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black cohosh

( blak coe-hosh) ,


(trade name),


(trade name),

black snakeroot

(trade name),


(trade name),


(trade name),

rattle root

(trade name),


(trade name),

rattle top

(trade name),


(trade name)


Therapeutic: none assigned
Do not confuse black cohosh with blue or white cohoshManagement of menopausal symptomsPremenstrual discomfortDysmenorrheaMild sedativeRheumatism


Therapeutic effects are produced by glycosides isolated from the fresh or dried rhizome with attached roots.
Mechanism of action is unclear.

Therapeutic effects

May decrease symptoms of menopause, including hot flashes, sweating, sleep disturbance, and anxiety. Has no effect on vaginal epithelium.


Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile



Contraindicated in: Obstetric: Pregnancy and lactation.
Use Cautiously in: Breast cancer (may increase risk of metastasis); Hormone-sensitive cancers ; Protein S deficiency (increased risk for thrombosis); Liver disease.

Adverse Reactions/Side Effects


  • seizures (in combination with evening primrose and chasteberry) (life-threatening)
  • headache
  • dizziness


  • GI upset
  • hepatotoxicity


  • rash


  • weight gain
  • cramping
  • breast tenderness
  • vaginal spotting/bleeding


Unknown effects when combined with hormone replacement therapy and antiestrogens (e.g., tamoxifen ).Concurrent use with hepatotoxic drugs may ↑ risk of liver damage.Alcohol-containing preparations may interact with disulfiram and metronidazole.May ↓ cytotoxic effects of cisplatin.May precipitate hypotension when used in combination with antihypertensives.May ↑ risk of hepatotoxicity when used with chaparral, comfrey, kava-kava, and niacin.
Oral (Adults) Tablets (Remifemin®)—20 mg bid. Liquid extract—0.3–2 mL bid-tid. Tincture—2–4 mL bid–tid. Dried rhizome—0.3–2 g tid. Do not use for more than 6 mo.


Alone or in combination with other herbal medicinals: OTC
Tablets (Remifemin® 20 mg [best studied black cohosh product]): OTC
Liquid extract (1:1 in 90% alcohol): OTC
Tincture (1:10 in 60% alcohol): OTC
Dried rhizome:

Nursing implications

Nursing assessment

  • Assess frequency and severity of menopausal symptoms.
  • Monitor BP for patients on antihypertensive drugs; may increase effects and cause hypotension.
  • Assess for history of seizures or liver disease.

Potential Nursing Diagnoses

Sleep deprivation (Indications)


  • Administration with food may help to minimize nausea.

Patient/Family Teaching

  • Advise patient to notify health care professional if pregnancy is planned or suspected. Avoid use during pregnancy; may induce a miscarriage.
  • Patients with seizures, liver dysfunction, excessive alcohol intake, cancer, or other medical problems should be advised to consult their health care professional prior to initiating self-therapy with this herb.
  • Advise patient to consult health care professional before taking with other estrogen replacements.
  • Emphasize the importance of continued medical supervision for Pap smears, mammograms, pelvic examinations, and BP monitoring at the intervals indicated by health care professional.

Evaluation/Desired Outcomes

  • Resolution of menopausal vasomotor symptoms.
Drug Guide, © 2015 Farlex and Partners

black co·hosh

(blak kō'hosh)
A herbal made from Cimifuga racemosa and other Cimifuga spp.; widely used for its purported value in treating disorders of the female reproductive system, gastrointestinal disease, insect bites, and other uses; because of its effect on hormonal states, its use in pregnant women must be monitored very carefully.
Synonym(s): baneberry, black snake root, rattleweed, squaw root (1) .
Medical Dictionary for the Health Professions and Nursing © Farlex 2012
References in periodicals archive ?
(25) Actaea racemosa is an oestrogen modulating herb and does not bind to oestrogen receptors or exhibit oestrogenic effects in vitro.
Baneberry (Actaea spp.) Red or white fruit is very poisonous.
Comparative analysis of the floral odors of Actaea spicata and A.
The characteristic ground-flora species of the north-facing old-growth ecosystem include Actaea pachypoda Ell., Circaea lutetiana L., Osmorhiza claytoni (Michx.) C.B.
Black cohosh (Actaea racemosa, Cimicifuga racemosa) is used for a variety of women's health conditions.
A current research project is focusing on Black Cohosh (Actaea racemosa), which is traditionally harvested for its roots; it is at potential risk of future extirpation from its native habitat.
Many boreal species adapt to the shade by increasing the area of their leaves, as do baneberries (Actaea (Ranunculaceae); some boreal ferns, such as the lady fern (Athyrium filix-femina) and Diplazium sibiricum; and some grasses (Cinna and Hystrix).
To examine variation within patches at the scale of decimeters to meters, seeds of Paris and Campanula were sown into two plots each and Actaea was sown into three plots per site.
april/may Ornamental Garlic "Actaea" Small-cupped Daffodil Star of Bethlehem
Among the more conservative species present in this unit, that were lacking elsewhere at Eagle Marsh, were Actaea pachypoda, Amphicarpaea bracteata, Arisaema dracontium, Carex conjuncta, Dryopteris carthusiana, Galium triflorum, Lindera benzoin, and Persicaria arifolia.
Well-known examples of frequently wildcrafted herbs include American ginseng (Panax quinquefolius L.), black cohosh (Actaea racemosa L.), goldenseal (Hydrastis canadensis L.) and osha (Ligusticum porteri J.M.
For Spring Pond in 1996, two species with C-value of 8 (Anemone acutiloba and Fagus grandifolia) and four with C-values of 7 (Galium asprellum, Actaea pachyoda, Hydrangea arborescens, and Jeffersonia diphylla) were identified.