Black Cohosh Root Ingredients & Drug Interactions
by TerraVita
What is this page for?
First and foremost: checking Black Cohosh Root 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 Root is a dietary supplement by TerraVita with 1 active ingredient. Its ingredients are commonly taken for hot flashes and night sweats, other menopause symptoms, mood changes during menopause.Based on those ingredients, 652 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Cohosh Root Glycerite Liquid Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Black Cohosh Root by TerraVita
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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 Root by TerraVita
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
This product contains one active ingredient: black cohosh root glycerite liquid extract. Black cohosh is a plant native to North America, traditionally used to help manage menopausal symptoms like hot flashes.
The extract is suspended in glycerin, an inactive sweetening and preserving agent.
Does it work?
Moderate evidence
Black cohosh is possibly effective for menopausal symptoms, the main reason people use it. For acne, sexual dysfunction, and anxiety, the evidence we have is insufficient to establish whether it works or doesn't.
The data on its use for breast cancer-related hot flashes is also incomplete.
How safe is it?
Well-documented data
Short-term use at typical doses is generally well tolerated. The most common side effects are mild — breast tenderness, dizziness, stomach upset, headache, irritability, rash, and tiredness.
Rare but serious concerns exist around liver damage and endometrial hyperplasia (overgrowth of the uterine lining), though research on these risks is conflicting. There's also one case report of serotonin syndrome in a person taking black cohosh with antidepressants.
Black cohosh is rated possibly unsafe during pregnancy due to lack of safety data and theoretical effects on the uterus. Safety while breastfeeding hasn't been established, so it's best avoided.
Meds to double-check
Moderate interaction found
Check with your pharmacist or doctor before using this product if you take serotonergic drugs (antidepressants like sertraline, duloxetine, or similar medications that affect serotonin). Also flag it if you're on drugs that are hard on the liver, take CYP2D6 substrates (a large enzyme-processed medication group), use atorvastatin (Lipitor), take estrogen therapy, or receive cisplatin chemotherapy.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.
Black cohosh may help with menopausal hot flashes if you're not on medications that interact with it — especially serotonergic antidepressants or drugs that stress your liver. If you take any prescription medication, check it against our tool first.
Talk to your pharmacist or doctor before starting, particularly 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: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 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
General information
Key facts about Black Cohosh Root, straight from the product 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 Root by TerraVita, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Black Cohosh Root Glycerite Liquid Extract | 0.13 mL | -- |
Other ingredients: Glycerin
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.
Brand IP Statement(s)
Copyright 2018 TerraVita - Distributed by ZooScape LLC, All Rights Reserved.
Formula
Glycerite liquid extract (1:5)
Formulation
Alcohol free No flavor
Suggested/Recommended/Usage/Directions
Suggested Use: Take 25-40 drops of extract in a small amount of warm water 3-4 times daily. Shake well before using.
Precautions
Keep away from children.
Do not use if safety seal around cap is broken or missing.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Black Cohosh Root by TerraVita 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 Root by TerraVita
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size25 Drop(s) Dosage formLiquid Servings per container227 Amounts shown are per serving.
Black Cohosh Root Glycerite Liquid 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 Root Glycerite Liquid Extract monograph & interactionsOther (inactive) ingredients: Glycerin. These complete the product’s ingredient list but are not active constituents.
Black Cohosh Root by TerraVita Drug Interactions
HelloPharmacist Interaction Report
Black Cohosh Root by TerraVita can interact with a number of medications.
The most serious concerns involve serotonergic drugs — antidepressants and similar medications that work on serotonin. Black cohosh may increase serotonin activity in your brain, and combining it with these drugs carries a Moderate risk of serotonin syndrome, a potentially serious condition marked by agitation, confusion, rapid heart rate, and muscle rigidity.
Read the full breakdown — every affected drug type, severity by severity
You'll also want to check if you take CYP2D6 substrates (a large category of drugs your liver processes through a specific enzyme) — black cohosh may inhibit that enzyme and raise drug levels, though research on this is mixed. There's a Moderate concern with drugs that stress the liver (hepatotoxic drugs), atorvastatin (Lipitor), estrogen therapy, and the chemotherapy drug cisplatin.
Black cohosh may increase the risk of liver damage when combined with hepatotoxic drugs, might raise liver enzyme levels if you're on atorvastatin, could interfere with estrogen therapy, and may reduce how well cisplatin works. Minor interactions are possible with OATP substrates, a group of drugs absorbed through a specific transporter in your gut and liver.
Altogether, these interactions span 653 individual medications. Use the medication checker on this page to look up your exact prescriptions before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Black Cohosh Root?
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 Root interact with 652 drugs. Click any drug to see the details.
1 of the 1 ingredient in Black Cohosh Root interact with drugs. Each result below shows which ingredient is responsible. Black Cohosh Root Glycerite Liquid Extract
Acetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Pamabrom, Pyrilamine interactionAcetaminophen, PentazocineTalacen
How Acetaminophen, Pentazocine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Pentazocine interactionAcetaminophen, Phenylephrine, ChlorpheniramineSuper Cold Tabs
How Acetaminophen, Phenylephrine, Chlorpheniramine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid 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 Root Glycerite Liquid Extract + Acetaminophen, Phenylephrine, Chlorpheniramine interactionAcetaminophen, PhenylpropanolamineTetra Caps
How Acetaminophen, Phenylpropanolamine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Phenylpropanolamine interactionAcetaminophen, Phenylpropanolamine, PhenyltoloxamineSinubid
How Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Phenylpropanolamine, Phenyltoloxamine interactionAcetaminophen, PhenyltoloxaminePercogesic, Relagesic
How Acetaminophen, Phenyltoloxamine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Phenyltoloxamine interactionAcetaminophen, Phenyltoloxamine, SalicylamideLobac
How Acetaminophen, Phenyltoloxamine, Salicylamide interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Phenyltoloxamine, Salicylamide interactionAcetaminophen, PropoxypheneDarvocet-N 100, Darvocet-N 50, E-Lor, Wygesic
How Acetaminophen, Propoxyphene interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid 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 Root Glycerite Liquid Extract + Acetaminophen, Propoxyphene interactionAcetaminophen, PseudoephedrineChildren's Tylenol Sinus, Dristan N.D., Non-Aspirin Sinus, Ornex, Ornex-Max, Sinutab +5 more
How Acetaminophen, Pseudoephedrine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Pseudoephedrine interactionAcetaminophen, Pseudoephedrine, TriprolidineActifed Plus ES
How Acetaminophen, Pseudoephedrine, Triprolidine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetaminophen, Pseudoephedrine, Triprolidine interactionAcetohexamideDymelor
How Acetohexamide interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Acetohexamide interactionAdagrasibKrazati
How Adagrasib interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Adagrasib interactionAerosphere Budesonide, Formoterol Fumarate, GlycopyrrolateBreztri
How Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Glycerite Liquid Extract + Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate interactionAldesleukinProleukin
How Aldesleukin interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Aldesleukin interactionAlectinib HydrochlorideAlecensa
How Alectinib Hydrochloride interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Alectinib Hydrochloride interactionAllopurinolCaplenal, Cosuric, Rimapurinol, Zyloprim, Zyloric
How Allopurinol interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Allopurinol interactionAlmotriptanAlmogran, Axert
How Almotriptan interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractSerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Root Glycerite Liquid Extract + Almotriptan interactionAlogliptinNesina
How Alogliptin interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Alogliptin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Alogliptin, Pioglitazone interactionAlosetronLotronex
How Alosetron interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractSerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Root Glycerite Liquid Extract + Alosetron interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractCytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Glycerite Liquid Extract + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAmbrisentanLetairis, Volibris
How Ambrisentan interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Ambrisentan interactionAminosalicylic AcidPaser
How Aminosalicylic Acid interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Aminosalicylic Acid interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amiodarone interactionAmitriptylineElavil
How Amitriptyline interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Serotonergic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amitriptyline interactionAmitriptyline, ChlordiazepoxideLimbitrol DS
How Amitriptyline, Chlordiazepoxide interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractSerotonergic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amitriptyline, Chlordiazepoxide interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Serotonergic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amitriptyline, Perphenazine interactionAmoxapineAsendin
How Amoxapine interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractSerotonergic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amoxapine interactionAmoxicillinAmix, Amoram, Amoxident, Amoxil Capsules, Amoxil Injection, Galenamox +3 more
How Amoxicillin interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amoxicillin interactionAmoxicillin VeterinaryBiomox
How Amoxicillin Veterinary interacts with Black Cohosh Root — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh Root Glycerite Liquid ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Root Glycerite Liquid Extract + Amoxicillin Veterinary interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Black Cohosh Root with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Black Cohosh Root Glycerite Liquid 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.
Brand information
Manufacturer and brand details for Black Cohosh Root, from the product label.
TerraVita
See all TerraVita products- Name
- ZooScape LLC
- Phone Number
- 844-449-0444
- Web Address
- www.ZooScape.com
Black Cohosh Root by TerraVita: Common Questions
Does Black Cohosh Root by TerraVita interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take black cohosh if I'm on an antidepressant?
Is black cohosh safe for hot flashes during menopause?
What are the most common side effects?
Can I take black cohosh while pregnant or breastfeeding?
Does black cohosh work for anxiety?
What's in this product besides the active ingredient?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Black Cohosh Root is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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.
The Full Monographs Behind Black Cohosh Root’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Black Cohosh Root'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 68 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
- 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
- Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
- Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
- Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
- 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.
- 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
- Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
- Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
- 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
- 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
- Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
- 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
- Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
- 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
- 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.
- 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
- 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
- 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
- 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
- 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.
- 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
- Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
- 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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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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