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Dietary supplement

Blue Cohosh 450 mg Ingredients & Drug Interactions

by Nature's Sunshine

Blue Cohosh 450 mg label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Blue Cohosh 450 mg 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 450 mg is a dietary supplement by Nature's Sunshine 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. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Blue Cohosh 450 mg by Nature's Sunshine

Ask about any prescription or over-the-counter medication and we check it for interactions with Blue Cohosh 450 mg by Nature's Sunshine — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Blue Cohosh 450 mg by Nature's Sunshine

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, a botanical extract dosed at 450 mg per capsule. The capsules also contain two inactive ingredients — kosher gelatin and water — that serve as the capsule shell and carrier.

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

We hold no graded evidence for this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: female glandular system support.
  • We looked for evidence on: menstrual irregularity, menopausal symptoms, uterine health.
  • Our graded evidence for these ingredients doesn't cover that particular purpose.

We have no effectiveness data on file for blue cohosh. The facts we hold do not include evidence ratings for what this ingredient may or may not do.

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 serious safety concerns you need to know about. It contains compounds that affect the heart and has been linked to significant adverse events, including chest pain (angina), high blood pressure, raised blood sugar, stomach upset with diarrhea and cramping, and an abnormally fast heartbeat.

In one reported case, when a mother took a blue cohosh combination product about a month before delivery, her newborn developed a heart attack, heart failure, and shock — a medical emergency. Blue cohosh is not safe in pregnancy; it may trigger uterine contractions and has been tied to severe harm in newborns, including seizures, kidney failure, and respiratory distress.

There isn't enough safety information to recommend it while breastfeeding, so you should avoid it during lactation as well.

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.

Check with your doctor or pharmacist before taking blue cohosh if you use blood pressure medications (like captopril, enalapril, losartan, valsartan, or diltiazem), diabetes drugs (including insulin, glimepiride, glyburide, pioglitazone, or rosiglitazone), or nicotine products — these are Moderate-severity interactions that could reduce drug effectiveness or intensify side effects.

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 a good choice if you take blood pressure medications, diabetes drugs, or nicotine products — the interactions are well documented and could reduce how well your medications work or intensify unwanted effects. It should be avoided completely during pregnancy and breastfeeding.

Because this herb carries real risks to your heart and serious potential harms to a developing baby or nursing infant, talk with your doctor or pharmacist before considering it.

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 Dec 22, 2019.

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 450 mg, straight from the product label.

Brand Nature's Sunshine
Barcode (UPC) 099904001107
Net contents 100 Capsule(s)
Market status On market
Date entered into DSLD Dec 22, 2019
DSLD ID 210656
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Kosher, Adult Female (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 450 mg by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
UPC/BARCODE
099904001107
IngredientAmount% DV
Blue Cohosh450 mg--

Other ingredients: kosher Gelatin, Water

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.
General Statements

01000110010409

Nature's Sunshine uses natural source materials in its products that are subject to color variation.

Product of U.S.A. Herb specialists since 1972 Quality, service, integrity

Guaranteed pure

Formula

Female glandular system support

Ko Pareve

Suggested/Recommended/Usage/Directions

Recommendation Take one capsule with a meal twice daily.

Precautions

Notice: Pregnant or lactating women should consult their health care professional prior to taking this supplement.

This bottle was sealed for your protection. Do not use if inner seal is missing or damaged.

Brand IP Statement(s)

2009 Nature's Sunshine Products, Inc.

FDA Statement of Identity

Herbal Dietary Supplement

Seals/Symbols

Ko Pareve

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

See for yourself

Blue Cohosh 450 mg by Nature's Sunshine label

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

Blue Cohosh 450 mg 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 450 mg by Nature's Sunshine

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

Serving size1 Capsule(s) Dosage formCapsule Amounts shown are per serving.

Blue Cohosh

Interacts with
259 drugs
450 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 monograph & interactions

Other (inactive) ingredients: Kosher Gelatin, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Blue Cohosh 450 mg by Nature's Sunshine Drug Interactions

Want to check YOUR meds against Blue Cohosh 450 mg?

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 259

Individual Drug Interactions

The ingredients in Blue Cohosh 450 mg interact with 259 drugs. Click any drug to see the details.

1 of the 1 ingredient in Blue Cohosh 450 mg interact with drugs. Each result below shows which ingredient is responsible. Blue Cohosh

Each ingredient & the kinds of drugs it affects

For each ingredient in Blue Cohosh 450 mg 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 Cohosh3 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 full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Blue Cohosh 450 mg, from the product label.

Nature's Sunshine

See all Nature's Sunshine products
Name
Nature's Sunshine Products, Inc.
City
Spanish Fork
State
UT
ZipCode
84660
Phone Number
1-800-223-8225
Web Address
www.naturessunshine.com
Pharmacist Counseling Corner

Blue Cohosh 450 mg by Nature's Sunshine: Common Questions

Does Blue Cohosh 450 mg by Nature's Sunshine interact with any medications?
Yes. Based on its ingredients, Blue Cohosh 450 mg 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 450 mg 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.
Is blue cohosh safe to take while I'm pregnant or breastfeeding?
No. Blue cohosh is not safe in pregnancy — it can stimulate the uterus and has been linked to serious harm in newborns, including heart attack, heart failure, shock, seizures, and kidney failure. There also isn't enough safety data to use it while breastfeeding. Talk with your doctor or pharmacist if you're pregnant, planning to become pregnant, or nursing.
What are the side effects I might experience?
Blue cohosh can cause stomach upset including diarrhea and cramping, nausea, vomiting, chest pain, high blood pressure, an abnormally fast heartbeat, and raised blood sugar. Mouth and throat irritation can also occur. Because it affects the heart, these effects can be serious — let your doctor know right away if you have chest pain or other concerning symptoms.
Can I take blue cohosh with my blood pressure medication?
You shouldn't without checking first. Blue cohosh may raise your blood pressure and reduce how well blood pressure drugs work — this is a documented moderate-severity interaction. Talk with your doctor or pharmacist before combining them.
Can I take blue cohosh if I'm on insulin or diabetes medication?
You should check with your doctor or pharmacist first. Blue cohosh may raise your blood glucose levels and potentially make diabetes medications less effective. Because this is a moderate-severity interaction, your healthcare provider needs to know you're considering it.
What is blue cohosh used for?
We don't have effectiveness information on file for what blue cohosh is intended to do. If you're considering it for a specific health reason, your doctor or pharmacist can discuss whether there's evidence for that use.

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

Not sure if Blue Cohosh 450 mg is safe with your meds?

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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.

Blue Cohosh 450 mg label
Go deeper

The Full Monographs Behind Blue Cohosh 450 mg’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 450 mg'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

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