⚠️ Mechanism
Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
📋 Effect
Increased plasma levels of salmeterol (beta2-agonists), potentially leading to toxicity or enhanced adverse effects.
💊 Management
Monitor for increased adverse effects of salmeterol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Plain Language Summary
This combination carries a moderate risk because Black Cohosh can slow down how your body breaks down beta-2 agonists. This may cause the medication to build up in your system, potentially increasing the risk of side effects.
Source
Flockhart CYP450 Table (drug-interactions.medicine.iu.edu)
Supporting Research
[Efficacy of black cohosh extracts for improving low estrogen status induced by postoperative GnRHa treatment in patients with endometriosis: a systematic review]
Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause
Suspected black cohosh hepatotoxicity: no evidence by meta-analysis of randomized controlled clinical trials for isopropanolic black cohosh extract
Menopausal symptoms
Menopausal symptoms
Menopausal symptoms
Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis
Medical Disclaimer: This interaction record is for informational and educational purposes only and does not constitute medical advice. Drug-supplement interactions can be dangerous. Always consult your healthcare provider or pharmacist before combining any supplement with prescription medications. Do not stop or change any medication without professional guidance.