Blue cohosh

Blue cohosh/Drug Interactions:

  • Antidiabetic agentsAntidiabetic agents: Blue cohosh may increase blood glucose levels, based on an animal study of the constituent N-methylcytisine due to its nicotinic effects (2).
  • Antispasmodic drugsAntispasmodic drugs: Blue cohosh may have antispasmodic effects.
  • Cardiovascular drugsCardiovascular drugs: Based on a case report and the nicotinic effects of the constituent N-methylcytisine, blue cohosh may cause coronary vasoconstriction, tachycardia, and possible increase in blood pressure (1; 3; 2).
  • NicotineNicotine: A constituent of blue cohosh, methylcytisine, is pharmalogically similar to nicotine and may lead to nicotinic toxicity (1). There is a case report of a 21 year-old woman developing signs similar to nicotinic toxicity, including tachycardia, diaphoresis, abdominal pain, vomiting and muscle weakness, and twitching after using blue cohosh (3).
  • Oxytocin (Pitocin ?)Oxytocin (Pitocin ?): Based on in vitro and in vivo studies, blue cohosh may induce labor (1).
  • CocaineCocaine: Based on a case report, blue cohosh could possibly be tainted with cocaine (5).

    • Blue cohosh/Herb/Supplement Interactions:

  • Antispasmodic herbsAntispasmodic herbs: Blue cohosh may have antispasmodic effects.
  • Cardiovascular herbs or supplementsCardiovascular herbs or supplements: Based on a case report and the mechanism on action, blue cohosh may cause coronary vasoconstriction, tachycardia, and possible increase in blood pressure (1; 3).
  • HypoglycemicsHypoglycemics: Blue cohosh may increase blood glucose levels, based on an animal study of the constituent N-methylcytisine due to its nicotinic effects (2).
  • Labor-stimulating herbsLabor-stimulating herbs: Based on in vitro and in vivo studies, blue cohosh may induce labor (1).
  • NicotineNicotine: A constituent of blue cohosh, methylcytisine, is pharmacologically similar to nicotine and may lead to nicotinic toxicity (1). There is a case report of a 21 year-old woman developing signs similar to nicotinic toxicity, including tachycardia, diaphoresis, abdominal pain, vomiting and muscle weakness, and twitching after using blue cohosh (3).
  • Coca leavesCoca leaves: Based on a case report, blue cohosh could possibly be tainted with cocaine (5).

    • Blue cohosh/Food Interactions:

  • Insufficient available evidence,

    • Blue cohosh/Lab Interactions:

  • Blood glucoseBlood glucose: Blue cohosh may increase blood glucose levels, based on an animal study of the constituent N-methylcytisine due to its nicotinic effects (2).
  • CocaineCocaine: A case report describes an infant having a stroke shortly following birth after the mother had ingested blue cohosh tea in order to induce labor (5). A urine analysis later showed the cocaine metabolite benzoylecgonine, and cocaine is known to cause perinatal stroke. Benzoylecgonine was also present in the mother's bottle of blue cohosh upon testing. Whether benzoylecgonine is a metabolite of both cocaine and blue cohosh or whether the blue cohosh was contaminated with cocaine is unknown. It also unknown whether the mother used cocaine.