Black Cohosh

Safety and Pitfalls

• Elevated adverse/interactions signal in literature; review medications and conditions before use.[2,94,138, etc.]
• High interaction-signal count detected in literature search.[2,94,138, etc.]
• Potential side effect: side effect[2,94,138, etc.]
• Potential side effect: anxiety[2,94,138, etc.]
• Potential side effect: side effects[2,94,138, etc.]
• ODS safety note: Ask ODS Join the ODS Email List Health Professional Other Resources Table of Contents Introduction Black Cohosh Dietary Supplements Black Cohosh and Menopausal Symptoms Health Risks Interactions with Medications References Disclaimer Introduction Black cohosh ( Actaea racemosa or Cimicifuga racemosa ), a member of the buttercup family, is a perennial plant native to North America.[2,94,138, etc.]
• ODS safety note: Health Risks Clinical trials using various black cohosh preparations to treat menopausal symptoms have shown that its use is associated with a low incidence of adverse effects.[2,94,138, etc.]
• ODS safety note: The most commonly reported side effects are gastrointestinal upset and rashes, both of which are mild and transient [ 1 , 24 ].[2,94,138, etc.]
• ODS safety note: Other reported adverse effects in clinical trials have included breast pain/enlargement, infection, vaginal bleeding/spotting, and musculoskeletal complaints, although their incidence was similar in women taking black cohosh and those taking placebo [ 5 ].[2,94,138, etc.]
• ODS safety note: Across the world, reports have described at least 83 cases of liver damage—including hepatitis, liver failure, elevated liver enzymes, and assorted other liver injuries—associated with black cohosh use [ 1 , 25 ].[2,94,138, etc.]
• ODS safety note: It is possible that at least some reported cases of hepatotoxicity were due to impurities, adulterants, or incorrect Acteae species in the black cohosh products used.[2,94,138, etc.]
• ODS safety note: In 2007, the Australian Department of Health began requiring that products containing black cohosh carry the following label statement: "Warning: Black cohosh may harm the liver in some individuals.[2,94,138, etc.]
• ODS safety note: Pharmacopeia (a nonprofit standard-setting organization for foods and drugs) recommended labeling black cohosh products with the following cautionary statement: "Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice" [ 30 ].[2,94,138, etc.]
• ODS interaction note: Ask ODS Join the ODS Email List Health Professional Other Resources Table of Contents Introduction Black Cohosh Dietary Supplements Black Cohosh and Menopausal Symptoms Health Risks Interactions with Medications References Disclaimer Introduction Black cohosh ( Actaea racemosa or Cimicifuga racemosa ), a member of the buttercup family, is a perennial plant native to North America.[2,94,138, etc.]