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

Blue Cohosh 4:1 Extract Powder Ingredients & Drug Interactions

by TerraVita Premium Collection

Blue Cohosh 4:1 Extract Powder label
See full label image
Powder Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 30, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Blue Cohosh 4:1 Extract Powder 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

Blue Cohosh 4:1 Extract Powder is a dietary supplement by TerraVita Premium Collection with 1 active ingredient. Its ingredients are commonly taken for inducing labor or starting menstruation, menstrual cramps and irregular periods, symptoms of menopause.Based on those ingredients, 259 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Blue Cohosh Extract, Powder. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection

Ask about any prescription or over-the-counter medication and we check it for interactions with Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection

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 16, 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 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: blue cohosh extract in powder form, a 4:1 concentration. The extract comes from blue cohosh, a plant traditionally used for women's health, though we hold no established effectiveness ratings for it in our data.

There are no inactive ingredients listed.

Does it work?

Couldn't assess
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
Not assessable

This is a single-ingredient Blue Cohosh product and its label doesn't state a use — see Blue Cohosh's own graded uses on its monograph.

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.

We hold no effectiveness ratings for blue cohosh in our data, so we cannot tell you whether it works for any particular purpose. If you're considering this product for a specific health goal, that's worth discussing with your doctor or pharmacist to see what the evidence actually supports.

The evidence, ingredient by ingredient Blue Cohosh

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 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Blue cohosh carries real safety concerns. It contains compounds that can affect heart function and has been linked to serious adverse events, including chest pain (angina), high blood pressure, and rapid heartbeat.

Digestive side effects—stomach upset, diarrhea, cramping, nausea, and vomiting—are also possible. The safety data advises strongly against use in pregnancy; it may stimulate the uterus and has been linked to severe harm to newborns, including heart attacks, heart failure, and shock when mothers used blue cohosh products around the time of delivery.

There isn't enough safety information to recommend it while breastfeeding either.

Side effects, ingredient by ingredient Blue Cohosh

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?
  • 1 of the 1 matched ingredient can interact with medications — Blue Cohosh.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: diabetes medications.
  • For scale: 259 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 doctor or pharmacist if you take blood pressure medications (like captopril, enalapril, losartan, valsartan, or diltiazem) or diabetes medications (like insulin, glimepiride, glyburide, pioglitazone, rosiglitazone, or chlorpropamide). Blue cohosh may also increase nicotine effects if you use nicotine products.

All three categories carry Moderate-severity risks.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Blue cohosh is not for everyone. If you take blood pressure or diabetes medications, or use nicotine products, this product poses real interaction risks you need to discuss with your doctor or pharmacist before starting.

It's absolutely off-limits in pregnancy and breastfeeding. Given the heart and digestive side effects on record, talk with your own healthcare provider about whether this product is right for you and how to use it safely.

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 Jun 22, 2023.

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 Blue Cohosh 4:1 Extract Powder, straight from the product label.

Brand TerraVita Premium Collection
Barcode (UPC) 064435229825
Net contents 1 Ounce(s)
Market status On market
Date entered into DSLD Jun 22, 2023
DSLD ID 290934
Product type Botanical
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection, 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:
0.25 Teaspoon(s)
Maximum serving Sizes:
0.25 Teaspoon(s)
Servings per container
28
UPC/BARCODE
064435229825
IngredientAmount% DV
Blue Cohosh Extract, Powder1000 mg--

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.
FDA Statement of Identity

A Dietary Supplement

Brand IP Statement(s)

Copyright 2020 TerraVita - Distributed by ZooScape LLC, All Rights Reserved.

Suggested/Recommended/Usage/Directions

Directions Stir 1/4 of a teaspoon into a glass of water and consume 3 times daily, with meals.

General Statements

TerraVita is an exclusive line of premium natural products that use the finest, purest and most potent ingredients in the world. TerraVita's hallmarks are the highest possible standards of purity, potency, stability and freshness. All products are prepared with the greatest quality control, from raw materials through the entire manufacturing process, right up to the moment your product is sealed for freshness and shipped to you.

Please recycle!

FDA Disclaimer Statement

Statements not evaluated by FDA. Product not intended to diagnose, treat, cure, or prevent any disease.

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

See for yourself

Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection label

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

Blue Cohosh 4:1 Extract Powder 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 Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size0.25 Teaspoon(s) Dosage formPowder Servings per container28 Amounts shown are per serving.

Blue Cohosh Extract, Powder

Interacts with
259 drugs
1000 mg per serving

Blue cohosh is a traditional herb historically used by Native Americans and midwives to bring on labor or menstruation, but it carries serious safety...

Blue Cohosh Extract, Powder monograph & interactions
Interaction report

Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection Drug Interactions

Want to check YOUR meds against Blue Cohosh 4:1 Extract Powder?

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
259Drugs
259 Moderate

Ingredients driving the most interactions

Blue Cohosh Extract, Powder 259

Individual Drug Interactions

The ingredients in Blue Cohosh 4:1 Extract Powder interact with 259 drugs. Click any drug to see the details.

1 of the 1 ingredient in Blue Cohosh 4:1 Extract Powder interact with drugs. Each result below shows which ingredient is responsible. Blue Cohosh Extract, Powder

Each ingredient & the kinds of drugs it affects

For each ingredient in Blue Cohosh 4:1 Extract Powder 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.

Blue Cohosh Extract, Powder3 drug types · 259 drugs

Antidiabetes Drugs

There is some concern that blue cohosh might increase blood glucose levels. Theoretically, it might decrease the effectiveness of medicines used for diabetes. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Likelihood Possible Evidence D
Antihypertensive Drugs

Constituents in blue cohosh might increase blood pressure by causing coronary vasoconstriction. Theoretically, concomitant use might decrease the effectiveness of drugs used for angina and high blood pressure; use with caution. Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Likelihood Possible Evidence D
Nicotine

Blue cohosh can increase the effects of nicotine.

Likelihood Possible Evidence D
Blue Cohosh Extract, Powder full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Blue Cohosh 4:1 Extract Powder, from the product label.

TerraVita Premium Collection

See all TerraVita Premium Collection products
Name
TerraVita Fine Whole Herbs
City
Brampton
State
Ontario
Pharmacist Counseling Corner

Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection: Common Questions

Does Blue Cohosh 4:1 Extract Powder by TerraVita Premium Collection interact with any medications?
Yes. Based on its ingredients, Blue Cohosh 4:1 Extract Powder has a known interaction with 259 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Blue Cohosh 4:1 Extract Powder contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism 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.
Can I take this while pregnant or breastfeeding?
No. The safety data advises against it in pregnancy — blue cohosh may stimulate the uterus and has been linked to serious harm to newborns, including heart attacks and heart failure when used around delivery time. There isn't enough safety information to use it while breastfeeding either. Talk with your doctor or pharmacist about safer options for whatever you're trying to address.
What side effects can blue cohosh cause?
Orally, it can cause chest pain, high blood pressure, rapid heartbeat, stomach upset with diarrhea and cramping, nausea, vomiting, and irritation of the mouth and throat. Because it affects the heart, these aren't minor risks — especially the chest pain and blood pressure effects.
I take blood pressure medication. Is this safe for me?
Not without checking first. Blue cohosh can raise blood pressure by tightening blood vessels and may make your blood pressure medication less effective. Talk with your doctor or pharmacist before starting — they'll need to know your exact medication to advise you properly.
I have diabetes. Can I use this?
You should check with your doctor or pharmacist first. Blue cohosh may raise blood glucose levels and could reduce how well your diabetes medications work. Your healthcare provider can tell you whether it's safe given your specific situation.
What is blue cohosh used for?
Traditionally it's been used for women's health, but we don't have established effectiveness ratings for it in our data. Your doctor or pharmacist can tell you what the actual evidence shows for whatever condition you're thinking about.

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

Not sure if Blue Cohosh 4:1 Extract Powder is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Blue Cohosh 4:1 Extract Powder label
Go deeper

The Full Monographs Behind Blue Cohosh 4:1 Extract Powder’s Ingredients

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

Herb & supplement monograph

Blue Cohosh

Interacts with 259 drugs

Blue cohosh is a traditional herb historically used by Native Americans and midwives to bring on labor or menstruation, but it carries serious safety concerns, especially for the heart and d...

Read the full Blue Cohosh monograph →
Sources

Sources & How We Checked

Blue Cohosh 4:1 Extract Powder'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 16 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.

Blue Cohosh 16 references
  1. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2. PubMed
  2. 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
  3. Wright IM. Neonatal effects of maternal consumption of blue cohosh. J Pediatr 1999;134:384-5. DOI
  4. Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int Midwife 1999;52:34-5.
  5. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  6. Irikura B, Kennelly E. American Health Consultants. Blue Cohosh: a word of caution. 1999. Available at: http://www.ahcmedia.com/articles/50424-blue-cohosh-a-word-of-caution.
  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. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3. PubMed
  10. Kennelly, E. J., Flynn, T. J., Mazzola, E. P., Roach, J. A., McCloud, T. G., Danford, D. E., and Betz, J. M. Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. J.Nat.Prod. 1999;62(10):1385-1389. PubMed
  11. Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
  12. Gunn, T. R. and Wright, I. M. The use of black and blue cohosh in labour. N.Z Med J 10-25-1996;109(1032):410-411.
  13. Scott, C. C. and Chen, K. K. The pharmacological action of N-methylcytisine. The Journal of Pharmacology and Experimental Therapuetics 1943;79:334-339. DOI
  14. Low, D. T. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
  15. Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73.
  16. Sirtori CR, Triolo M, Bosisio R, et al. Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals. Br J Nutr 2012;107:1176-83. PubMed

See these in context on the Blue Cohosh monograph →

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

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team