Black cohosh ( Cimicifuga racemosa ) is an herbal medicine used mainly to alleviate menopausal symptoms.
Adverse reactions ( Ars ) to black cohosh include gastrointestinal irritation, headache, dizziness and vomiting.

Recently, there have been international case reports of liver dysfunction suspected to be associated with its use.

As of March 31, 2005, the United Kingdom's Medicines and Healthcare products Regulatory Agency received 20 reports of liver reactions suspected of being associated with the use of black cohosh.
The cases ranged in severity from abnormal liver function test results to various forms of hepatitis. At the time of reporting, most of the patients had recovered or were recovering.
In addition, a case of hepatic failure associated with the use of black cohosh was recently published.

From Jan. 1, 1998, to Feb. 28, 2005, Health Canada received 7 reports of ARs suspected of being associated with ingestion of black cohosh.
There were no reports of liver dysfunction.
All of the cases involved women, aged 33 to 55 years.
Some of the ARs reported included dizziness, rash, pruritus, edema, increased pulse rate, bradycardia, atrial fibrillation, changes in serum thyroid levels, vaginal bleeding and convulsions. Causality could not be assigned specifically to black cohosh because most of the reports contained insufficient clinical information and lacked details on the use of concomitant medications.

Source: Health Canada, 2005


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