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Dietary supplement

Blue Cohosh Ingredients & Drug Interactions

by TerraVita

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Blue Cohosh is a dietary supplement by TerraVita 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 Glycerite Liquid Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Blue Cohosh 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.

From our pharmacy team — supplement deep dive

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: a Blue Cohosh glycerite liquid extract. Glycerite means the herb has been extracted using glycerin as the solvent.

The inactive ingredient is glycerin itself, which serves as both the extraction medium and a sweetener in the liquid form.

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: menstrual and reproductive health support.
  • We looked for evidence on: menstrual irregularity, menopausal symptoms, uterine health.
  • Our graded evidence for these ingredients doesn't cover that particular purpose.

Our data does not include effectiveness ratings for blue cohosh. We don't have evidence from the facts on file about what this extract is meant to treat or how well it works.

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 warnings. The herb contains compounds that affect heart function and has been linked to significant adverse events including chest pain (angina), high blood pressure, fast heartbeat, and high blood glucose.

More alarming, infants born to mothers who used blue cohosh products have developed heart attacks (myocardial infarction), heart failure, shock, seizures, kidney failure, and respiratory distress. The safety data advises against use in pregnancy — blue cohosh may trigger uterine contractions and poses a serious risk to newborns.

There isn't enough safety information to use it while breastfeeding; talk with your doctor or pharmacist before considering it.

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 you take this product, double-check your medications with your doctor or pharmacist, especially if you take blood pressure drugs, diabetes medications, or nicotine products. These are Moderate severity interactions with blue cohosh.

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 casual supplement. It affects your heart, blood pressure, and blood sugar — which means it can interfere with common medications for those conditions.

If you take any blood pressure or diabetes drugs, or use nicotine products, you need to check with your doctor or pharmacist before taking this. It's not for pregnancy or breastfeeding.

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

At a glance

General information

Key facts about Blue Cohosh, straight from the product label.

Brand TerraVita
Barcode (UPC) 064435221522
Net contents 1 Fluid Ounce(s); 30 mL
Market status On market
Date entered into DSLD Nov 22, 2022
DSLD ID 280115
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
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 by TerraVita, 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:
25 Drop(s)
Maximum serving Sizes:
40 Drop(s)
Servings per container
227
UPC/BARCODE
064435221522
IngredientAmount% DV
Blue Cohosh Glycerite Liquid Extract0.13 mL--

Other ingredients: Glycerin

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.
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.

See for yourself

Blue Cohosh by TerraVita label

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

What’s inside

The Ingredients in Blue Cohosh 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.

Blue Cohosh Glycerite Liquid Extract

Interacts with
259 drugs
0.13 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...

Blue Cohosh Glycerite Liquid Extract monograph & interactions

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

Interaction report

Blue Cohosh by TerraVita Drug Interactions

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

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.

Blue Cohosh Glycerite Liquid 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
The maker

Brand information

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

TerraVita

See all TerraVita products
Name
ZooScape LLC
Phone Number
844-449-0444
Web Address
www.ZooScape.com
Pharmacist Counseling Corner

Blue Cohosh by TerraVita: Common Questions

Does Blue Cohosh by TerraVita 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.
Can I take this if I'm pregnant or breastfeeding?
No. The safety data advises against blue cohosh in pregnancy — it may trigger uterine contractions and has been linked to serious harm in newborns, including heart attacks and heart failure. There also isn't enough safety information for breastfeeding. Talk with your doctor before considering it.
What are the side effects I might experience?
Blue cohosh can cause stomach upset including diarrhea, cramping, nausea, and vomiting. More concerning are effects on the heart and blood vessels: chest pain, high blood pressure, and fast heartbeat. It can also raise blood sugar. If you experience chest pain or shortness of breath, stop and seek medical attention.
Why does this interact with so many medications?
Blue cohosh contains compounds that directly affect your heart, blood vessels, and blood sugar. Because blood pressure and diabetes drugs work by controlling those same systems, blue cohosh can interfere with how they function.
Is this safe to use long-term?
The data we hold doesn't address long-term safety. Given the heart and blood vessel effects documented in the adverse events, this is something to discuss carefully with your doctor or pharmacist before regular use.

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
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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