety, amenorrhea, and alcohol use disorder is not yet established.

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

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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 Plus label
Go deeper

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.

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

Motherwort

Interacts with 248 drugs

Motherwort 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 monograph

Lemon Balm

Interacts with 264 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 sores. Early studies are promising but gen...

Read the full Lemon Balm monograph →
Sources

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.

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.

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
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See these in context on the Motherwort monograph →

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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

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