Black Cohosh (Herb/Suppl)

Brand and Other Names:actaea racemosa, baneberry, more...black snakeroot, bugbane, bugwort, cimicifuga racemosa, macrotys, rattle root, rattlesnake root, rattletop, rattleweed, rheumatism weed, squawroot

Suggested Dosing

Dried root: 300-2000 mg PO TID

Extract: 0.3-2 mL PO daily; 1:1, 90% alcohol

Tincture: 2-4 mL PO daily; 1:10, 60% alcohol

Tablet: 20-80 mg PO BID; standardized to 1 mg triterpene glycosides/20 mg tablet

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Suggested Uses

Cough/sore throat, dysmenorrhea, dyspepsia, labor induction, menopausal symptoms, nervous tension, premenstrual syndrome, rheumatism

Efficacy

Likely effective for menopausal vasomotor symptoms

Possibly effective for PMS/dysmenorrhea

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Interactions

Interaction Checker

and Black Cohosh

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (1)

              • iobenguane I 131

                black cohosh will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

              Monitor Closely (0)

                Minor (4)

                • nevirapine

                  nevirapine, black cohosh. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hepatoxicity.

                • tamoxifen

                  black cohosh increases effects of tamoxifen by pharmacodynamic synergism. Minor/Significance Unknown.

                • tenofovir DF

                  black cohosh, tenofovir DF. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hepatoxicity.

                • zidovudine

                  black cohosh increases toxicity of zidovudine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hepatoxicity.

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                Adverse Effects

                Frequency Not Defined

                Cramping

                Dizziness

                GI upset

                Headache

                Sweating

                Weight gain

                Rash

                Overdose: Bradycardia

                CNS disturbances

                Nausea/vomiting

                Visual disturbances

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                Warnings

                Contraindications

                Breast cancer, endometrial cancer, endometriosis, hormone sensitive conditions, ovarian cancer, pregnancy, lactation, uterine fibroids

                Cautions

                May be associated with liver damage

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                Pregnancy & Lactation

                Pregnancy Category: unsafe

                Lactation: unsafe

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Metabolism: N/A

                Excretion: N/A

                Mechanism of Action

                May act by blocking serotonin reuptake

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.