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Dietary supplement

Blue Cohosh Ingredients & Drug Interactions

by Herbalist & Alchemist

Blue Cohosh label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 23, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Blue Cohosh 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 is a dietary supplement by Herbalist & Alchemist 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 dried Blue Cohosh root 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 Blue Cohosh by Herbalist & Alchemist

Ask about any prescription or over-the-counter medication and we check it for interactions with Blue Cohosh by Herbalist & Alchemist — and tell you which ingredient is responsible.

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Computed from our clinical databases

HelloPharmacist Scorecard of Blue Cohosh by Herbalist & Alchemist

Four independent checks of what is known — a summary of the available information, not a grade of the product itself.

Evidence for Intended Use
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

The stated purpose hasn't been mapped to our evidence data yet.

Why this rating?
  • We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Ingredient Transparency
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.
Known Interaction Concern
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.
Safety Information
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.

HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated May 24, 2018.

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, straight from the product label.

Brand Herbalist & Alchemist
Barcode (UPC) 667056103330
Net contents 2 fl. Oz.; 60 mL
Market status Off market
Date entered into DSLD May 24, 2018
DSLD ID 173725
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Kosher, Organic
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 by Herbalist & Alchemist, 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:
0.5 mL
Maximum serving Sizes:
1 mL
Servings per container
60
UPC/BARCODE
667056103330
IngredientAmount% DV
dried Blue Cohosh root extract1 mL--

Other ingredients: Ethyl Alcohol, distilled 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.
Formula

Caulophyllum thalictroides

OK

General Statements

Balances uterine function

Botanical preparation ratio 1:4

FDA Statement of Identity

Herbal Supplement

Suggested/Recommended/Usage/Directions

Suggested Use: 10-20 drops (0.5-1 mL) in juice or water. Take 3 times per day. Shake well before using.

Precautions

Contraindications: Do no use during pregnancy.

Keep out of children's reach

FDA Disclaimer Statement

This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.

General

NO. BLU-2 1735MO

Seals/Symbols

OK

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

See for yourself

Blue Cohosh by Herbalist & Alchemist label

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

Blue Cohosh 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 by Herbalist & Alchemist

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

Serving size0.5 mL Dosage formLiquid Servings per container60 Amounts shown are per serving.

Dried Blue Cohosh root extract

Interacts with
259 drugs
1 mL 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...

Dried Blue Cohosh root extract monograph & interactions

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

Interaction report

Blue Cohosh by Herbalist & Alchemist Drug Interactions

Blue Cohosh contains a single active ingredient, and it has known interactions with 259 medications. Here’s the picture, then you can look up your own drug.

Want to check YOUR meds against Blue Cohosh?

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

dried Blue Cohosh root extract 259

Individual Drug Interactions

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

1 of the 1 ingredient in Blue Cohosh interact with drugs. Each result below shows which ingredient is responsible. dried Blue Cohosh root extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Blue Cohosh 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.

dried Blue Cohosh root extract3 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
dried Blue Cohosh root extract full monograph & interactions
The maker

Brand information

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

Herbalist & Alchemist

See all Herbalist & Alchemist products
Name
Herbalist & Alchemist, Inc.
City
Washington
State
NJ
ZipCode
07882
Phone Number
800-611-8235
Web Address
www.herbalist-alchemist.com
Pharmacist Counseling Corner

Blue Cohosh by Herbalist & Alchemist: Common Questions

Does Blue Cohosh by Herbalist & Alchemist interact with any medications?
Yes. Based on its ingredients, Blue Cohosh 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 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.

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

Not sure if Blue Cohosh 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 label
Go deeper

The Full Monographs Behind Blue Cohosh’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'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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