Uses & Effectiveness
Overview
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.
Black cohosh is not actually a vitamin, but rather a medicinal plant native to North America. It has been used for centuries by Native American tribes for various purposes, including relieving menopausal symptoms, such as hot flashes and mood swings.
Side Effects
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, and a feeling of heaviness. 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.
Interactions
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Cisplatin (Platinol-AQ) interacts with BLACK COHOSH
Cisplatin is used to treat cancer. There is some concern that black cohosh might decrease how well cisplatin works for cancer.
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Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with BLACK COHOSH
Some medications are changed and broken down by the liver. Black cohosh might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
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Medications that can harm the liver (Hepatotoxic drugs) interacts with BLACK COHOSH
Black cohosh might harm the liver. Some medications can also harm the liver. Taking black cohosh along with a medication that can harm the liver might increase the risk of liver damage.
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Atorvastatin (Lipitor) interacts with BLACK COHOSH
There is concern that black cohosh might harm the liver. Taking black cohosh with atorvastatin might increase the chance of liver damage.
Moderate Interaction
Be cautious with this combination
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Medications moved by pumps in cells (Organic anion-transporting polypeptide substrates) interacts with BLACK COHOSH
Some medications are moved in and out of cells by pumps. Black cohosh might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.
Minor Interaction
Be watchful with this combination
Special Precautionsand Warnings
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, and a feeling of heaviness. 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. 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: There is some concern that black cohosh may worsen existing breast cancer. But this concern hasn’t been confirmed in scientific research. People who have breast cancer, have had breast cancer in the past, or are at high-risk for breast cancer, should speak with a healthcare professional before using black cohosh.
Hormone-sensitive conditions, including endometriosis, fibroids, ovarian cancer, uterine cancer, and others: Black cohosh acts somewhat like estrogen in the body. There is some concern that it might worsen conditions that are sensitive to estrogen. If you have a condition that could be affected by estrogen, speak with a healthcare professional before using black cohosh.
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.
Dosing
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.
