Meta-Balance Ingredients & Drug Interactions
by Thorne
What is this page for?
First and foremost: checking Meta-Balance 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
Meta-Balance is a dietary supplement by Thorne with 4 active ingredients. Its ingredients are commonly taken for menopausal symptoms, menstrual cramps, hormone balance (popular belief).Based on those ingredients, 961 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Black Cohosh extract, Pycnogenol French Maritime Pine bark extract, Chaste Tree extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Meta-Balance by Thorne
Ask about any prescription or over-the-counter medication and we check it for interactions with Meta-Balance by Thorne — 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
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HelloPharmacist Scorecard of Meta-Balance by Thorne
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
Meta-Balance contains four active herbal ingredients. Wild Yam is traditionally used for hormonal balance during menopause.
Chaste Tree extract, also called Vitex, is used to support premenstrual symptoms and breast tenderness. Pycnogenol French Maritime Pine bark extract is included for circulation and joint support.
Black Cohosh rounds out the formula, also targeted at menopausal symptom relief. The capsule itself is made from hypromellose, microcrystalline cellulose, and calcium laurate — standard inactive ingredients that help hold the capsule together.
Does it work?
Moderate evidence
The evidence for these ingredients is mixed. Chaste Tree shows possibly effective evidence for premenstrual syndrome (PMS) and breast tenderness (mastalgia).
Black Cohosh is possibly effective for menopausal symptoms. Pycnogenol has possibly effective evidence for osteoarthritis and chronic venous insufficiency (CVI, or poor circulation in the legs).
Wild Yam, however, is rated possibly ineffective for menopausal symptoms — the evidence doesn't back that use. For other uses like sexual dysfunction, dysmenorrhea, and aging skin, we don't have enough reliable evidence to rate them in our data.
How safe is it?
Well-documented data
These herbs are generally well tolerated in the short term. Wild Yam may cause fever, headache, upset stomach, or vomiting, and very rarely, anaphylaxis.
Chaste Tree can cause diarrhea, fatigue, headache, insomnia, irregular menstruation, nausea, skin irritation, stomach pain, or vomiting — and skin conditions like rash, acne, or eczema have been reported. Pycnogenol may cause gastrointestinal complaints, dizziness, or vertigo.
Black Cohosh typically causes mild effects like breast tenderness, dizziness, headache, or tiredness, but rare cases of liver problems have been reported. Long-term safety for all four ingredients is not well studied.
None of these ingredients should be used during pregnancy — the safety data advises against it. Black Cohosh and Chaste Tree should be avoided while breastfeeding; for Wild Yam and Pycnogenol, there isn't enough safety data, so talk with your doctor or pharmacist before using them if you're nursing.
Meds to double-check
Moderate interaction found
Check your medications against this product if you take estrogens or hormone replacement therapy (Moderate risk with three of the four ingredients), contraceptive drugs (Moderate), antipsychotic medications (Moderate), dopamine agonists like those for Parkinson's disease (Moderate), blood thinners or antiplatelet drugs (Moderate), diabetes medications (Moderate), metoclopramide/Reglan (Moderate), serotonergic antidepressants or anxiety drugs (Moderate), atorvastatin/Lipitor (Moderate), cisplatin (Moderate), or any drugs your liver metabolizes heavily. No interactions are documented for the inactive ingredients in this product.
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.
Meta-Balance may help with PMS symptoms and menopausal hot flashes if those are your concerns, though the evidence is strongest for Chaste Tree and Black Cohosh on those specific issues. If you take any prescription medications — especially hormonal birth control, estrogen therapy, diabetes drugs, blood thinners, antipsychotics, or antidepressants — check them against this product first with your pharmacist.
This is not a product to take during pregnancy or while breastfeeding.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated May 24, 2023.
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 Meta-Balance, straight from the product label.
| Brand | Thorne |
|---|---|
| Barcode (UPC) | 693749711032 |
| Net contents | 60 Capsule(s) |
| Market status | On market |
| Date entered into DSLD | May 24, 2023 |
| DSLD ID | 284242 |
| Product type | Botanical |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free |
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 Meta-Balance by Thorne, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Wild Yam | 200 mg | -- |
| Chaste Tree extract | 200 mg | -- |
| Pycnogenol French Maritime Pine bark extract | 60 mg | -- |
| Black Cohosh extract | 200 mg | -- |
Other ingredients: Hypromellose, Microcrystalline Cellulose, Calcium Laurate
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.
Formula
Women's health
Menopause formula
Suggested/Recommended/Usage/Directions
Suggested use: Take 2 capsules daily or as recommended by your health-care practitioner.
Precautions
Tamper evident: Use only if bottle is sealed.
Warning: If pregnant or nursing, do not use this product.
Storage
Store tightly sealed in a cool, dry place.
Formulation
Gluten free
Seals/Symbols
Manufactured in the USA using US & imported ingredients
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Pycnogenol is a registered trademark of Horphag Research Ltd. Use of this product may be protected by one or more U.S. patents and other international patents.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Meta-Balance by Thorne 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 Meta-Balance by Thorne
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size2 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Wild Yam
Interacts with41 drugs
Wild yam is a root traditionally used for menopausal symptoms, cramps, and as a so-called 'natural' hormone supplement, but solid human evidence for t...
Wild Yam monograph & interactionsChaste Tree extract
Interacts with121 drugs
Vitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS sympto...
Chaste Tree extract monograph & interactionsPycnogenol French Maritime Pine bark extract
Interacts with327 drugs
Maritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research...
Pycnogenol French Maritime Pine bark extract monograph & interactionsBlack 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: Hypromellose, Microcrystalline Cellulose, Calcium Laurate. These complete the product’s ingredient list but are not active constituents.
Meta-Balance by Thorne Drug Interactions
HelloPharmacist Interaction Report
Thorne's Meta-Balance contains four herbal ingredients, and together they interact with a substantial number of medications.
The most serious concern is Wild Yam's Moderate interaction with estrogens — it may increase or decrease how estrogens work in your body, potentially interfering with hormone therapy.
Read the full breakdown — every affected drug type, severity by severity
Chaste Tree extract carries Moderate interactions with contraceptive drugs, metoclopramide (Reglan, used for nausea and stomach issues), antipsychotic drugs, dopamine agonists (medications for Parkinson's disease), and estrogens. Pycnogenol French Maritime Pine bark has Moderate interactions with blood thinners and antiplatelet drugs, immunosuppressants, and diabetes medications — it may lower blood sugar, so if you take diabetes drugs, you'll need close monitoring.
Black Cohosh carries the most interaction categories: it may affect how your liver metabolizes certain drugs (CYP2D6 substrates), increase the risk of liver damage with hepatotoxic drugs, interact with atorvastatin (Lipitor), reduce the effect of cisplatin (a cancer drug), alter estrogen therapy, and potentially add to serotonin effects if you take serotonergic antidepressants or anxiety medications.
Altogether, these interactions span 962 individual medications. Before you start Meta-Balance, run your exact medications through the interaction checker on this page.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Meta-Balance?
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 Meta-Balance interact with 961 drugs. Click any drug to see the details.
4 of the 4 ingredients in Meta-Balance interact with drugs. Each result below shows which ingredient is responsible. Black Cohosh extract Pycnogenol French Maritime Pine bark extract Chaste Tree extract Wild Yam
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Meta-Balance — through 2 ingredients. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractImmunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
Read the full Pycnogenol French Maritime Pine Bark Extract + 6-mercaptopurine interactionBlack 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 Meta-Balance — 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 Meta-Balance — 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 interactionAbciximabReoPro
How Abciximab interacts with Meta-Balance — through 1 ingredient. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol French Maritime Pine Bark Extract + Abciximab interactionAbiraterone
How Abiraterone interacts with Meta-Balance — 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 Meta-Balance — 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 interactionAbrocitinibCibinqo
How Abrocitinib interacts with Meta-Balance — through 1 ingredient. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractAnticoagulant/antiplatelet Drugs, Immunosuppressants Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol French Maritime Pine Bark Extract + Abrocitinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Meta-Balance — through 2 ingredients. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.
Read the full Pycnogenol French Maritime Pine Bark Extract + Acarbose interactionBlack 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 Meta-Balance — 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 interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Meta-Balance — through 1 ingredient. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol French Maritime Pine Bark Extract + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Meta-Balance — through 1 ingredient. Tap an ingredient for the detail:
Chaste Tree ExtractAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, vitex agnus-castus could interfere with the activity of antipsychotic drugs.
Read the full Chaste Tree Extract + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Meta-Balance — 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 Meta-Balance — through 2 ingredients. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol French Maritime Pine Bark Extract + Acetaminophen, Aspirin interactionBlack 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 Meta-Balance — through 2 ingredients. Tap an ingredient for the detail:
Pycnogenol French Maritime Pine Bark ExtractAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Read the full Pycnogenol French Maritime Pine Bark Extract + Acetaminophen, Aspirin, Caffeine interactionBlack 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 Meta-Balance — 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 interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Meta-Balance — 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 Hydrobromide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Meta-Balance with known interactions, here are the types of medications they 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.
Pycnogenol French Maritime Pine bark extract
Anticoagulant/Antiplatelet Drugs
Theoretically, maritime pine bark extract might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Clinical research suggests that maritime pine bark extract inhibits platelet aggregation. However, the clinical significance of this effect is unclear.
Antidiabetes Drugs
Theoretically, maritime pine bark extract might increase the risk of hypoglycemia when used with antidiabetes drugs.
One clinical study shows that maritime pine bark extract decreases blood sugar in patients with diabetes being treated with antidiabetes agents. Monitor blood glucose levels closely. Dose adjustments might be necessary.
Immunosuppressants
Theoretically, maritime pine bark extract might decrease the effectiveness of immunosuppressant therapy.
In vitro and animal research suggests that maritime pine bark extract has immunostimulant activity. This effect has not been reported in humans.
Chaste Tree extract
Antipsychotic Drugs
Theoretically, vitex agnus-castus could interfere with the activity of antipsychotic drugs.
Vitex agnus-castus might interfere with the action of dopamine antagonists such as antipsychotic drugs due to its dopamine agonist effects.
Contraceptive Drugs
Theoretically, vitex agnus-castus could interfere with oral contraceptives.
Vitex agnus-castus might interfere with the efficacy of oral contraceptives due to possible hormone modulating activity.
Dopamine Agonists
Theoretically, vitex agnus-castus could interfere with dopamine agonists.
Vitex agnus-castus might potentiate the actions of dopaminergic agonists due to possible dopaminergic effects.
Estrogens
Theoretically, vitex agnus-castus could interfere with the activity of estrogens.
Vitex agnus-castus has hormone modulating activity that can interfere with the efficacy of hormone replacement therapy.
Metoclopramide (Reglan)
Theoretically, dopaminergic effects of vitex agnus-castus could interfere with metoclopramide.
Vitex agnus-castus might interfere with the action of dopamine antagonists such as metoclopramide due to its possible dopaminergic effects.
Wild Yam
Estrogens
Theoretically, wild yam might increase or decrease the effects of estrogen.
Wild yam root shows estrogenic and anti-estrogenic effects in vitro. Theoretically, wild yam might interfere with hormone therapy.
Brand information
Manufacturer and brand details for Meta-Balance, from the product label.
Meta-Balance by Thorne: Common Questions
Does Meta-Balance by Thorne interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Is Meta-Balance safe during pregnancy?
Can I use Meta-Balance while breastfeeding?
Does Meta-Balance actually work for hot flashes?
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The Full Monographs Behind Meta-Balance’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Wild Yam
Interacts with 41 drugsWild yam is a root traditionally used for menopausal symptoms, cramps, and as a so-called 'natural' hormone supplement, but solid human evidence for these uses is lacking. Despite popular cl...
Read the full Wild Yam monograph → Herb & supplement monographVitex Agnus-castus
Interacts with 121 drugsVitex (chasteberry) is an herbal remedy most often used for PMS and menstrual cycle problems, and the strongest evidence is for easing some PMS symptoms. It is generally well tolerated by ma...
Read the full Vitex Agnus-castus monograph → Herb & supplement monographMaritime Pine
Interacts with 327 drugsMaritime pine bark extract (often sold as Pycnogenol) is a plant-based antioxidant most studied for circulation, vein, and skin health. Some research is promising, but many studies are small...
Read the full Maritime Pine monograph → Herb & supplement monographBlack Cohosh
Interacts with 652 drugsBlack 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 is generally well tolerated for short-t...
Read the full Black Cohosh monograph →Sources & How We Checked
Meta-Balance'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 112 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.
Wild Yam 7 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
- 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
- Rosenberg Zand, R. S., Jenkins, D. J., and Diamandis, E. P. Effects of natural products and nutraceuticals on steroid hormone-regulated gene expression. Clin Chim.Acta 2001;312(1-2):213-219. PubMed
- Araghiniknam M, Chung S, Nelson-White T, and et al. Antioxidant activity of Dioscorea and dehydroepiandrosterone (DHEA) in older humans. Life Sciences 1996;59:L147-L157.
- Zeng M, Zhang L, Li M, et al. Estrogenic effects of the extracts from the Chinese Yam (Dioscorea opposite Thunb.) and its effective compounds in vitro and in vivo. Molecules. 2018 Jan 23;23(2). Pii: E11. PubMed
- Lu J, Wong RN, Zhang L, et al. Comparative analysis of proteins with stimulating activity on ovarian estradiol biosynthesis from four different Dioscorea species in vitro using both phenotypic and target-based approaches: implication for treating menopaus
Vitex Agnus-castus 23 references
- Wuttke W. Dopaminergic action of extracts of Agnus Castus. Forschende Komplementarmedizen 1996;3:329-30.
- Jarry H, Leonhardt S., Gorkow C, Wuttke W. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus Castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994;102:448- PubMed
- Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo-controlled study. BMJ 2001;322:134-7. PubMed
- Lauritzen CH, Reuter HD, Repges R, et al. Treatment of premenstrual tension syndrome with Vitex agnus castus: Controlled-double blind versus pyridoxine. Phytomedicine 1997;4:183-9.
- Berger D, Schaffner W, Schrader E, et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with premenstrual syndrome (PMS). Arch Gynecol Obstet 2000;264:150-3.
- Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med 2000;9:315-20. PubMed
- Meier B, Berger D, Hoberg E, et al. Pharmacological activities of Vitex agnus-castus extracts in vitro. Phytomedicine 2000;7:373-81. PubMed
- Liu J, Burdette JE, Xu H, et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 2001;49:2472-9.. PubMed
- Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications. Phytomedicine 2003;10:348-57. PubMed
- Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003;18:191-5..
- Daniele C, Thompson Coon J, Pittler MH, Ernst E. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005;28:319-32..
- Halaska M, Beles P, Gorkow C, Sieder C. Treatment of cyclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study. Breast 1999;8:175-81. PubMed
- Prilepskaya VN, Ledina AV, Tagiyeva AV, Revazova FS. Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome. Maturitas 2006;55 Suppl 1:S55-63. DOI
- Ma, L., Lin, S., Chen, R., and Wang, X. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol.Endocrinol. 2010;26(8):612-616. PubMed
- Ma, L., Lin, S., Chen, R., Zhang, Y., Chen, F., and Wang, X. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Aust.N.Z.J Obstet.Gynaecol. 2010;50(2):189-193. PubMed
- Dinç T, Coskun F. Comparison of fructus agni casti and flurbiprofen in the treatment of cyclic mastalgia in premenopausal women. Ulus Cerrahi Derg. 2014 Mar 1;30(1):34-8 PubMed
- Momoeda M, Sasaki H, Tagashira E, Ogishima M, Takano Y, Ochiai K. Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label study. Adv Ther. 2014 Mar;31(3):362-73. PubMed
- Yavarikia P, Shahnazi M, Hadavand Mirzaie S, Javadzadeh Y, Lutfi R. Comparing the effect of mefenamic Acid and vitex agnus on intrauterine device induced bleeding. J Caring Sci. 2013 Aug 31;2(3):245-54.
- Van Die MD, Burger HC, Teede HG, Bone KM. Vitex agnus castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med 2013:79:562-575. PubMed
- Ooi SL, Watts S, McClean R, Pak SC. Vitex agnus-castus for the treatment of cyclic mastalgia: A systematic review and meta-analysis. J Womens Health (Larchmt). 2020;29(2):262-278. PubMed
- Mollazadeh S, Mirghafourvand M, Abdollahi NG. The effects of Vitex agnus-castus on menstrual bleeding: A systematic review and meta-analysis. J Complement Integr Med. 2019;17(1). pii: /j/jcim.2019.17.issue-1/jcim-2018-0053/jcim-2018-0053.xml.
- Najib FS, Poordast T, Mahmudi MS, Shiravani Z, Namazi N, Omrani GR. Does Vitex Agnus-Castus L. Have Deleterious Effect on Fertility and Pregnancy Outcome? An Experimental Study on Rats for Prediction of Its Safety. J Pharmacopuncture 2022;25(2):106-113. PubMed
- Somuncu E, Solak IHA. Colonic Obstruction Secondary to Phytobezoar Caused by Vitex Agnus-Castus Seeds: A Case Report. J Coll Physicians Surg Pak 2022;32(8):S115-S117. PubMed
Maritime Pine 14 references
- Rice-Evans CA, Packer L, eds. Flavonoids in Health and Disease. Manhattan, NY: Marcel Dekker, Inc., 1998.
- Liu FJ, Zhang YX, Lau BH. Pycnogenol enhances immune and haemopoietic functions in senescence-accelerated mice. Cell Mol Life Sci 1998;54:1168-72. PubMed
- Putter M, Grotemeyer KH, Wurthwein G, et al. Inhibition of smoking-induced platelet aggregation by aspirin and pycnogenol. Thromb Res 1999;95:155-61. PubMed
- Kohama T, Inoue M. Pycnogenol alleviates pain associated with pregnancy. Phytother Res 2006;20:232-4.
- Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract pycnogenol dose-dependently lowers glucose in type 2 diabetic patients (letter). Diabetes Care 2004;27:839. PubMed
- Liu X, Wei J, Tan F, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci 2004;75:2505-13. PubMed
- Wilson D, Evans M, Guthrie N et al. A randomized, double-blind, placebo-controlled exploratory study to evaluate the potential of pycnogenol for improving allergic rhinitis symptoms. Phytother Res 2010;24:1115-9.
- Araghi-Niknam, M., Hosseini, S., Larson, D., Rohdewald, P., and Watson, R. R. Pine bark extract reduces platelet aggregation. Integr.Med. 3-21-2000;2(2):73-77. PubMed
- Trebaticka, J., Kopasova, S., Hradecna, Z., Cinovsky, K., Skodacek, I., Suba, J., Muchova, J., Zitnanova, I., Waczulikova, I., Rohdewald, P., and Durackova, Z. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur.Child Adolesc.Psychi PubMed
- Suzuki, N., Uebaba, K., Kohama, T., Moniwa, N., Kanayama, N., and Koike, K. French maritime pine bark extract significantly lowers the requirement for analgesic medication in dysmenorrhea: a multicenter, randomized, double-blind, placebo-controlled study
- Cisar, P., Jany, R., Waczulikova, I., Sumegova, K., Muchova, J., Vojtassak, J., Durackova, Z., Lisy, M., and Rohdewald, P. Effect of pine bark extract (Pycnogenol) on symptoms of knee osteoarthritis. Phytother.Res. 2008;22(8):1087-1092.
- Enseleit, F., Sudano, I., Periat, D., Winnik, S., Wolfrum, M., Flammer, A. J., Frohlich, G. M., Kaiser, P., Hirt, A., Haile, S. R., Krasniqi, N., Matter, C. M., Uhlenhut, K., Hogger, P., Neidhart, M., Luscher, T. F., Ruschitzka, F., and Noll, G. Effects
- Schoonees, A., Visser, J., Musekiwa, A., and Volmink, J. Pycnogenol(R) (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;4:CD008294.
- Wang S, Tan D Zhao Y et al. The effect of pycnogenol on the microcirculation, platelet function and ischemic myocardium in patients with coronary artery diseases. Eur Bull Drug Res 1999;7:19-25.
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
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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.
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