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PRECAUTIONS: Before taking black cohosh, tell your doctor or pharmacist if you are allergic to it; or to salicylates (e.g., aspirin); or if you have any other allergies. This product contains salicylates. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.If you have any of the following health problems, consult your doctor or pharmacist before using this product: hormone-sensitive cancer (e.g., breast, ovarian, endometrial), high risk of breast cancer, clotting problems (e.g., protein S deficiency, stroke), heart problems (e.g., heart attack, heart failure), high blood pressure, liver problems, problems of the uterus (e.g., endometriosis, fibroids).This product may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.To avoid dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Liquid preparations of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.Black cohosh is not recommended for use during pregnancy. It may cause premature labor. Consult your doctor before using this product.It is unknown if this product passes into breast milk. Breast-feeding while using this product is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.Some products that may interact with this drug include: cisplatin, drugs that can harm the liver (e.g., acetaminophen, amiodarone, carbamazepine, isoniazid, methotrexate, methyldopa), hormones (e.g., estrogen, birth control pills/patch/ring), warfarin, drugs removed from your body by certain liver enzymes (e.g., codeine, flecainide, haloperidol, metoprolol, ondansetron, risperidone, tramadol, antidepressants such as amitriptyline, desipramine, imipramine, paroxetine, venlafaxine).Check the labels on all your pain relievers/fever reducers because they may contain aspirin (which is like an ingredient in this product) or acetaminophen (which can harm the liver). Ask your pharmacist about using those products safely while also using black cohosh.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

Report Problems to the Food and Drug Administration   You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088. Need help identifying pills and medications? Use the pill identifier tool on RxList.