Cohosh

Back cohosh, a herb reported to be beneficial in managing symptoms of menopause, is generally regarded as safe when used as directed. Back cohosh is a member of the buttercup flower family. The dosage of standardized extract is 2 tablets twice a day, or 40 dropsof standardized tincture twice a day or one 500- to 600-mg tablet or capsule three times daily. Back cohosh tea is not considered as effective as other forms Boiling of the root releases only a portion of the therapeutic constituents... 

The benefits of black cohosh (not to be confused with blue cohosh) include ... 

Hack Cohosh, Qmidfuga Management of Overdose causes Siould not be used during... 

A number of non-hormonal therapies have been studied for symptomatic management of vasomotor symptoms, including antidepressants [e.g., selective serotonin reuptake inhibitors (SSRIs) and venlafaxine], herbal products (e.g., soy, black cohosh, and dong quai), and a group of miscellaneous agents (e.g., gabapentin, clonidine, and megestrol). The choice of therapy depends on the patient s concomitant disease states, such as depression and hypertension, and the risk for potential adverse effects. 

Black cohosh has been one of the most studied herbal remedies for vasomotor symptoms, and it has not demonstrated a substantial benefit over placebo. The mechanism of action, safety profile, drug-drug interactions, and adverse effects of black cohosh remain unknown. In non-placebo-controlled trials conducted for 6 months or less, black cohosh demonstrated a small reduction in vasomotor symptoms. It has not been shown to be effective for vasomotor symptoms in women with breast cancer.33 There have been case reports of hepatotoxicity with the use of black cohosh.36 Caution should be exercised when considering the use of this product, especially in patients with liver dysfunction. 

Black cohosh Short-term (less than 6 months) symptomatic relief demonstrated Varied dosing based on herbal product combination most studied Reminfemin 20-80 mg twice daily Gl upset (take with food) potential hepatoxicity... 

Note that the dried rhizome of Cimicifuga racemosa (British Pharmaceutical Codex, 1934 black cohosh) has been used as a bitter and mild expectorant in the form of a liquid alcoholic extract (1 in 1 dose 0.3-2 mL) and is sold as alternative remedy for the treatment of menopausal syndrome at dose of 40-80 mg/day. The active constituents of black cohosh, and, therefore, the precise molecular mechanism of action involved in the climacteric property of Cimicifuga racemosa, are still unknown. The most recent data suggest that the plant is not estrogenic sensu stricto (126). 

Mahady GB. Black cohosh (Cimicifuga racemosa) review of the clinical data for safety and efficacy in menopausal symptoms. Treat Endocrinol 2005 4 177-184. 

Black cohosh Preliminary evidence for effective use against "hot flashes"and other menstrual problems... 

Nicotine Nasal Spray (Nicolrol NS) [Smoking Deterrent/ Cholinergic] Uses Aid to smoking cessation, relieve nicotine withdrawal Action Systemic delivery of nicotine Dose 0.5 mg/actuation 1-2 sprays/h, 10 sprays/h max Caution [D, M] Contra Life-threatening arrhythmias, unstable angina Disp Nasal inhaler SE Local irritation, tach, HA, taste p v sion Interactions T Effects W/ cimetidine, black cohosh t effects OF catecholamines, cortisol T hemodynamic AV blocking effects OF adenosine EMS See Nicotine Gum OD See Nicotine Gum... 

Black cohosh Remifemin preparation) appears modestly effective in menopausal symptom relief, according to several German stupes of up to 6 months duration however, more research is necessary before it can be recommended as an estrogen alternative. Black cohosh is less effective than estrogen for symptom reduction and is not known to have any effect against osteoporosis. 

Black cohosh may cause nausea, vomiting, hypotension, and even miscarriage. It is absolutely contraindicated in pregnancy. Red clover contains coumarins and should therefore be avoided with anticoagulants. Diets high in red clover isoflavones have reduced livestock fertility and theoretically could do the same in humans. Flaxseed may cause nausea, diarrhea, and flatulence. Cyanogenic nitrates in flax (especially in immature seed pods) have produced toxic reactions. 

Black cohosh root doses vary widely, with up to 2000 mg/day of root being taken several times daily. Remifemin is the best-studied brand, and tablets containing 40 mg of black cohosh extract with 1 mg of triterpenes are given as one or two tablets twice daily. 

Black cohosh may reduce menopausal symptoms, and it appears safe and well tolerated for at least a 6-... 

Black cohosh Menopausal symptoms Hepatotoxicity Avoid1... 

Cases of hepatotoxicity have occurred these cases are rare given the widespread use of black cohosh. 

Black cohosh is said to possess antirheumatic, antitussive, sedative, and emmenagogue properties. It is used for intercostals myalgia, sciatica, whooping cough, chorea, tinnitus, dysmenorrheal, uterine colic, and specifically for muscular rheumatism and rheumatoid arthritis. 

Blue cohosh is said to possess antispasmodic, emmenagogue, uterine tonic, and antirheumatic properties. Traditionally, it has been used for amenorrhea, threatened miscarriage, false labor pains, dysmenorrhea, rheumatic pains, and specifically for conditions associated with uterine atony. 

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