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Dietary supplement

Blue Cohosh Non-Alcohol Ingredients & Drug Interactions

by Hawaii Pharm

Blue Cohosh Non-Alcohol label
See full label image
Liquid 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 Non-Alcohol 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 Non-Alcohol is a dietary supplement by Hawaii Pharm 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 wild harvested Blue Cohosh 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 Non-Alcohol by Hawaii Pharm

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

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HelloPharmacist Scorecard of Blue Cohosh Non-Alcohol by Hawaii Pharm

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 1 active ingredient.

This product contains one active ingredient: a wild harvested Blue Cohosh extract. The extract is delivered in a non-alcohol liquid base made with vegetable palm glycerin and Hawaiian water.

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 don't have effectiveness ratings on file for blue cohosh in the data we hold. This product's uses and how well it works aren't documented in our information.

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 significant safety warnings. The ingredient can cause stomach upset, diarrhea, cramping, nausea, vomiting, chest pain, and abnormal heartbeat.

There's also a serious cardiac concern: compounds in blue cohosh can affect the heart, and maternal use has been linked to heart attacks and heart failure in newborns. The safety data advises strongly against use in pregnancy — blue cohosh may stimulate the uterus and has been tied to serious harm in newborns.

There isn't enough safety information to recommend it while breastfeeding; talk with your doctor or pharmacist before using it if you're pregnant or nursing.

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 or diabetes drugs — both are moderate-severity concerns. If you use nicotine products, you should also review this with your healthcare provider.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Blue cohosh is a single-ingredient herbal extract that interacts with blood pressure medications, diabetes drugs, and nicotine. Because it carries documented risks to the heart and serious pregnancy-related warnings, you should check with your doctor or pharmacist before starting it — especially if you take medications for high blood pressure or diabetes, or if you're pregnant, planning 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 Oct 23, 2020.

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 Non-Alcohol, straight from the product label.

Brand Hawaii Pharm
Barcode (UPC) 6339127898462
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Oct 23, 2020
DSLD ID 238564
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free
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 Non-Alcohol by Hawaii Pharm, 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:
20 Drop(s)
Maximum serving Sizes:
30 Drop(s)
UPC/BARCODE
6339127898462
IngredientAmount% DV
wild harvested Blue Cohosh extract0 NP--

Other ingredients: Vegetable Palm Glycerin, crystal clear artesian Hawaiian 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

Hawaii Pharm Non-Alcohol Herbal Extract Highest quality since 2008

Made with Aloha!

Formulation

Contains no gluten, artificial colors, pesticides, preservatives, heavy metals. Non GMO.

Super concentrated liquid herbal extract Dry herb/menstruum ratio: 1:3

Contains no alcohol

Description: We produced this extract according to precise standards where each herbs are individually extracted according to their distinct characteristic. We use a cold maceration extraction method, so that the active constituents of the herbs are extracted and maintained.

Non GMO Gluten free

Manufactured in an FDA registered facility. Ultra Sonic

Made in USA, Hawaii

Suggested/Recommended/Usage/Directions

Directions for use: Shake well before using. Take about 20-30 drops in juice, water, tea or as desired up to four times per day.

Precautions

Warnings: Keep out of the reach of children.

Not to be used during pregnancy.

Do not use if you are allergic to any ingredients.

Consult a physician before using if nursing or taking any medications.

Do not use if seal is broken or missing.

Storage

Refrigerate after opening.

Formula

(Caulophyllum thalictroides)

FDA Statement of Identity

Herbal Dietary Supplement

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Seals/Symbols

FDA Registered Facility Made in United States of America USA

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

See for yourself

Blue Cohosh Non-Alcohol by Hawaii Pharm label

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

Blue Cohosh Non-Alcohol 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 Non-Alcohol by Hawaii Pharm

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

Serving size20 Drop(s) Dosage formLiquid Amounts shown are per serving.

Wild harvested Blue Cohosh extract

Interacts with
259 drugs
0 NP 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...

Wild harvested Blue Cohosh extract monograph & interactions

Other (inactive) ingredients: Vegetable Palm Glycerin, Crystal clear artesian Hawaiian Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Blue Cohosh Non-Alcohol by Hawaii Pharm Drug Interactions

Want to check YOUR meds against Blue Cohosh Non-Alcohol?

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

wild harvested Blue Cohosh extract 259

Individual Drug Interactions

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

1 of the 1 ingredient in Blue Cohosh Non-Alcohol interact with drugs. Each result below shows which ingredient is responsible. wild harvested Blue Cohosh extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Blue Cohosh Non-Alcohol 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.

wild harvested Blue Cohosh 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
wild harvested Blue Cohosh extract full monograph & interactions
The maker

Brand information

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

Hawaii Pharm

See all Hawaii Pharm products
Name
Hawaii Pharm LLC
City
Honolulu
State
HI
ZipCode
96815
Pharmacist Counseling Corner

Blue Cohosh Non-Alcohol by Hawaii Pharm: Common Questions

Does Blue Cohosh Non-Alcohol by Hawaii Pharm interact with any medications?
Yes. Based on its ingredients, Blue Cohosh Non-Alcohol 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 Non-Alcohol 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 stimulate the uterus and has been linked to serious harm in newborns, including heart attacks. There also isn't enough safety information to recommend it while breastfeeding. Talk with your doctor or pharmacist before using it if you're pregnant, planning to get pregnant, or nursing.
What side effects might I experience?
Blue cohosh can cause stomach upset, diarrhea, cramping, nausea, vomiting, and abdominal pain. More seriously, it can cause chest pain, high blood pressure, and abnormal heart rhythms. It affects the heart and has been linked to severe cardiac events, so you should discuss it with your doctor before starting.
I take a blood pressure medication. Can I use this product?
Blue cohosh may raise your blood pressure by narrowing blood vessels in the heart, which could make your blood pressure medication less effective. This is a moderate-severity interaction, so you need to check with your doctor or pharmacist before taking it.
I'm diabetic. Is this safe for me?
Blue cohosh may raise blood sugar levels and could reduce how well your diabetes medication works. This is a moderate-severity concern, so talk with your doctor or pharmacist before using it.
Does this product work for anything?
We don't have effectiveness ratings on file for blue cohosh in the data we hold. If you're considering it for a specific health goal, ask your doctor or pharmacist whether there's evidence supporting that use.

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

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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 Non-Alcohol label
Go deeper

The Full Monographs Behind Blue Cohosh Non-Alcohol’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 Non-Alcohol'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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