The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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  • Recent Comments

    What we know about black cohosh

    A continuing education article on Medscape presents a nice summary on the use of black cohosh to treat the symptoms of menopause.

    Current use

    • It’s an alternative to hormonal therapy to treat hot flashes, mood disturbances, sweating, heart palpitations, and vaginal dryness.
    • Supporting evidence is mixed, especially beyond 6 months of treatment.
    • Most studies use the black cohosh product Remifemin (Schaper & Brümmer).

    What we know.

    • Black cohosh is well tolerated for up to 6 months.
    • Side effects include rash and gastrointestinal symptoms, headache, nausea, dizziness, seizures, sweating, or constipation.
    • Low blood pressure has been reported.
    • Hepatitis and liver toxicity have been reported.
    • There are reports of interactions with drugs that are metabolized via the CYP450 liver enzyme system.
      • CYP450 enzymes account for almost half of the elimination of commonly used drugs, although that does not mean they are all significantly affected.
    • Use with salicylates and medicine associated with bleeding risk, including anticoagulants or herbs such as garlic and ginkgo biloba, is not recommended.

    What we don’t know.

    • The mechanism of its action is not known.
    • Safety during pregnancy and breastfeeding is not known.
    • The effect of black cohosh with estrogens, evening primrose oil, soy, and other products that have purported estrogenic properties is not known.

    Now you know.

    2/14/08 15:10 JR

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