Charms & Harms: Black cohosh

Abstract

SUMMARY MESSAGE: Evidence for the efficacy of black cohosh extracts for treatment of menopausal symptoms is inconclusive. Black cohosh extracts have been associated with hepatotoxic reactions including changes in liver function test values, hepatitis, jaundice and hepatic failure. Health professionals should be aware of the possibility of (undisclosed) use of black cohosh, particularly among patients of menopausal age, be vigilant to signs of liver injury in patients using black cohosh, inform users of black cohosh about the possibility of hepatotoxic reactions and signs and symptoms of liver injury. Suspected adverse drug reactions should be reported to CARM. As with all herbal medicines, different black cohosh products vary in their pharmaceutical quality, and the implications of this for efficacy and safety should be considered.