⚠️ 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 sertraline (ssri), potentially leading to toxicity or enhanced adverse effects.
💊 Management
Monitor for increased adverse effects of sertraline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Plain Language Summary
This combination may be moderately unsafe because Black Cohosh can slow down how your body processes your SSRI medication. This can cause the medication to build up in your bloodstream, which may increase your risk of experiencing 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.