Black Cohosh, Cimicifuga racemosa oral dosage forms

What is this medicine?

BLACK COHOSH (blak KOH hosh) or Cimicifuga racemosa is a dietary supplement. It is promoted to relieve symptoms of menopause, such as hot flashes. The FDA has not approved this supplement for any medical use.

This supplement may be used for other purposes; ask your health care provider or pharmacist if you have questions.

How should I use this medicine?

Take this herb by mouth with a glass of water. Follow the directions on the package labeling, or talk to your health care professional. Do not use for longer than 6 months without the advice of a health care professional. Do not use if you are pregnant or breast-feeding. Talk to your obstetrician-gynecologist or certified nurse-midwife.

This herb is not for use in children under the age of 18 years.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• dizziness

• palpitations

• signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellowing of the eyes or skin

• unusual vaginal bleeding

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• breast tenderness

• headache

• nausea

• upset stomach

What may interact with this medicine?

• atorvastatin

• cisplatin

• fertility treatments

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees C). Throw away any unused herb after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• breast cancer

• cervical, ovarian or uterine cancer

• high blood pressure

• infertility

• liver disease

• menstrual changes or irregular periods

• unusual vaginal or uterine bleeding

• an unusual or allergic reaction to black cohosh, soybeans, tartrazine dye (yellow dye number 5), other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Since this herb is derived from a plant, allergic reactions are possible. Stop using this herb if you develop a rash. You may need to see your health care professional, or inform them that this occurred. Report any unusual side effects promptly.

If you are taking this herb for menstrual or menopausal symptoms, visit your doctor or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will need a regular breast and pelvic exam while on this therapy. Follow the advice of your doctor or health care professional.

Women should inform their doctor if they wish to become pregnant or think they might be pregnant. If you have any reason to think you are pregnant, stop taking this herb at once and contact your doctor or health care professional.

Herbal or dietary supplements are not regulated like medicines. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

• Always read product labels and follow directions.

• Natural does not mean a product is safe for humans to take.

• Look for products that include USP after the ingredient name. This means that the manufacturer followed the standards of the U.S. Pharmacopoeia.

• Supplements made or sold by a nationally known food or drug company are more likely to be made under tight controls. You can write to the company for more information about how the product was made.