Botanical Description & Habitat
Women's best friend
Canada, the United States, and eastern Asia; it flourishes near running streams, around swamps, and in other moist places.
Blue cohosh is a perennial plant which has a round, smooth stem growing from a knotty rootstock. The stem grows from 1-3 feet in height. Its leaflets are oval, irregularly lobed, and they have pale undersides. Small greenish-yellow flowers bloom from May to June. Its blue, spherical fruits, which are naked seeds, grow on fleshy stalks; they ripen in August. The seeds are poisonous.
Rhizome and roots - dried, collected in autumn.
Historical Properties & Uses
Blue cohosh is used mainly as an antispasmodic agent for the uterus, relieving cramps and spasms. It is used to stimulate menstrual flow, a use passed into medicine from the Native American Indians.
The plant is also used as a diuretic, diaphoretic, anthelmintic and oxytocic. The berries are poisonous, and hypersensitive persons may be allergic to the plant.
Method of Action
Blue cohosh has good anti-inflammatory activity.
A similar Russian species has been found to have fungicidal activity.
A pharmacological work-up on this herb appears to be lacking. The pharmacological effects of blue cohosh have been attributed to the presence of several glycosides and alkaloids (including caulosaponin and methylcytisine).
Oxytocic effects are attributed to caulosaponin. This substance constricts the coronary vessels, stimulates intestinal contractions or spasms and in high doses produces toxic effects on cardiac muscle tissue of small lab animals.
Methylcytisine produces nicotinic effects (though not nearly as potent), i.e., it elevates blood pressure and stimulates respiration as well as intestinal motility.
Drug Interactions & Precautions
Diuretics, such as blue cohosh, may potentiate the action of antihypertensive, ganglionic or peripheral adrenergic blocking drugs, tubocurarine and, to a lesser degree, norepinephrine.
The oxytocic property of blue cohosh, in conjunction with such vasoconstrictors as ephedrine, methoxamine, phenylephrine or sympathomimetics, may cause severe hypertension. In addition, citrates taken in conjunction with the herb may produce erratic and unpredictable results due to the oxytocic action. It should also be noted this herb and sparteine may have synergistic oxytocic activity.
Blue cohosh may increase the metabolism of digitoxin, oral contraceptives, phenytoin, corticosteroids, fluroxene, methadone, metyrapone, and tetracyclines.
The metabolism of blue cohosh may be increased by barbiturates, ethanol, diazoxide, loxapaine, and vitamin B-6. Conversely, the metabolism of this herb may be decreased by propoxyphene, troleandomycin, aminosalicylic acid, antihistamines, chloramphenicol, disulphiram, halothane, isoniazid, methylphenidate, phenothiazines, sulfa drugs.
By sequestering blue cohosh, mineral oil may reduce the herb's anthelmintic effect. The same may be true, to a lesser extent, of antacids.
The diuretic action of blue cohosh may reduce renal clearance of lithium. The use of diuretics may require dosage adjustments of antidiabetic drugs.
The neuromuscular relaxing action of blue cohosh may be enhanced by the use of certain aminoglycositic antibiotics, such as clindamycin. Prolonged use of this diuretic may affect certain laboratory test results such as electrolytes (especially potassium and sodium), blood urea nitrogen (BUN), uric acid, glucose, and protein bound iodine (PBI).
The antidiabetic ability of blue cohosh may be decreased by concomitant use of acetazolamide, oral contraceptives, corticosteroids, ethanol, dextrothyroxine, epinephrine, glucagon, and marijuana.
The antidiabetic effects of blue cohosh may also be decreased when used in conjunction with phenothiazines, rifampin, thiazide diuretics, and thyroid hormones.
Conversely, the antidiabetic action of blue cohosh may be enhanced when it is used with allopurinol, anabolic steroids, chloramphenicol, clofibrate, fenfluramine, guanethidine, MAOI's, phenylbutazone, probenecid, and phenyramidol.
The antidiabetic action of blue cohosh may also be enhanced when used in conjunction with salicylates, sulfinpyrazone, sulfonamides, and tetracyclines.
Safety Factors & Toxicity
Preparation & Administration
Three times a day
Dried tuber and roots
made from 1/4-1/2 tsp of dried tuber and roots
1:1 in 70% alcohol, 0.5-1 ml
This herb should not be taken during pregnancy.
Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.
Adnitt, P.I. 1968. Hypoglycemic action of monoamine oxidase inhibitors. Diabetes. 17. p. 628.
Am Hospital Formulary Service. Am Soc of Hosp Pharm. Wash, D.C.
Arky, R.A., et.al. 1968. Irreversible hypoglycemia, a complication of alcohol and insulin. J of the Am Med Assoc, 206. p. 575.
Arneson, G. 1964. Phenothiazine derivatives and glucose metabolism. Journal of Neuropsychiatry, 5. p. 181.
Beaudry, C. & L. Laplante. 1973. Treatment of renal failure from diabetic nephropathy with cadaveric homograft. Canadian Medical Assoc Journal, 108. p. 887.
Benoit, P.S., et.al., Lloydia, 39, 160, 1976.
Bergman, H. 1965. Hypoglycemic coma during sulfonylurea therapy. Acto Med Scand. 177. p. 287.
Boston Collaborative Drup Surveillance Program. 1972. Tetracycline and drug-attributed rises in blood urea nitrogen. Journal of the Am Medical Assoc. 220. pp. 377-379.
Bressler, R., M.D. Bogdonoff & G.J. Subak-Sharpe. 1981. The Physicians Drug Manual. Doubleday & Co, Inc. Garden City, NY. 1213 pp.
Casaday, G.N., et.al. 1960. Postpartum hypertension after the use of vasoconstrictors and oxytocic drugs. Etiology, incidence, complications and treatment. J of the Am Med Assoc, 172 (Mar 5).
Chambers, G., R.J. Kerry & G. Owen. 1977. Lithium used with a diuretic. British Medical Journal, 2. pp. 805-806.
Chandrasekhar, K & Sarma, GHR: Observation on the effect of low and high doses of Caulophyllum on ovaries and the consequential changes in the uterus and thyroid in rats. J. Reprod. fertil. 1974, 38:236.
Chiles, V.K. 1968. Drug interactions and the pharmacist. Canadian Pharaceutical Journal. 101(7). pp. 241-247.
Committee on Pharmocopaeia of the Am Institute of Homeopathy, The Homeopathic Pharmacopaeia of the United States. 8th ed., Vol 1. Otis Clapp and Son, Agents, Boston, l981.
Council on Drugs: Evaluation of a hypocholesterolemic agent. 1969. Destrothyroxine sodium (Choloxin). J of the Am Med Assoc, 208 pp. 1014.
De Martinis, et.al. 1980. Milk thistle (silybum marianum) derivatives in the therapy of chronic hepatopathies. Clin. Ter., 94(3). pp. 283-315.
Dollery, C. 1965. Physiological and pharmacological interactions of antihypertensive drugs. Proceedings of the Royal Society of Medicine, 58(11). pp. 983-987.
Drug package insert (FDA approved official brochure) and other labeling based on sponsored clinical investigations and New Drug Application data.
Ferguson, HC & Edwards, LD: A pharmacological study of crystalline glycoside of Caulophyllum thalictroides. J. Am. Pharm. Assoc. 1954, 43:16.
Ferrarini, A. Med. Int., 50, 121, 1942.
Foldes, F., J. Lunn & H. Benz. 1963. Prolonged respiratory depression caused by drug combinations. Muscle relaxants and intraperitoneal antibiotics as etiologic agents. Journal of the Am Medical Assoc, 183(2). pp. 672-673.
Frey, H. & E. Kampmann. 1966. Interaction of amphetamine with anticonvulsant drugs. II. Effect of amphetamine on the absorption of anticonvulsant drugs. Acta Pharmachologic et Toxicologica, 24. p.310.
Goldner, M.G., H. Zarowitz & S. Akgun. 1960. Hyperglycemia and glycosuria due to thiazide derivatives administered in diabetes mellitus. New England Journal of Medicine, 262(Feb 2). pp. 403-405.
Goodman, L.S. & A. Gilman. 1975. Pharm Basis of Thera. MacMillan, NY.
Gunn, T.R. & Wright, I.M. : The use of black and blue cohosh in labor. (Letter) N Z Med. J. 1996, 109, (1032): 410 - 411.
Gupta, K.K. 1969. The anti-diabetic action of guanethidine. Postgraduate Medical Journal, 45. p. 455.
Hansen, J. et.al. 1966. Dicumarol-induced diphenylhydantoin intoxication. Lancet, 2. p. 265.
Hansten, P.D. 1979. Drug Interactions, 4th ed. Lea & Febiger, Phila.
Hansten, P.D. 1968. Antidiabetic drug interactions. Hospital Form. Management, 4(2). pp. 30-32.
Hiatt, N. & G. Bonorris. 1970. Insulin response in pancreatectomized dogs treated with oxytetracycline. Diabetes, 19. p. 307.
Hurtig, H.I. & W.L. Dyson. 1974. Lithium toxicity enhanced by diuresis. New England J of Med, 290(Mar 28). pp. 748-749.
Hyde, F.F. British Herbal Pharmacopoeia. British Herbal Medicine Assoc: West Yorks, England, 1983
Kaegi, A., et.al. 1974. Arteriovenous-shunt thrombosis. Prevention by sulfinpyrazone. New England Journal of Medicine. pp. 290, 304.
Karlin, J.M. & H. Kutt. 1970. Acute diphenylhydantoin intoxication following halothane anesthesia. Journal of Pediatrics, 76. p. 941.
Kastrup, E.K., ed. 1981. Drug Facts and Comparisons, 1982 edition. Facts and Comparisions Division, J.P. Lippincott Co, Phila(St. Louis).
Kutt, H., et.al. 1968. Inhibition of diphenylhydantoin metabolism in rats and rat liver microsomes by antitubercular drugs. Neurology, 18.
Landon, J., et.al. 1963. The effect of anabolic steroids on blood sugar and plasma insulin levels in man. Metabolism, 12. p.924.
The Lawrence Review of Natural Products. Oct, 1992.
List, P. & L. Hoerhammer. 1969-1976. Hagers Hanbuch der Pharmazeutischen Praxis, vols. 2-5. Springer-Verlag, Berlin.
Lockhart, J.G. 1970. Effects of `speed' and `pot' on the juvenile diabetic (questions and answers). J of the Am Med Assoc, 214. p. 2065.
Lutz, E.G. 1975. Lithium toxicity precipitated by diuretics. Journal of the Medical Society of New Jersey, 72(5). pp. 439-440.
Malims, J.M. 1968. Diuretics in diabetes millitus. Practitioner, 201. p. 529.
Martin, E.W. 1978. Drug Interactions Index, 1978/79. J.B. Lippincott Company, Philadelphia.
Middleton, E. & S.R. Finke. 1968. Metabolic response to epinephrine in bronchial asthma. Journal of Allergy, 42. p.288.
Miller, R.D., et.al. 1976. Enhancement of d-tubocurarine neuromuscular blockage by diuretics in man. Anesth, 45. p.442.
Miller, L. & R.D. Lindeman. Red Blood Cell and Serum Selenium Concentration as Influenced by Age and Selected Diseases. Journal Of Am College Nutrition, 2. 1983.
Mowrey, Daniel B., Ph.D. Exper. Psych., Brigham Young University. Director of Nebo Institute of Herbal Sciences. Director of Behavior Change Agent Training Institute. Director of Research, Nova Corp.
Nagata, R.E. 1969. Drug interactions -- digitalis glycosides and kaliuresis. Hospital Form Management, 4(8). pp. 30-32.
Nord, H.J., et.al. 1970. Treatment of congestive heart failure with glucagon. Annals of Internal Medicine, 72. p. 649.
Olesen, O.V. 1966. Disulfiram (antabuse) as inhibitor of phenytoin metabolism. Acta Pharmacologica et Toxicologica, 24. p. 317.
Peaston, M.J.T. & P. Finnegan. 1968. A case of combined poisoning with chlorpropamide, acetylsalicylic acid and paracetamol. British Journal of Clin Practice, 22. p. 30.
Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., New York. 2212 pp.
Reddy, C.C. & E.J. Massaro. Biochemistry of Selenium: A Brief Overview. Fundamental Applied Toxicology, 3. 1983.
Refetoff, S. 1975. Thyroid hormone therapy. Medical Clinics of North America, 59. p. 1147.
Rose, J.Q., et.al. 1977. Intoxication caused by interaction of chloramphenicol and phenytoin. J of the Am Med Assoc, 237. p. 2630.
Sara, C. 1965. Drugs that complicate the course of anaesthesia. Medical Journal of Australia, 52. pp. 139-142.
Scientific Committee, British Herbal Pharmocopaeia, British Herbal Med Assoc, Lane House, Cowling, Na Keighley, West Yorks, Bd Bd220lx, l983
Siris, J.H., et.al. 1974. Anticonvulsant drug-serum levels in psychiatric patients with seizure disorders. NY St J of Med, 74 p.1554.
Solomon & Schrogie. 1967. Effect of phenyramidol and bishydroxycoumarin on the metabolism of tolbutamide in human subjects. Metabolism, 16. p. 1029.
Strigina, L.I., et. al. Phytochemistry, 14, 1583, 1975 (and other soviet works, reported in Chem Abstracts 74, 50520T, 1971; 78, 628W, 1973; 86, 15261U, 1977.)
Stuart, D.M. 1968. Drug metabolism Part 2. Drug interactions. PharmIndex, 10(10). pp. 4-16.
Tannenbaum, H., et.al. 1974. Phenylbutazone-tolbutamide drug interaction Letter. New England Journal of Medicine, 290. p.344.
Thorn, G.W. 1966. Clin considerations in the use of corticosteroids. New England J of Medicine, 274(Apr 7). pp. 775-781.
Turtle, J.R. & J.A. Burgess. 1973. Hypoglycemic action of fenfluramine in diabetes meillitus. Diabetes, 22. p. 858.
Tuttle, C.B. 1969. Drug interactions. Canadian Journal of Hospital Pharmacy, 22(5-6). pp. 2-15.
Warner, W.A. & E. Saunders. 1971. Neuromuscular blockade associated with gentamicin therapy. J of the Am Med Assoc, 215. pp. 1153-1154.
Zilly, W., et.al. 1976. Induction of drug metabolism in man after rifampicin treatment measured by increased hexobarbital and tolbutamide clearance. European J of Clin Pharm, 9. p. 439.
? Southwest School of Botanical Medicine
- Product Categories
- Detox & Immunity
- Digestive Health
- Joint Health
- Weight Loss
- Popular Products
- CellRenew Collagen Hyaluronic Acid
- Foundation Blue-Green Algae
- Dream Health System
- Liver Cleanse
- Reference Materials
- Product Testimonials
- Health Journal Archive
- Health Briefs
- Health Basics
- Frequent Product Q&A's
- Med-Scope (health database)
- Health Conditions
- Natural Solutions
- Alternative Therapies
- Toxicity Sources
- Foods Advice
- Anatomy & Fitness
We test only on humans