Common Name Black Cohosh, Black Snakeroot, Cimicifuga, Macrotys Acaea
Latin Binomial Cimicifuga racemosa L. Nutt
Family: Ranunculaceae
Part Used Rhizome, root
Active Constituents Triterpene glycosides are the main phytoconstituents, which include:
Actein
23-epi-26-deoxyactein
Dosage Dried root/rhizome: 40-200mg per day. (19)
Liquid extract: 40mg per day. (17)(37)
Tincture: 40mg per day for up to 24 weeks.
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Herbal Use/Indication Black Cohosh is used as an anti-rheumatic, anti-tussive, sedative, and to regularize the menstrual cycle. It has been used for intercostal myalgia, sciatica, whooping cough, chorea, tinnitus, dysmenorrhoea, uterine colic, and specifically for muscular rheumatism and rheumatoid arthritis. (19)(20)(22)(29)(64)
Modern use of black cohosh is focused on its use in treating peri- and postmenopausal symptoms. (1)
Summary Rigorous randomised controlled clinical trials do not support the efficacy and use of black cohosh in treating menopausal symptoms. (1)
Recent findings from preclinical research indicate that extracts of black cohosh extract do no have oestrogenic effects, but further study is required to confirm. (1)
In light of conclusive evidence for the efficacy of black cohosh, and the potential for serious harm, use of black cohosh is not recommended.
Contra-Indications Persons with a history of liver problems should not use black cohosh without consulting a doctor. (1)
Black Cohosh preparations should not be taken by individuals with oestrogenic sensitive tumors. (1)
Drug Interactions
Medications with similar or opposing effects should not be used concurrently with black cohosh root/rhizome.
Pregnancy and lactation
Due to a lack of data, use of black cohosh preparation should be avoided during pregnancy or lactation.
Pharmacological Actions Anti-inflammatory and analgesic activities of black cohosh have been documented.
The triterpene glycosides and flavonoids are considered to be important, however their mechanism of action is unknown.
Side effects Hepatotoxic reactions have been reported with the use of black cohosh preparations.

AHP

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BHC 1992

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BHP 1996

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BHMA 2003

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Complete German Commission E 1998

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ESCOP 2003

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Mills S, Bone K. Principles and Practice of Phytotherapy. Edinbugh: Chuchill Livingstone, 2000.

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British Herbal Pharmacopoeia, 1990, bol 1. Bournemouth: British Herbal Medicine Association, 1990.

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Foster S, Tyler VE. Tyler's Honest Herbal, 4th edn. New York: The Haworth Herbal Press, 1999.

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Wren RC. Potter's New Cyclopedia of Botanical Drugs and Preparations (revised, Williamson WE, Evans FJ). Saffron Walden: Daniel, 1988.

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British Herbal Pharmacopoeia, 1990, vol.1. Bournemouth: British Herbal Medicine Association, 1990.

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Barnes J, Anderson LA, Phillipson DJ. Herbal Medicines. Third edition. Grayslake, Il Phrmaceutical Press; 2007. 710p.

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