blue cohosh (generic name)

an herbal product -
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Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or sensitivity to blue cohosh (Caulophyllum thalictroides), any of its constituents, or members of the Berberidaceae family.

Side Effects and Warnings

One commonly reported effect of blue cohosh is its uterine-stimulating effects, which may be viewed as a desirable effect when used to induce labor, but an adverse effect when used for other purposes during pregnancy.

Other adverse effects of blue cohosh may include nausea, vomiting, abdominal pain, and cardiotoxic effects on the fetus (when used in pregnant women). Myocardial infarction (heart attack), congestive heart failure, shock, and myocardial toxicity have also been reported.

Strokes and seizures have been documented in infants whose mother ingested blue cohosh during pregnancy.

Due to nicotinic effects of the constituent N-methylcytisine, blue cohosh could cause dilated pupils, hyperventilation, nystagmus (involuntary, alternating, rapid and slow movements of the eyeballs), thirst, hyperthermia, seizures, hyper- or hypotension (high or low blood pressure), chest pain, tachycardia (fast heart rate), irregular pulse, or coma.

Blue cohosh may cause hyperglycemia (increased blood sugar levels) and anemia in infants following maternal use.

Patients who smoke or are quitting smoking, and those with diabetes should use blue cohosh cautiously and consult with a qualified healthcare professional, including a pharmacist.

Pregnancy and Breastfeeding

Pregnancy: Although there is conflicting evidence about the use of blue cohosh during pregnancy, it has traditionally been used to induce labor or abortion. The use of blue cohosh to induce abortion has been associated with adverse effects in the mother and/or fetus. There have been reports of cardiotoxicity in the newborn infants of the mothers who ingested blue cohosh; the resulting adverse effects included congestive heart failure, myocardial infarction (heart attack) or toxicity, stroke, and shock. Use of blue cohosh during pregnancy to stimulate the uterus in order to ease the effects of labor should only be used under medical supervision.

Breastfeeding: Blue cohosh is not recommended in breastfeeding women due to a lack of available scientific evidence.

Interactions

Interactions with Drugs

Blue cohosh may increase blood glucose levels. Caution is advised when using medications that may lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary.

Blue cohosh may have antispasmodic effects. Individuals using blue cohosh with other drugs with antispasmodic effects should consult with a qualified healthcare professional, including a pharmacist.

Blue cohosh may cause coronary vasoconstriction (decreased blood flow due to constriction of blood vessels), tachycardia (increased heart rate), and possible increases in blood pressure. Individuals taking medications that affect heart rate or blood pressure should consult with a qualified healthcare professional, including a pharmacist.

A constituent of blue cohosh, methylcytisine, is similar to nicotine and may lead to nicotinic toxicity. Caution is advised in patients who smoke or use other products containing nicotine.

Blue cohosh may induce labor and should not be used with oxytocin (Pitocin ®).

Interactions with Herbs and Dietary Supplements

Blue cohosh may have antispasmodic effects. Individuals using blue cohosh with other herbs or supplements with antispasmodic effects should consult with a qualified healthcare professional, including a pharmacist.

Blue cohosh may cause coronary vasoconstriction, tachycardia, and possible increases in blood pressure. Individuals taking herbs and supplements that affect heart rate or blood pressure should consult with a qualified healthcare professional, including a pharmacist.

Blue cohosh may increase blood glucose levels. Caution is advised when using herbs or supplements that may alter blood sugar. Caution is advised.

Blue cohosh may induce labor and caution is advised when taking blue cohosh with other herbs and supplements that have labor-inducing effects.

A constituent of blue cohosh, methylcytisine, is similar to nicotine and may lead to nicotinic toxicity. Caution is advised in patients who smoke or use other products containing nicotine.

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