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Black Cohosh, or Cimicifuga racemosa, is a perennial dicot of the Buttercup family native to the Eastern half of the United States and Canada. It is also known as baneberry, black snakeroot, bug root, and bugbane. Black cohosh is considered an herbal remedy or dietary supplement. No specific therapeutic claims are made of its efficacy in treating any medical condition. This activity will discuss the purported uses of this substance, potential mechanisms of action, and potential toxicities, so members of the health care team can be aware of the possible issues arising when patients take this herbal supplement. Objectives: Identify the alleged indications for black cohosh. Summarize a few of the possible mechanisms of action of black cohosh. Review potential adverse effects and contraindications for black cohosh. Review interprofessional team strategies for improving care coordination and communication within the health care team and the patient regarding the use of black cohosh. Access free multiple choice questions on this topic.

There is no known antidote, as the exact mechanism of action is not understood and may occur through several mechanisms. Treatment would consist of discontinuation of the dietary supplement, medical evaluation of new symptoms, and supportive measures until normalization occurs.

Black Cohosh is widely used by many women for the treatment of a range of medical disorders, but solid clinical evidence to back up the claims made by the manufacturers is lacking. Thus, the primary care provider (MD, DO, NP, or PA), pharmacist, and nursing staff should educate the patient on the use of black cohosh and other dietary supplements. Patients should be informed that efficacy in achieving relief of menopausal symptoms has been published for over 50 years. But clinical studies relating to human physiology have been largely inconclusive. Studies do not show any consistent effect on the follicle-stimulating hormone, luteinizing hormone, or estrogen. Studies have shown no consistent impact on tissues of the female reproductive tract. As of now, black cohosh has actions similar to placebo.[10][11] While black cohosh supplements are generally safe, the potential for interactions or adverse should not be discounted. When taking a patient's medication history, black cohosh (as well as any other supplements) should be included, so patients will not encounter any medically-related problems.