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
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
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

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.
Adverse Effects
Frequency Not Defined
Cramping
Dizziness
GI upset
Headache
Sweating
Weight gain
Rash
Overdose: Bradycardia
CNS disturbances
Nausea/vomiting
Visual disturbances
Warnings
Contraindications
Breast cancer, endometrial cancer, endometriosis, hormone sensitive conditions, ovarian cancer, pregnancy, lactation, uterine fibroids
Cautions
May be associated with liver damage
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.Pharmacology
Metabolism: N/A
Excretion: N/A
Mechanism of Action
May act by blocking serotonin reuptake