HERBAL MONOGRAPHS BLACK COHOSH/93(Remifemen) 40 drops twice daily was determined after a
duration of 3 months. The participants had either refused
hormone treatment or had conditions where hormone treat-
ment was contraindicated. The efficacy of the herb was
measured according to the Kupperman-Index, Profile of
Mood States (POMS) scale and the Clinical Global Impres-
sions (CGI) scale. A significant improvement in menopausal
complaints for all testing protocols were recorded. (Vorberg,
1984).Note: Cimicifuga racemosa should not be substituted for
hormone replacement therapy with estrogen. There is no
information to date that the herb contains cardioprotective
effects or protective effects against osteoporosis, as those
seen with estrogen therapy.INDICATIONS AND USAGE
Approved by Commission E:- Climacteric complaints
- Premenstrual syndrome (PMS)
Unproven Uses: In folk medicine, the plant is used for
rheumatism, sore throats and bronchitis. The tincture is also
used as a sedative, for choreic states (involuntary, rapid
motions), fever, lumbago (pain in the lumbar region) and
snakebite. The herb is also available commercially in
combination with St. John's Wort for depressive moods
associated with premenstrual and menopausal symptoms.Chinese Medicine: The Chinese have used Black Cohosh for
the above indications as well as for measles in the pre-
exanthem stage.
CONTRAINDICATIONS
The use of Black Cohosh is contraindicated during pregnan-
cy due to an increased risk of spontaneous abortion.PRECAUTIONS AND ADVERSE REACTIONS
General: No health hazards or side effects are known in
conjunction with the proper administration of designated
therapeutic dosages, although occasional stomach complaints
have been observed.Drug Interactions: Black Cohosh can potentiate the effect of
antihypertensive medications. The concomitant use of these
drugs may result in hypotension (Einer-Jensen, 1996;
Lehmann-Willenbrock, 1988).OVERDOSAGE
An intake of very high dosages of die drug (5 g) or an extract
(12 g) leads to vomiting, headache, dizziness, limb pains and
lowered blood pressure.DOSAGE
Mode of Administration: Galenic preparations for internal
use.
flow Supplied:
Capsules — 60 mg, 80 mg, 450 mg, 540 mg, 545 mgDrops
Solutions
Tablets — 60 mg, 120 mg.
Daily Dosage: Alcoholic-aqueous extracts (ethanolic-aque-
ous 40-60% (WV) or isopropanolic-aqueous 40% (V/V))
corresponding to 40 mg drug. The herb is not recommended
for treatment longer than 6 months unless advised by a
physician.
LITERATURE
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Berger S, Junior P, Kopanski L, 27-Desoxyactein: a New
Polycyclic Triterpenoid Glycoside from Actaea racemosa. In:
PM 54:579-780. 1988.
Beuscher N, Cimicifuga racemosa L. - Die Traubensilberkerze.
In: ZPT 16(5):301-310. 1995.
Corsano S, Panizzi L, Sull' Acteina, principio attivo della
Actaea racemosa. In: Atti Acca Nazi Lincei, Rend, Classe Sci,
Fis. Mat. Nat 38:600-604. 1965.
Daiber W, Klimakterische Beschwerden: ohne Hormone zum
Erfolg! In: Arztl Praxis 35:1946-1947. 1983.
Duke JA, Handbook of Medicinal Herbs. Boca Raton: CRC,
1985.
Duker EM, Kopanski L, Jarry H, Wuttke W, (1991) Effects of
extracts from cimicifuga racemosa on gonadotropin release in
menopausal women and ovariectomized rats. Planta Med
57:420-424.
Einer-Jensen N, Zhao J, Andersen KP, Kristoffersen K.
Cimicifuga and Melbrosia lack oestrogenic effects in mice and
rats. In: Matuntas 25(1995):149-153. 1996.
Foldes J, Die Wirkungen eines Extraktes aus Cimicifuga
racemosa. In: Arzd Forsch 13:623-624. 1959.
Genazzani, E et al., (1962) Nature 194:544.
Gerhard I, Liske E, Wustenberg P, Behandlung von
psychovegetativen Beschwerden im Klimakterium mit
Remifemin(R)plus (Poster). In: ZPT 16(5, Supplemental, 6.
Phytotherapiekongrep* in Berlin. 1995.
Gorlich N, Behandlung ovarieller Storungen in der
Allgemeinpraxis. In: Arzd Praxis 14:1742-1743. 1962.
Harnischfeger G, Cillien N, Influence of Cimicifuga racemosa
extract fractions on the proliferation of human carcinoma cells
in vitro with regard to their estrogen receptor sensitivity. In:
PM 62, Abstracts of the 44th Ann Congress of GA, 40. 1996.
Harnischfeger G, Stolze H, Bewahrte Wirksubstanzen aus
Naturstoffen. Traubensilberkerze. In: Notabene medici 10:446-
- Jarry H, Gorkow Ch, Wutdce W, (1995) Treatment of
Menopausal Symptoms with Extracts of Cimicifuga Racemosa,
- Jarry H, Gorkow Ch, Wutdce W, (1995) Treatment of