What drugs interact with Black Cohosh?

There is concern that black cohosh might be toxic to the liver and may rarely increase liver toxicity with certain medications. Some interactions include:

• atorvastatin (Lipitor)
• acetaminophen (Tylenol)
• alcohol
• disulfiram (Antabuse)
• leflunomide (Arava)
• lomitapide (Juxtapid)
• pexidartinib (Turalio)
• teriflunomide (Aubagio)

Learn more: Review drug interactions for Black Cohosh (in more detail)

Drug interactions are complicated, so have all of your medications -- even herbals, vitamins and other OTCs -- screened by your doctor or pharmacist to review for Black Cohosh drug interactions.

Black Cohosh is a shrub-like plant found in North America. It is often used for menopausal disorders ("hot flashes"), painful menstruation, uterine spasms, and vaginitis. However, prescription drugs broken down by certain liver enzymes may accumulate in the body and lead to toxicity if used with black cohosh.

Signs of liver disease include:

• fever
• chills
• joint pain or swelling
• unusual bleeding or bruising
• skin rash
• itching
• loss of appetite
• fatigue
• nausea, vomiting
• abdominal pain
• dark urine
• pale stools
• yellowing of the skin or eyes.

If you notice these symptoms, call your doctor right away.

This is not all the information you need to know about Black Cohosh for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.