Black Cohosh

blak COH-hosh

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?

This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider.

Black cohosh has been used to treat:

  • Arthritis
  • Osteoporosis
  • Symptoms of menopause (when monthly periods stop)

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

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, capsules, 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?

If you have a hormone-sensitive condition (such as uterine fibroids, endometriosis, breast, uterine, or ovarian cancer), talk with your healthcare provider before taking black cohosh.

This remedy may cause a miscarriage if you take it while pregnant.

Do not use black cohosh if you have:

  • Liver problems
  • Protein S deficiency

Do not confuse black cohosh with blue cohosh or white cohosh. They are different plants and have very different effects.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this remedy.

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.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Nausea, vomiting, vision problems, slow heartbeat, breathing problems, chest pain, itchy or swollen skin, increased sweating, yellowing of the skin or eyes, unusual tiredness, dark urine, seizures.

Other: Headache, dizziness, cramping, breast pain, joint pain, 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) or products that contain acetaminophen
  • Antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, duloxetine (Cymbalta), fluoxetine (Prozac), fluvoxamine (Luvox CR), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), trazodone, and venlafaxine (Effexor),
  • Antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
  • Antipsychotic medicines such as haloperidol (Haldol) and risperidone (Risperdal)
  • Antiseizure medicines such as carbamazepine (Tegretol) and phenytoin (Dilantin)
  • Cholesterol-lowering medicines (statins) such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor)
  • Cisplatin
  • Estrogens
  • Heart medicines such as amiodarone (Cordarone), flecainide (Tambocor), methyldopa, and metoprolol (Lopressor, Toprol XL)
  • Methotrexate (Rheumatrex)
  • Natural remedies such as chaparral, comfrey, DHEA, garlic, kava, niacin, pennyroyal, red yeast rice, and saw palmetto
  • Ondansetron (Zofran)
  • Pain medicines such as codeine and tramadol (Ultram)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. 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.


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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