+ Add to myCart

Black cohosh (Actaea racemose) is a woodland herb native to North America. The root is used as medicine and is often used for estrogen-related conditions.

In some parts of the body, black cohosh might increase the effects of estrogen. In other parts of the body, black cohosh might decrease the effects of estrogen. Black cohosh should not be thought of as an "herbal estrogen" or a substitute for estrogen.

People commonly use black cohosh for symptoms of menopause, premenstrual syndrome (PMS), painful menstruation, weak and brittle bones, and many other conditions, there is no good scientific evidence to support most of these uses.

Don't confuse black cohosh with blue cohosh or white cohosh. These are unrelated plants.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
No data available.
No data available.
  • Menopausal symptoms.  Several clinical trials using a specific black cohosh product (Remifemin, Phytopharmica/Enzymatic Therapy) have shown a modest reduction in menopausal symptoms. Research on other formulations shows considerable variability in results.
  • Login for details

No data available.
No data available.
No data available.
Info
No data available.

When taken by mouth: Black cohosh is possibly safe when taken appropriately for up to one year. It can cause some mild side effects such as stomach upset, headache, rash, a feeling of heaviness, and weight gain. There is also some concern that black cohosh might cause liver damage in some people. People who take black cohosh should watch for symptoms of liver damage such as dark urine and fatigue.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Black cohosh is possibly unsafe to use when pregnant or breast-feeding. It might increase the risk of miscarriage or affect a nursing infant.

Breast cancer: Black cohosh may worsen existing breast cancer. People who have breast cancer or who have had breast cancer in the past, and those at high-risk for breast cancer, should avoid black cohosh.

Hormone-sensitive conditions, including endometriosis, fibroids, ovarian cancer, uterine cancer, and others: Black cohosh acts somewhat like estrogen in the body. It might worsen conditions that are sensitive to estrogen. Don't take black cohosh if you have a condition that could be affected by female hormones.

Liver disease: Black cohosh might cause liver damage in some people. But it isn't clear how often this occurs. Until more is known, people with liver disease should avoid taking black cohosh.

Atorvastatin (Lipitor)

Interaction Rating=Moderate Be cautious with this combination.

There is concern that black cohosh might harm the liver. Taking black cohosh with atorvastatin (Lipitor) might increase the chance of liver damage. However, there is not enough scientific information to know if this is an important concern. Before taking black cohosh talk to your healthcare provider if you take atorvastatin (Lipitor).

Cisplatin (Platinol-AQ)

Interaction Rating=Moderate Be cautious with this combination.

Cisplatin (Platinol-AQ) is used to treat cancer. There is some concern that black cohosh might decrease how well cisplatin (Platinol-AQ) works for cancer. Do not take black cohosh if you are taking cisplatin (Platinol-AQ).

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver.
Black cohosh might decrease how quickly the liver breaks down some medications. Taking black cohosh along with some medications that are change by the liver can increase the effects and side effects of your medication. Before taking black cohosh talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

Medications that can harm the liver (Hepatotoxic drugs)

Interaction Rating=Moderate Be cautious with this combination.

There is concern that black cohosh might harm the liver. Taking black cohosh along with medication that might also harm the liver can increase the risk of liver damage. Do not take black cohosh if you are taking a medication that can harm the liver.
Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.

Herbs and supplements that might harm the liver: Black cohosh might harm the liver. Taking it with other supplements that can also harm the liver might increase the risk of liver damage. Examples of supplements with this effect include garcinia, greater celandine, green tea extract, kava, and kratom.

There are no known interactions with foods.

Black cohosh has most often been used by adults in doses of 40-128 mg by mouth daily for up to one year. Speak with a healthcare provider to find out what dose might be best for a specific condition.

Actaea macrotys, Actaea racemosa, Actée à Grappes, Actée à Grappes Noires, Actée Noire, Aristolochiaceae Noire, Baie d'actée, Black Cohosh, Baneberry, Black Aristolochiaceae, Black Snakeroot, Bugbane, Bugwort, Cimicaire à Grappes, Cimicifuga, Cimicifuga Racemosa, Cimicifuge, Cohosh Negro, Cohosh Noir, Cytise, Herbe aux Punaises, Macrotys, Phytoestrogen, Phytoestrogène, Racine de Serpent, Racine de Squaw, Racine Noire de Serpents, Rattle Root, Rattle Top, Rattlesnake Root, Rattleweed, Rhizoma Cimicifugae, Sheng Ma, Snakeroot, Squaw Root.

Natural Medicines disclaims any responsibility related to medical consequences of using any medical product. Effort is made to ensure that the information contained in this monograph is accurate at the time it was published. Consumers and medical professionals who consult this monograph are cautioned that any medical or product related decision is the sole responsibility of the consumer and/or the health care professional. A legal License Agreement sets limitations on downloading, storing, or printing content from this Database. Except for any possible exceptions written into your License Agreement, no reproduction of this monograph or any content from this Database is permitted without written permission from the publisher. Unlawful to download, store, or distribute content from this site.

For the latest comprehensive data on this and every other natural medicine, health professionals should consult the Professional Version of the Natural Medicines. It is fully referenced and updated daily.

© Copyright 1995-2021. Therapeutic Research Faculty, publishers of Natural Medicines, Prescriber's Letter, and Pharmacist's Letter. All rights reserved.

trclogo Licensed from Therapeutic Research Center, LLC Copyright © 1995-2022 by Therapeutic Research Center, LLC. All Rights Reserved.