FemQOL Ingredients & Drug Interactions
by OncoQOL
What is this page for?
First and foremost: checking FemQOL 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
FemQOL is a dietary supplement by OncoQOL with 1 active ingredient. Its ingredients are commonly taken for hot flashes and night sweats, other menopause symptoms, mood changes during menopause.Based on those ingredients, 652 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Cohosh extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against FemQOL by OncoQOL
Ask about any prescription or over-the-counter medication and we check it for interactions with FemQOL by OncoQOL — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
Ask the Pharmacist
A licensed pharmacist will answer your question by email — free, usually within 24 hours.
Got it — thank you!
A licensed pharmacist will answer within 24 hours. Keep an eye on your email (worth checking spam, just in case).
HelloPharmacist Scorecard of FemQOL by OncoQOL
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.
What’s inside
Full disclosure
FemQOL contains one active ingredient: black cohosh extract. Black cohosh is a plant whose root has been used traditionally for menopause-related hot flashes and other symptoms.
The product also includes inactive ingredients — microcrystalline cellulose, hypromellose (a cellulose-based capsule material), leucine, and silicon dioxide — which are fillers and binders that help form and stabilize the capsule.
Does it work?
Moderate evidence
Black cohosh extract is possibly effective for menopausal symptoms based on the evidence we have. For other uses listed — acne, sexual dysfunction, anxiety, and breast cancer-related hot flashes — we don't hold enough reliable evidence to rate how well it works.
How safe is it?
Well-documented data
Black cohosh is generally well tolerated when used short-term at typical doses. The most common side effects are mild: breast tenderness, dizziness, gastrointestinal upset, headache, irritability, rash, and tiredness.
Rare but serious concerns include liver damage and changes to the uterine lining, though data on both are conflicting. During pregnancy, the safety data advises against use — it's rated possibly unsafe.
The same applies to breastfeeding; safety has not been established, so it's best avoided. If you're pregnant, breastfeeding, or planning to become pregnant, talk with your doctor or pharmacist before taking this product.
Meds to double-check
Moderate interaction found
Before taking FemQOL, double-check with your doctor or pharmacist if you're on serotonergic drugs (antidepressants and similar medications for mood or anxiety), drugs metabolized by the CYP2D6 enzyme, medications that can stress your liver, atorvastatin or other cholesterol drugs, cisplatin or other cancer drugs, estrogen therapy, or any medications transported by the OATP2B1 carrier protein. No interactions are documented for ingredients we could not check, but the ones listed above warrant confirmation before you start.
The bottom line
Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
FemQOL may help with menopausal hot flashes, but its interactions with serotonergic drugs, cholesterol and cancer medications, and drugs handled by your liver mean you should run your full medication list past your doctor or pharmacist before starting it. It's not recommended in pregnancy or while breastfeeding.
If you're considering this supplement, have that conversation with your healthcare provider first.
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 24, 2013.
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
General information
Key facts about FemQOL, straight from the product label.
| Brand | OncoQOL |
|---|---|
| Barcode (UPC) | 693749001201 |
| Net contents | 60 Vegetarian Capsule(s) |
| Market status | On market |
| Date entered into DSLD | Dec 24, 2013 |
| DSLD ID | 28474 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), No Allergies |
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 FemQOL by OncoQOL, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Black Cohosh extract | 20 mg | -- |
Other ingredients: Microcrystalline Cellulose, Hypromellose (derived from Cellulose) Capsule, Leucine, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
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)
Enhancing Quality of Life Through Targeted Nutraceuticals(TM)
General Statements
Promotes normal vasomotor function
FDA Statement of Identity
DIETARY SUPPLEMENT
Suggested/Recommended/Usage/Directions
Suggested Use: Take 1 capsule two times daily or as recommended by your health-care practitioner.
Precautions
Tamper Evident: Use only if bottle is sealed.
If pregnant, consult your health-care practitioner before using this product.
Storage
Store tightly sealed in a cool, dry place.
Formula
Standardized to 5% Saponins
HYPOALLERGENIC
Seals/Symbols
{pulled apart capsule}(R)
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
QOL108 LQOL10803
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
FemQOL by OncoQOL label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in FemQOL by OncoQOL
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.
Black Cohosh extract
Interacts with652 drugs
Black cohosh is a North American plant most often used to ease menopause symptoms like hot flashes, but the research is mixed and far from settled. It...
Black Cohosh extract monograph & interactionsOther (inactive) ingredients: Microcrystalline Cellulose, Hypromellose (derived from Cellulose) Capsule, Leucine, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
FemQOL by OncoQOL Drug Interactions
HelloPharmacist Interaction Report
FemQOL by OncoQOL contains black cohosh extract, which has documented interactions with a considerable number of medications.
The most serious concern is with serotonergic drugs (antidepressants and similar medications) — there's a risk of serotonin syndrome, a potentially dangerous buildup of serotonin in your system. One case reported this happening when black cohosh was added to duloxetine and sertraline.
Read the full breakdown — every affected drug type, severity by severity
Black cohosh may also affect how your liver handles drugs metabolized by the CYP2D6 enzyme, though the evidence is mixed — some studies suggest it might increase levels of these medications, while others don't. It can theoretically worsen liver damage when combined with drugs that are hard on the liver, and there's a case report of elevated liver enzymes in someone taking it with atorvastatin (a cholesterol medication).
Additionally, black cohosh may interfere with cisplatin (a cancer drug), reduce the effects of certain estrogen therapies, or lower the effectiveness of some other medications transported into the body by a specific carrier protein (OATP2B1 substrates).
Altogether, these interactions span 653 individual medications. Before starting this product, check your exact medications with the tool on this page, and talk with your doctor or pharmacist about whether it's safe to combine with anything you're taking.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against FemQOL?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in FemQOL interact with 652 drugs. Click any drug to see the details.
1 of the 1 ingredient in FemQOL interact with drugs. Each result below shows which ingredient is responsible. Black Cohosh extract
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + 6-mercaptopurine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Abacavir, Lamivudine interactionAbiraterone
How Abiraterone interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Abiraterone Acetate interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acebutolol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs, Serotonergic Drugs +1 Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractSerotonergic Drugs, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs, Serotonergic Drugs +1 Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PseudoephedrineChildren's Tylenol Cold Plus Cough, Tylenol Cold Ex Strength
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractCytochrome P450 2d6 (cyp2d6) Substrates, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Dextromethorphan, Pseudoephedrine interactionAcetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, SalicylamideRhinogesic GG
How Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractSerotonergic Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Guaifenesin, Phenylephrine, Salicylamide interactionAcetaminophen, Chlorpheniramine, PhenylephrineAlka-Seltzer PLUS, Histex SR, Protid
How Acetaminophen, Chlorpheniramine, Phenylephrine interacts with FemQOL — through 1 ingredient. Tap an ingredient for the detail:
Black Cohosh ExtractHepatotoxic Drugs, Serotonergic Drugs Moderate
Interaction Summary
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
Read the full Black Cohosh Extract + Acetaminophen, Chlorpheniramine, Phenylephrine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in FemQOL 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.
Black Cohosh extract
Atorvastatin (Lipitor)
Taking black cohosh with atorvastatin might increase the risk for elevated liver function tests.
In one case report, a patient taking atorvastatin (Lipitor) developed significantly elevated liver function enzymes after starting black cohosh 100 mg four times daily. Liver enzymes returned to normal when black cohosh was discontinued. It is unclear whether the elevated liver enzymes were due to black cohosh itself or an interaction between atorvastatin and black cohosh.
Cisplatin (Platinol-Aq)
Theoretically, black cohosh may reduce the clinical effects of cisplatin.
Animal research suggests that black cohosh might decrease the cytotoxic effect of cisplatin on breast cancer cells.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Some research suggests that black cohosh might inhibit CYP2D6, but there is conflicting evidence.
Some clinical research suggests that black cohosh might modestly inhibit CYP2D6 and increase levels of drugs metabolized by this enzyme. However, contradictory clinical research shows a specific black cohosh product (Remifemin, Enzymatic Therapy) 40 mg twice daily does not significantly inhibit metabolism of a CYP2D6 substrate in healthy study volunteers. Until more is known, use black cohosh cautiously in patients taking drugs metabolized by CYP2D6.
Estrogens
Theoretically, black cohosh may alter the effects of estrogen therapy.
Some research suggests that black cohosh has estrogenic effects. This may enhance or inhibit the effects of estrogen therapy.
Hepatotoxic Drugs
Theoretically, taking black cohosh with hepatotoxic drugs may increase the risk of liver damage.
There is concern that black cohosh might be linked to cases of liver failure and autoimmune hepatitis.
Serotonergic Drugs
Combining serotonergic drugs with black cohosh might cause additive serotonergic effects.
Black cohosh might increase the risk of serotonin syndrome when combined with other serotonergic drugs. Black cohosh acts as an agonist at several serotonin receptor subtypes and might interact with other serotonergic medications. In one case, a 55-year-old female who had been on stable treatment with sertraline 50 mg and duloxetine 60 mg daily developed serotonin syndrome after taking black cohosh extract 40 mg daily for 3 days.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Black cohosh may inhibit one form of OATP, OATP2B1, which could reduce the bioavailability and clinical effects of OATP2B1 substrates.
In vitro research shows that black cohosh modestly inhibits OATP2B1. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
Brand information
Manufacturer and brand details for FemQOL, from the product label.
OncoQOL
See all OncoQOL products- Name
- Thorne Research, Inc.
- Street Address
- P.O. Box 25
- City
- Dover
- State
- Idaho
- ZipCode
- 83825
- Phone Number
- 1-855-662-6765
FemQOL by OncoQOL: Common Questions
Does FemQOL by OncoQOL interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Does black cohosh really help with hot flashes?
What are the most common side effects?
Can I take this if I'm pregnant or breastfeeding?
I'm on an antidepressant. Is this safe to add?
What is black cohosh extract and why is it in this product?
Does this product have fillers?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if FemQOL is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
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.
The Full Monographs Behind FemQOL’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
FemQOL'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 68 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.
Black Cohosh 68 references
- 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
- Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002;177:440-3. PubMed
- Pepping J. Black cohosh: Cimicifuga racemosa. Am J Health Syst Pharm 1999;56:1400-2. PubMed
- Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Adv Ther 1998;15:45-53.
- Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med 1999;65:763-4.
- Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 2001;19:2739-45. PubMed
- Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
- Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
- Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2003;179:390-1.. DOI
- Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 2003;44:S67-77. PubMed
- Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause 2003;10:58-64.. DOI
- Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7. PubMed
- Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2003;178:411-2.. PubMed
- Thomsen M, Vitetta L, Schmidt M, Sali A. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 2004;180:598-600.. DOI
- Cohen B, Schardt D. Center for Science in the Public Interest. Letter to Food and Drug Administration. Commissioner Mark McClellan, MD, PhD. March 4, 2004.
- Seidlova-Wuttke D, Hesse O, Jarry H, et al. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. Eur J Endocrinol 2003;149:351-62. PubMed
- Rockwell S, Liu Y, Higgins SA. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 2005;90:233-9. PubMed
- Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9. PubMed
- Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. PubMed
- Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. PubMed
- Minciullo PL, Saija A, Patafi M, et al. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006;13:115-8. PubMed
- Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Men PubMed
- MHRA. Black cohosh (Cimicifuga racemosa) - risk of liver problems. Herbal Safety News July 2006. Available at: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary= true&ssDocName=CON2024131&ssTargetNodeId=663.
- Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Can J Clin Pharmacol 2006;13:e257-61.
- Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 2006;13:678-91. PubMed
- Lynch CR, Folkers ME, Hutson WR. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl 2006;12:989-92. PubMed
- Bai W, Henneicke-von Zepelin HH, Wang S, et al. Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: A randomized, double blind, parallel-controlled study versus tibol
- Meyer S, Vogt T, Obermann EC, et al. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 2007;214:94-6.
- Gori L, Firenzuoli F. Is black cohosh a hepatotoxic medicinal herb? Forsch Komplementarmed 2007;14:109-10. PubMed
- Assessment of case reports connected to herbal medicinal products containing cimicifugae racemosa rhizoma (black cohosh, root). Doc. Ref. EMEA/269259/2006. Available at: www.emea.eu.int/pdfs/human/hmpc/26925806en.pdf (Accessed 30 November 2007).
- Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John's wort (GYNO-Plus) for climacteric symptoms. Yonsei Med J 2007;48:289-94. PubMed
- Chow ECY, Teo M, Ring JA, Chen JW. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust 2008;188:420-2. PubMed
- Mahady GB, Low Dog T, Barrett ML, et al. United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Menopause 2008;15:628-38. PubMed
- Hepatotoxicity with black cohosh. Australian Adv Drug Reactions Bull 2006;25:6. Available at: www.tga.gov.au/adr/aadrb/aadr0604.htm#a1.
- Dunbar K, Solga SF. Black cohosh, safety, and public awareness. Liver Int 2007;27:1017. PubMed
- Patel NM, Derkits RM. Possible increase in liver enzymes secondary to atorvastatin and black cohosh administration. J Pharm Pract 2007;20:341-6. DOI
- Joy D, Joy J, Duane P. Black cohosh: a cause of abnormal postmenopausal liver function tests. Climacteric 2008;11:84-8. PubMed
- Australian Adverse Drug Reactions Advisory Committee. Black cohosh and liver toxicity - an update. Aust Adv Drug Reactions Bull 2007;26:11.
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63.
- Spangler L, Newton KM, Grothaus LC, et al. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas 2007;57:195-204. PubMed
- Teschke R, Bahre R, Genthner A, et al. Suspected black cohosh hepatotoxicity - challenges and pitfalls of causality assessment. Maturitas 2009;63:302-14. PubMed
- Brasky TM, Lampe JW, Potter JD, et al. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) cohort. Cancer Epidemiol Biomarkers Prev 2010;19:1696-708. PubMed
- Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed
- Vermes G, Bánhidy F, Acs N. The effects of remifemin on subjective symptoms of menopause. Adv Ther 2005;22:148-54. PubMed
- Nuntanakorn, P., Jiang, B., Einbond, L. S., Yang, H., Kronenberg, F., Weinstein, I. B., and Kennelly, E. J. Polyphenolic constituents of Actaea racemosa. J Nat Prod 2006;69(3):314-318.
- Oktem M, Eroglu D, Karahan HB, Taskintuna N, Kuscu E, Zeyneloglu HB. Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial. Adv Ther 2007;24:448-61. PubMed
- Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HH. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study. Maturitas 2007;57:405-14. PubMed
- Naser, B. and Liske, E. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust. 1-19-2009;190(2):99. PubMed
- van de Meerendonk, H. W., van Hunsel, F. P., and van der Wiel, H. E. [Autoimmune hepatitis induced by Actaea racemosa. Side affects of an herb extract]. Ned.Tijdschr.Geneeskd. 2-7-2009;153(6):246-249.
- Wong, V. C., Lim, C. E., Luo, X., and Wong, W. S. Current alternative and complementary therapies used in menopause. Gynecol.Endocrinol. 2009;25(3):166-174. PubMed
- Pierard, S., Coche, J. C., Lanthier, P., Dekoninck, X., Lanthier, N., Rahier, J., and Geubel, A. P. Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution. Eur J Gastroenterol Hepatol. 2009;21(8):941-945 PubMed
- Vannacci, A., Lapi, F., Gallo, E., Vietri, M., Toti, M., Menniti-Ippolito, F., Raschetti, R., Firenzuoli, F., and Mugelli, A. A case of hepatitis associated with long-term use of Cimicifuga racemosa. Altern.Ther Health Med 2009;15(3):62-63.
- Zimmermann, R., Witte, A., Voll, R. E., Strobel, J., and Frieser, M. Coagulation activation and fluid retention associated with the use of black cohosh: a case study. Climacteric. 2010;13(2):187-191. PubMed
- Amsterdam JD, Yao Y, Mao JJ, Soeller I, Rockwell K, Shults J. Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause. J Clin Psychopharmacol 2009;29:478-83. PubMed
- Bai WP, Wang SY, Liu JL, Geng L, Hu LN, Zhang ZL, Chen SL, Zheng SR. [Efficacy and safety of remifemin compared to tibolone for controlling of perimenopausal symptoms]. Zhonghua Fu Chan Ke Za Zhi 2009;44:597-600.
- McKenzie, S. C. and Rahman, A. Bradycardia in a patient taking black cohosh. Med J Aust. 10-18-2010;193(8):479-481. PubMed
- Stolze H. [An alternative to treat menopausal complaints]. Gynecologie 1982;1:14-16.
- Guzman G, Kallwitz ER, Wojewoda C, et al. Liver Injury with Features Mimicking Autoimmune Hepatitis following the Use of Black Cohosh. Case Rep Med. 2009;2009:918156. PubMed
- Enbom ET, Le MD, Oesterich L, Rutgers J, French SW. Mechanism of hepatotoxicity due to black cohosh (Cimicifuga racemosa): histological, immunohistochemical and electron microscopy analysis of two liver biopsies with clinical correlation. Exp Mol Pathol. PubMed
- Sen A. Orobuccolingual dyskinesia after long-term use of black cohosh and ginseng. J Neuropsychiatry Clin Neurosci 2013 Fall;25(4):E50. PubMed
- Hoban CL, Byard RW, Musgrave IF. Analysis of spontaneous adverse drug reactions to echinacea, valerian, black cohosh and ginkgo in Australia from 2000 to 2015. J Integr Med. 2019;17(5):338-343. PubMed
- Pkhaladze L, Davidova N, Khomasuridze A, Shengelia R, Panossian AG. Actaea racemosa L. is more effective in combination with Rhodiola rosea L. for relief of menopausal symptoms: a randomized, double-blind, placebo-controlled study. Pharmaceuticals (Basel) PubMed
- Yalçin M, Oguz A, Bestepe EE, Saglam NGU, Ergelen M. Black cohosh associated mania in a patient with unipolar depression. Int J Psychiatry Med 2020 Sep 21:91217420961185. doi: 10.1177/0091217420961185. PubMed
- Brar HS, Marathi R. Case of cholestatic drug-induced liver injury (DILI) associated with black cohosh. BMJ Case Rep 2021;14(5):e240408. PubMed
- Castelo-Branco C, Navarro C, Beltrán E, Losa F, Camacho M; on the behalf of the Natural Products Study Group of the Spanish Menopause Society. Black cohosh efficacy and safety for menopausal symptoms. The Spanish Menopause Society statement. Gynecol Endoc PubMed
- Trant AA, Chagpar A, Wei W, et al. The Effect of Black Cohosh on Ki67 expression and Tumor Volume: A Pilot Study of Ductal Carcinoma in Situ Patients. Integr Cancer Ther 2022;21:15347354221137290. PubMed
- Dernbach MR, Carpenter JE, Shah N, Carter GB. Black Cohosh Interactions with Prescription Medications Associated with Serotonin Toxicity and Rhabdomyolysis: A Case Report. J Emerg Med 2024;66(5):e592-e596. PubMed
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