Black Cohosh

What are other names for this remedy?

Type of medicine: natural remedy

Scientific and common names: Cimicifuga racemosa, Actaea racemosa, Actaea macrotys, black cohosh, baneberry, black snakeroot, bugbane, bugwort, rattlesnake root, rattle root, rattle weed, snakeroot, squawroot

What is black cohosh?

Black cohosh is a plant that grows up to 8 feet tall with long plumes of white flowers. It is called black because the roots are very dark in color. The roots are used medicinally.

What is it used for?

Black cohosh has been used to treat:

• cough
• fever
• insect repellant
• nervous tension or trouble sleeping
• premenstrual syndrome (PMS)
• rheumatoid arthritis
• some symptoms of menopause (when monthly periods stop). When used for hot flashes, it may take about a month before symptoms improve.
• sore throat
• upset stomach

Some midwives use black cohosh to stimulate labor. Black cohosh has been used on the skin to treat acne and to remove warts.

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is it taken?

Black cohosh comes in various oral forms including tablets, liquid extracts (with alcohol), and teas. Follow the directions printed on the product label or given by your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Females of childbearing age: Do not take this remedy if you are pregnant. It may cause a miscarriage. Do not breast-feed without your healthcare provider's approval.

Black cohosh has effects similar to estrogen. Do not use black cohosh if you have a hormone-sensitive condition such as:

• breast cancer
• endometriosis
• ovarian cancer
• uterine cancer
• uterine fibroids

Do not use black cohosh if you have:

• kidney problems
• liver problems
• protein S deficiency

Do not confuse black cohosh with blue cohosh or white cohosh. They are different plants and have not been proven to be safe or effective.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may be contaminated. They may have different strengths and effects.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider right away): Nausea, vomiting, vision problems, reduced heart rate, breathing problems or tightness in your chest, chest pain, rash, itchy or swollen skin, increased sweating.

Other: Headache, dizziness, cramping, weight gain.

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects:

• acetaminophen (Tylenol)
• amiodarone (Cordarone)
• antidepressants such as venlafaxine (Effexor), paroxetine (Paxil), amitriptyline, desipramine (Norpramin), and imipramine (Tofranil)
• antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• antiseizure medicines such as carbamazepine (Tegretol) and phenytoin (Dilantin)
• cholesterol medicines such as lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), atorvastatin (Lipitor), rosuvastatin (Crestor), and fluvastatin (Lescol)
• cisplatin (Platinol-AQ)
• erythromycin (EES, Erythrocin)
• herbal remedies such as DHEA, androstenedione, chaparral, comfrey, niacin, pennyroyal oil, red yeast rice, and kava
• haloperidol (Haldol)
• isoniazid (INH)
• methotrexate (Rheumatrex)
• metoprolol (Lopressor, Toprol XL)
• methyldopa (Aldomet)
• ondansetron (Zofran)
• risperidone (Risperdal)
• tramadol (Ultram)

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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Keep all natural remedies and medicines out of the reach of children.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.

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