Black Cohosh

Are there any interactions with medications?

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Atorvastatin (Lipitor)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

There is concern that black cohosh might harm the liver. Taking black cohosh with atorvastatin (Lipitor) might increase the chance of liver damage. However, there is not enough scientific information to know if this is an important concern. Before taking black cohosh talk to your healthcare provider if you take atorvastatin (Lipitor).

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Cisplatin (Platinol-AQ)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Cisplatin (Platinol-AQ) is used to treat cancer. There is some concern that black cohosh might decrease how well cisplatin (Platinol-AQ) works for cancer. Do not take black cohosh if you are taking cisplatin (Platinol-AQ).

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Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver.
Black cohosh might decrease how quickly the liver breaks down some medications. Taking black cohosh along with some medications that are change by the liver can increase the effects and side effects of your medication. Before taking black cohosh talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

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Medications that can harm the liver (Hepatotoxic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

There is concern that black cohosh might harm the liver. Taking black cohosh along with medication that might also harm the liver can increase the risk of liver damage. Do not take black cohosh if you are taking a medication that can harm the liver.
Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.

Dosing considerations for Black Cohosh.

The following doses have been studied in scientific research:

BY MOUTH:

• Menopausal symptoms: 20-80 mg once or twice daily.
• Weak bones (Osteoporosis): 40 mg daily.