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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Black Cohosh - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Black Cohosh">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2021/05/17">
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<meta name="citation_pmid" content="30000840">
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<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK501781/">
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<meta name="citation_keywords" content="Cimicifuga">
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<meta name="citation_keywords" content="Remifemin">
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<meta name="citation_keywords" content="Actaea racemosa">
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<meta name="citation_keywords" content="Black cohosh">
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<meta name="citation_keywords" content="Bugbane, black">
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<meta name="citation_keywords" content="Cohosh, Black">
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<meta name="citation_keywords" content="Cimicifuga racemosa">
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<meta name="citation_keywords" content="Extract of black cohosh">
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<meta name="citation_keywords" content="Cimicifuga racemosa, ext.">
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<meta name="citation_keywords" content="Cimicifuga racemosa extract">
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<meta name="citation_keywords" content="CCRIS 9385">
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<meta name="citation_keywords" content="EINECS 283-951-6">
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<meta name="DC.Title" content="Black Cohosh">
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<meta name="DC.Date" content="2021/05/17">
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<meta name="description" content="Black cohosh (Cimicifuga racemosa, formerly Actaea racemosa) root was thought to have mild estrogenic activity based on its triterpene content, which is standardized based on 27-deoxyactein. However, recent studies have found no estrogenic activity.[1,2] It is primarily used for postmenopausal symptoms and has been used to promote labor.[3-8] Currently, it has no specific uses during breastfeeding, although historically it was supposedly used by native American women as a galactogogue.[9] No data exist on the safety and efficacy of black cohosh in nursing mothers or infants. In general, there is a low frequency of adverse reactions, but dizziness, nausea, headache, rash, vomiting, and rarely, hepatitis and allergic reactions have been reported.[3,10,11] Some sources recommend against its use during breastfeeding because of the lack of safety data and its potential estrogenic activity,[10] while others do not contraindicate its use.[9]">
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<meta name="og:description" content="Black cohosh (Cimicifuga racemosa, formerly Actaea racemosa) root was thought to have mild estrogenic activity based on its triterpene content, which is standardized based on 27-deoxyactein. However, recent studies have found no estrogenic activity.[1,2] It is primarily used for postmenopausal symptoms and has been used to promote labor.[3-8] Currently, it has no specific uses during breastfeeding, although historically it was supposedly used by native American women as a galactogogue.[9] No data exist on the safety and efficacy of black cohosh in nursing mothers or infants. In general, there is a low frequency of adverse reactions, but dizziness, nausea, headache, rash, vomiting, and rarely, hepatitis and allergic reactions have been reported.[3,10,11] Some sources recommend against its use during breastfeeding because of the lack of safety data and its potential estrogenic activity,[10] while others do not contraindicate its use.[9]">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501781_"><span class="title" itemprop="name">Black Cohosh</span></h1><p class="fm-aai"><a href="#_NBK501781_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 84776-26-1</p><div id="LM872.Drug_Levels_and_Effects"><h2 id="_LM872_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM872.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Black cohosh (<i>Cimicifuga racemosa</i>, formerly <i>Actaea racemosa</i>) root was thought to have mild estrogenic activity based on its triterpene content, which is standardized based on 27-deoxyactein. However, recent studies have found no estrogenic activity.[<a class="bibr" href="#LM872.REF.1" rid="LM872.REF.1">1</a>,<a class="bibr" href="#LM872.REF.2" rid="LM872.REF.2">2</a>] It is primarily used for postmenopausal symptoms and has been used to promote labor.[<a class="bibr" href="#LM872.REF.3" rid="LM872.REF.3">3</a>-<a class="bibr" href="#LM872.REF.8" rid="LM872.REF.8">8</a>] Currently, it has no specific uses during breastfeeding, although historically it was supposedly used by native American women as a galactogogue.[<a class="bibr" href="#LM872.REF.9" rid="LM872.REF.9">9</a>] No data exist on the safety and efficacy of black cohosh in nursing mothers or infants. In general, there is a low frequency of adverse reactions, but dizziness, nausea, headache, rash, vomiting, and rarely, hepatitis and allergic reactions have been reported.[<a class="bibr" href="#LM872.REF.3" rid="LM872.REF.3">3</a>,<a class="bibr" href="#LM872.REF.10" rid="LM872.REF.10">10</a>,<a class="bibr" href="#LM872.REF.11" rid="LM872.REF.11">11</a>] Some sources recommend against its use during breastfeeding because of the lack of safety data and its potential estrogenic activity,[<a class="bibr" href="#LM872.REF.10" rid="LM872.REF.10">10</a>] while others do not contraindicate its use.[<a class="bibr" href="#LM872.REF.9" rid="LM872.REF.9">9</a>]</p><p>Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to <i>prove</i> the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does <i>not</i> certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information <a href="/books/n/lactmed/LactMedDietarySupps/?report=reader">about dietary supplements</a> is available elsewhere on the LactMed Web site.</p></div><div id="LM872.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Relevant published information was not found as of the revision date.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM872.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM872.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM872.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM872.REF.1">Liske E, Hanggi W, Henneicke-von Zepelin HH, et al. Physiological investigation of a unique extract of black cohosh (<em>Cimicifugae racemosae</em> rhizoma): a 6-month clinical study demonstrates no systemic estrogenic effect. <span><span class="ref-journal">J Womens Health Gend Based Med. </span>2002;<span class="ref-vol">11</span>:163–74.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/11975864" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11975864</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM872.REF.2">Ruhlen RL, Haubner J, Tracy JK, et al. Black cohosh does not exert an estrogenic effect on the breast. <span><span class="ref-journal">Nutr Cancer. </span>2007;<span class="ref-vol">59</span>:269–77.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/18001221" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18001221</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM872.REF.3">Dennehy C, Tsourounis C, Bui L, et al. The use of herbs by California midwives. <span><span class="ref-journal">J Obstet Gynecol Neonatal Nurs. </span>2010;<span class="ref-vol">39</span>:684–93.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21044150" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21044150</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM872.REF.4">Zhang AL, Story DF, Lin V, et al. A population survey on the use of 24 common medicinal herbs in Australia. <span><span class="ref-journal">Pharmacoepidemiol Drug Saf. </span>2008;<span class="ref-vol">17</span>:1006–13.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/18816875" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18816875</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM872.REF.5">Dugoua JJ, Seely D, Perri D, et al. Safety and efficacy of black cohosh (<em>Cimicifuga racemosa</em>) during pregnancy and lactation. <span><span class="ref-journal">Can J Clin Pharmacol. </span>2006;<span class="ref-vol">13</span>:e257–61.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/17085773" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17085773</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="LM872.REF.6">Allaire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy: A survey of North Carolina certified nurse-midwives. <span><span class="ref-journal">Obstet Gynecol. </span>2000;<span class="ref-vol">95</span>:19–23.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10636495" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10636495</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="LM872.REF.7">Tesch BJ. Herbs commonly used by women: an evidence-based review. <span><span class="ref-journal">Am J Obstet Gynecol. </span>2003;<span class="ref-vol">188</span>(5) Suppl:S44–55.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/12748451" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12748451</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="LM872.REF.8">Low Dog T. The use of botanicals during pregnancy and lactation. <span><span class="ref-journal">Altern Ther Health Med. </span>2009;<span class="ref-vol">15</span>:54–8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/19161049" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19161049</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="LM872.REF.9">McKenna DJ, Jones K, Humphrey S, et al. Black cohosh: efficacy, safety, and use in clinical and preclinical applications. <span><span class="ref-journal">Altern Ther Health Med. </span>2001;<span class="ref-vol">7</span>:93–100.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/11347288" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11347288</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>10.</dt><dd><div class="bk_ref" id="LM872.REF.10">Hardy ML. Women's health series: Herbs of special interest to women. <span><span class="ref-journal">J Am Pharm Assoc (Wash). </span>2000;<span class="ref-vol">40</span>:234–42.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10730024" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10730024</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="LM872.REF.11">Mahady GB, Low Dog T, Barrett ML, et al. United States Pharmacopeia review of the black cohosh case reports of hepatotoxicity. <span><span class="ref-journal">Menopause. </span>2008;<span class="ref-vol">15</span>:628–38.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/18340277" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18340277</span></a>]</div></dd></dl></dl></div></div><div id="LM872.Substance_Identification"><h2 id="_LM872_Substance_Identification_">Substance Identification</h2><div id="LM872.Substance_Name"><h3>Substance Name</h3><p>Black Cohosh</p></div><div id="LM872.Scientific_Name"><h3>Scientific Name</h3><p>Cimicifuga racemosa</p></div><div id="LM872.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>84776-26-1</p></div><div id="LM872.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Complementary Therapies</p><p>Phytotherapy</p><p>Plants, Medicinal</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501781_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">May 17, 2021</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Black Cohosh. [Updated 2021 May 17].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1198/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM1098/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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