black cohosh extract

Black cohosh has been used for symptoms of menopause (e.g., hot flashes). Some herbal/diet supplement products have been found to contain possibly harmful impurities/additives. Check with your pharmacist for more details about the brand you use. The FDA has not reviewed this product for safety or effectiveness. Consult your doctor or pharmacist for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist. This herbal product should not be used for more than 6 months. If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.

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.

Tell your doctor that you are taking black cohosh. Keep all regular medical and laboratory appointments. Your doctor may order liver function tests to check for side effects. Check product labeling carefully. Some products may contain a combination of both black and blue cohosh. Blue cohosh has different effects and is used for different purposes.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow heartbeat, vision problems, severe dizziness, increased sweating, seizure.

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.

Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist. Keep all medications and herbal products away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Headache, stomach upset, nausea, vomiting, weight gain, vaginal spotting/bleeding, and dizziness may occur. If any of these effects persist or worsen, contact your doctor promptly. Tell your doctor immediately if any of these unlikely but serious side effects occur: muscle pain/weakness. This product may rarely cause serious (possibly fatal) liver disease. Stop taking this product and consult your doctor immediately if you develop symptoms of liver injury, including persistent nausea, loss of appetite, unusual tiredness, stomach/abdominal pain, pale stools, dark urine, yellowing eyes/skin. A very serious allergic reaction to this product is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.