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Black Cohosh × Statins

MODERATE INTERACTION — Possible Evidence

⚠️ Mechanism

Black cohosh may inhibit CYP3A4, potentially increasing statin levels (especially simvastatin/atorvastatin).

📋 Effect

Increased statin levels; possible myopathy risk

💊 Management

Monitor for statin side effects (muscle pain). Consider pravastatin as alternative.

Plain Language Summary

This combination requires caution because Black Cohosh may cause certain statins to build up in your system. This increase in medication levels can raise the risk of experiencing muscle pain or weakness.

Source

Gurley BJ et al. Clin Pharmacol Ther 2006

Supporting Research

[Efficacy of black cohosh extracts for improving low estrogen status induced by postoperative GnRHa treatment in patients with endometriosis: a systematic review] PMID:32762163 2020
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 PMID:28276200 DOI:10.1111/1471-0528.14619 2017
Suspected black cohosh hepatotoxicity: no evidence by meta-analysis of randomized controlled clinical trials for isopropanolic black cohosh extract PMID:21228727 DOI:10.1097/gme.0b013e3181fcb2a6 2011
Menopausal symptoms PMID:19450302 2007
Menopausal symptoms PMID:21696644 2011
Menopausal symptoms PMID:21718582 2010
Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis PMID:37192826 DOI:10.1097/GME.0000000000002196 2023
Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis PMID:20085176 2010
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.