Black Cohosh

Information
Application
Notes
References

Botanical name

Black cohosh, black bugbane, black snakeroot, fairy candle - Actaea racemosa L. [Syn. Cimicifuga racemosa (L.) Nutt.)]

Family

Buttercup family (Ranunculaceae)

Information about the plant

Black cohosh is native in eastern North America and Canada, and grows there in shady forests, now also in Europe. The North American Indians used slices of the rhizome for very different diseases. Because of growing medicinal importance and a growing need, it is now an endangered species and should really only be farmed for this purpose. In Europe it is also found as an ornamental plant in gardens and parks. The genus Actaea name is derived from the Greek name for elderberry (= aktaia). Much more meaningful is the genus name Cimicifuga. It is comes from Latin: cimex (Gen. cimicis) (= bug), in combination with -fuga (Latin, fugare = to rout out), this means that you can get rid of bugs with it. The intense smell of the plant is responsible for this characteristic, the name "Black Cohosh" clearly reflects it further. The epithet racemosa refers to the large racemose inflorescences of rich white, almost silvery flowering plant. The numerous small white flowers with prominent stamens sit in large clusters on the end of stalks of up to 2m high that protrude from the foliage of leaves. The leaves are two to three times pinnate, the individual leaflets are oblong and sharply serrate. Flowering time is June to July.

Medicinally used parts of plants (herbal drug)

The underground parts of the plant are used, consisting of the rhizome and root. They are dug up, after the fruit is ripe, then washed and dried. The drug is collected from the wild in certain areas of the U.S. and Canada.

Constituents of the herbal drug

Black Cohosh rhizome contains triterpene-and phenylpropane derivatives.

Quality of the drug

A monograph of the European Pharmacopoeia (Ph. Eur) with which the quality of the Black Cohosh rhizome (Cimicifuga rhizoma) is defined, is under preparation.

Medical applications

Recognised medical use

For premenstrual and dysmenorrhea and menopausal-related neuro-vegetative symptoms (Commission E), menopausal symptoms like hot flashes, profuse sweating, insomnia and nervous irritability (ESCOP). An area of use covered by clinical data (approved) is: "for the improvement of mental and neuro-vegetative symptoms caused by the menopause." The HMPC has accepted the internal use of Black Cohosh rhizome for the treatment of menopausal symptoms like hot flashes and excessive sweating as a "well-established medicinal use".

Traditional use

No listing for traditional use (� 109a).

Herbal drug preparations in finished dosage forms

dried extract in tablets and capsules
tincture in drops
mother tincture in drops

Dosage

To ensure the effect, Black Cohosh rhizome should only be used in the form of the finished medicinal products, the dosage is specified in the leaflet.

Preparation of a tea

The preparation of a tea infusion is not recommended.

Notes

Patients with liver dysfunction should take Black cohosh with care and stop taking the tablets as soon as any symptoms of liver failure appear (fatigue, anorexia, yellowing of the skin/eyes, or massive abdominal pain with nausea and vomiting, and dark coloured urine). Seek medical advice immediately, likewise if vaginal bleeding occurs. Black Cohosh rhizome should not be taken with estrogen. Also patients who are or were receiving treatment for estrogen-dependent tumours (e.g. breast cancer) should not take Black Cohosh rhizome without medical advice. The administration of the drug during pregnancy and breast-feeding is not recommended, because there are as yet no studies on its safety.

Side effects

Hepatotoxic reactions (hepatitis, jaundice, impaired liver function tests) have been observed (frequency not known). There are also isolated cases of skin reactions, facial swelling, and gastrointestinal symptoms such as dyspepsia and diarrhoea.