black snakeroot

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Related to black snakeroot: black cohosh, white snakeroot, Foam Flower

black cohosh

( blak coe-hosh) ,


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black snakeroot

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rattle root

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rattle top

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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.

black cohosh

Herbal medicine
A perennial herb, the roots and rhizomes of which contain triterpene glycosides (actein and cimigoside), cimicifugin, salycylates, isoferulic acid, tannins and volatile oils.
Black cohosh should not be used in pregnancy, as it may cause premature labour.


Any of numerous plants once believed to be useful as a remedy for poisonous snakebites.

black snakeroot

Black cohosh.

Seneca snakeroot

, senega snakerootSenega root.

Texas snakeroot

See: Aristolochia

Virginia snakeroot

See: Aristolochia

white snakeroot

A perennial herb (Eupatorium rugosum Houtt) that contains the toxin tremetol and was once thought to be useful as a remedy for snakebites. The tremetol causes trembles in animals and milk sickness in humans. See: milk sickness; trembles; tremetol
References in periodicals archive ?
Phillippe; SYN: Sanicula gregaria Bickn.; Cluster Sanicle, Clustered Black Snakeroot; Slope woods; Abundant; C = 2; BSUH 14916.
Phillippe; SYN: Sanicula gregaria Bickn.; Cluster Sanicle, Clustered Black Snakeroot; Woods; Infrequent to common; C = 2; BSUH 13634.