Black Cohosh Oral Dosage Forms

Black cohosh, also known as Cimicifuga racemosa, is a dietary supplement. Some claim it can relieve hot flashes and other symptoms of menopause. This supplement isn’t approved by the FDA for medical use.

What is this medication?

BLACK COHOSH (blak KOH hosh) may relieve the symptoms of menopause. The FDA has not evaluated this supplement for any medical use. It may contain ingredients not listed. Discuss all supplements you are taking with your care team. They can provide you with important safety information.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

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What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

  • Breast cancer
  • Cervical, ovarian or uterine cancer
  • High blood pressure
  • Infertility
  • Liver disease
  • Menstrual changes or irregular periods
  • Unusual vaginal or uterine bleeding
  • An unusual or allergic reaction to black cohosh, soybeans, tartrazine dye (yellow dye number 5), other supplements, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breast-feeding

How should I use this medication?

Take this herb by mouth with a glass of water. Follow the directions on the package labeling, or talk to your care team. Do not use for longer than 6 months without the advice of your care team. Do not use if you are pregnant or breast-feeding. Talk to your care team.

This supplement is not for use in children under the age of 18 years.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

  • Atorvastatin
  • Cisplatin
  • Fertility treatments

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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What should I watch for while using this medication?

Since this supplement is derived from a plant, allergic reactions are possible. Stop using this supplement if you develop a rash. You may need to see your care team, or inform them that this occurred. Report any unusual side effects promptly.

If you are taking this supplement for menstrual or menopausal symptoms, visit your care team for regular checks on your progress. You should have a complete check-up every 6 months. You will need a regular breast and pelvic exam while on this therapy. Follow the advice of your or care team.

Women should inform their care team if they wish to become pregnant or think they might be pregnant. If you have any reason to think you are pregnant, stop taking this supplement at once and contact your care team.

Herbal or dietary supplements are not regulated like medications. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

  • Always read product labels and follow directions.
  • Natural does not mean a product is safe for humans to take.
  • Look for products that include USP after the ingredient name. This means that the manufacturer followed the standards of the U.S. Pharmacopoeia.
  • Supplements made or sold by a nationally known food or drug company are more likely to be made under tight controls. You can write to the company for more information about how the product was made.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

  • Breast pain or tenderness
  • Irregular menstrual cycles or spotting
  • Nausea
  • Upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused supplement after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals.

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