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Black Cohosh Drug Interactions
Before taking black cohosh, you should talk to your healthcare provider about any other medications you are taking. Some medications (such as certain antidepressants, risperidone, and codeine) may cause negative interactions with black cohosh. Drug interactions with black cohosh can affect the way your body handles certain medicines, possibly increasing your risk of side effects or decreasing the effectiveness of the medications.
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Even though it is a natural herbal supplement, black cohosh (Actaea racemosa, Cimicifuga racemosa) can potentially interact with several medicines. Some of these medicines that may lead to black cohosh interactions include:
- Certain antidepressants, including:
- Amitriptyline (Elavil®)
- Desipramine (Norpramin®)
- Imipramine (Tofranil®, Tofranil PM®)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®)
- Venlafaxine (Effexor®, Effexor® XR)
- Cisplatin (Platinol®)
- Codeine (found in numerous pain killers and cough syrups)
- Flecainide (Tambocor®)
- Haloperidol (Haldol®)
- Metoprolol (Lopressor®, Toprol® XL)
- Ondansetron (Zofran®, Zuplenz™)
- Risperidone (Risperdal®)
- Tramadol (Rybix™ ODT, Ryzolt®, Ultram®, Ultram® ER) or tramadol/acetaminophen (Ultracet®).
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD