Black cohosh (Cimicifuga racemosa): a systematic review of adverse events

American Journal of Obstetrics and Gynecology

Volumn 199, Issue 5, 2008, Pages 455-466

  Borrelli, Francesca ^a   Ernst, Edzard ^b  

^a UNIVERSITY OF NAPLES FEDERICO II   (Italy)

^b PENINSULA MEDICAL SCHOOL   (United Kingdom)

Author keywords

black cohosh; Cimicifuga racemosa; safety; systematic review; toxicity

Indexed keywords

CARBAMAZEPINE; CIMICIFUGA RACEMOSA EXTRACT; CIMIFEMIN; DEXTROPROPOXYPHENE; ERYTHROMYCIN; FLUOXETINE; IBUPROFEN; PARACETAMOL; PRIMROSE OIL; PSEUDOEPHEDRINE; UNCLASSIFIED DRUG; VALACICLOVIR;

ABDOMINAL CRAMP; ACUTE HEPATITIS; ALLERGIC REACTION; AMED; ANAPHYLAXIS; ANEMIA; ARTHRALGIA; ASTHENIA; AUTOIMMUNE HEPATITIS; BLEEDING; BREAST TENDERNESS; CIMICIFUGA RACEMOSA; CLINICAL TRIAL; COCHRANE LIBRARY; CONNECTIVE TISSUE DISEASE; DATA BASE; DIZZINESS; DRUG SAFETY; DRUG SURVEILLANCE PROGRAM; EMBASE; FACE EDEMA; FATIGUE; GASTROINTESTINAL DISEASE; HEADACHE; HEPATITIS; HUMAN; HYPERTENSION; JAUNDICE; LIVER INJURY; LIVER TOXICITY; MALAISE; MEDLINE; MENOPAUSAL SYNDROME; MENOPAUSE; MIGRAINE; MOOD DISORDER; MULTIPLE ORGAN FAILURE; MUSCLE INJURY; MUSCULOSKELETAL DISEASE; NAUSEA; PHYTOBASE; PRIORITY JOURNAL; PSEUDOLYMPHOMA; RASH; REVIEW; SEIZURE; SYSTEMATIC REVIEW; VASCULITIS; VERTIGO; VOMITING;

CIMICIFUGA; FEMALE; HUMANS; MENOPAUSE; PHYTOTHERAPY; PLANT PREPARATIONS;

EID: 54849419085     PISSN: 00029378     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ajog.2008.05.007     Document Type: Review

References (126)

1. Eisenberg D., David R.B., Ettner S.L., et al. Trends in alternative medicine use in the United States; 1990-1997. JAMA 280 (1998) 1569-1575
2. Tindle H.A., Davis R.B., Phillips R.S., and Eisenberg D.M. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med 11 (2005) 42-49
3. Ernst E. Prevalence of use of complementary/alternative medicine: a systematic review. Bull World Health Organ 78 (2000) 252-257
4. Xue C.C., Zhang A.L., Lin V., Da Costa C., and Story D.F. Complementary and alternative medicine use in Australia: a national population-based survey. J Altern Complement Med 13 (2007) 643-650
5. Fukuda S., Watanabe E., Ono N., Tsubouchi M., and Shirakawa T. Use of complementary and alternative medicine and health problems. Nippon Koshu Eisei Zasshi 53 (2006) 293-300
6. Nicholson T. Complementary and alternative medicines (including traditional Maori treatments) used by presenters to an emergency department in New Zealand: a survey of prevalence and toxicity. N Z Med J 119 (2006) U1954
7. National Center for Complementary and Alternative Medicine. http:nccam.nih.gov/health/whatiscam/ Accessed January 10, 2008
8. Kam I.W., Dennehy C.E., and Tsourounis C. Dietary supplement use among menopausal women attending a San Francisco health conference. Menopause 9 (2002) 72-78
9. Hulley S., Grady D., Bush T., et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women: Heart and Estrogen/Progestin Replacement Study (HERS) Research Group. JAMA 280 (1998) 605-613
10. Rossouw J.E., Anderson G.L., Prentice R.L., et al., writing group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 288 (2002) 321-333
11. MacLennan A.H., Taylor A.W., and Wilson D.H. Hormone therapy use after the Women's Health Initiative. Climacteric 7 (2004) 138-142
12. Haas J.S., Kaplan C.P., Gerstenberger E.P., and Kerlikowske K. Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results. Ann Intern Med 140 (2004) 184-188
13. Foster S. Black cohosh: Cimicifuga racemosa: a literature review. Herbal Gram 45 (1999) 35-50
14. Nuntanakorn P., Jiang B., Einbond L.S., et al. Polyphenolic constituents of Actaea racemosa. J Nat Prod 69 (2006) 314-318
15. Fabricant D.S., Nikolic D., Lankin D.C., et al. Cimipronidine, a cyclic guanidine alkaloid from Cimicifuga racemosa. J Nat Prod 68 (2005) 1266-1270
16. Burdette J.E., Liu J., Chen S.N., et al. Black cohosh acts as a mixed competitive ligand and partial agonist of the serotonin receptor. J Agric Food Chem 51 (2003) 5661-5670
17. American College of Obstetricians and Gynecologists. Use of botanicals for management of menopausal symptoms: ACOG Practice Bulletin. Obstet Gynecol 28 (2001) 1-11
18. Huntley A., and Ernst E. A systematic review of the safety of black cohosh. Menopause 10 (2003) 58-64
19. Dog T.L., Powell K.L., and Weisman S.M. Critical evaluation of the safety of Cimicifuga racemosa in menopause symptom relief. Menopause 10 (2003) 299-313
20. Kesselkaul O. Uber die Behandlung klimakterischer Beschwerden mit Remifemin. Med Monatsschr 11 (1957) 87-88
21. Schotten E.W. Erfahrungen mit dem Cimicifuga-Praparat Remifemin. Landarzt 34 (1958) 353-354
22. Stefan H. Ein Beitrag zu den erscheinungsformen und zur therapie hormonal bedingter biopathiesyndrome der Frau. Ringelheimer Biol Umsch 14 (1959) 149-152
23. Foldes J. The actions of an extract of Cimicifuga racemosa. Arzneimittelforschung 13 (1959) 623-624
24. Stiehler K. Uber die Anwendung eines standardisierten Cimicifuga-Auszuges in der Gynakologie. Arztliche Praxis 11 (1959) 916-917
25. Heizer H. Kritisches zur Cimicifuga: therapie bei hormonalen storungen der Frau. Med Klin 55 (1960) 232-233
26. Brucker A. Beitrag zur phytotherapie hormonaler storungen der frau. Med Welt 44 (1960) 2331-2333
27. Starfinger W. Therapie mit oestrogen wirksamen Pfanzenextrakten. Med Heute 9 (1960) 173-174
28. Gorlich N. Behandlung ovarieller storungen der frau in der allgemein-praxis. Arztliche Praxis 14 (1962) 1742-1743
29. Langfritz W. Beitrag zur Therapie von Regelanomalien und deren Begleiterscheinungen bei jungen Madchen und jungen Frauen. Med Klin 57 (1962) 1497-1499
30. Schildge E. Beitrag zur Behandlung von pramenstruellen und klimakterischen Vestimmungs und Depression-Zustanden. Ringelh Biol Umsch 19 (1964) 18-22
31. Stolze H. An alternative to treat menopausal complaints. Gyne 3 (1982) 14-16
32. Daiber W. Climacteric complaints: success without using hormones: a phytotherapeutic agent lessens hot flushes, sweating and insomnia. Arztliche Praxis 35 (1983) 1946-1947
33. Vorberg G. Therapy of climateric complaints. Zeitschrift fur Allgemeinmedizin 60 (1984) 626-629
34. Warnecke G. Influence of a phytopharmaceutical on climacteric complaints. Die Meizinisch Welt 36 (1985) 871-874
35. Stoll W. Phytopharmacon influences atrophic vaginal epithelium: double-blind study: cimicifuga vs estrogenic substances. Therapeuticum 1 (1987) 23-31
36. Petho A. Climacteric complaints are often helped with black cohosh. Arztliche Praxis 47 (1987) 1551-1553
37. Lehmann W.E., and Riedel H.H. Clinical and endocrinologic examinations about therapy of climateric symptoms following hysterectomy with remaining ovaries. Zentralbl Gynakol 110 (1988) 611-618
38. Duker E.M., Kopanski L., Jarry H., and Wuttke W. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomised rats. Planta Med 57 (1991) 420-424
39. Balier-Jagodzinski G. Praxisstudien mit Cimisan bei klimaterischen Beschwerden, Pramenstruellem Syndrom und Dysmenorrhoe. Natur Heilpraxis Naturmedizin 48 (1995) 1284-1288
40. Georgiev D.B., and Iordanova E. Phytoestrogens: the alternative approach. Maturitas 27 (1997) 213
41. Mielnik J. Extract of Cimicifuga racemosa in the treatment of neurovegetative symptoms in women in the perimenipausal period. Maturitas 27 (1997) 215
42. Liske E., and Wustenberg P. Therapy of climacteric complaints with Cimicifuga racemosa: herbal medicine with clinically proven evidence. Menopause 5 (1998) 250
43. Nesselhut T., and Liske E. Pharmacological measures in postmenopausal women with an isopropanolic aqueous extract of Cimicifuga racemosae rhizome. Menopause 6 (1999) 1072-3714
44. Boblitz N., Schrader E., Henneicke-von Zepelin H.H., and Wustenberg P. Benefit of a a fixed drug combination containing St. John's wort and black cohosh for climateric patients: results of a randomized clinical trial. (poster presentation from: 6th Annual Symposium on Complemetary Health Care; Exeter, England; December 2-4, 1999). Focus alt Comp Ther (Fact) 5 (2000) 85-86
45. Jacobson J.S., Troxel A.B., Evans J., et al. Randomised trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol 19 (2001) 2739-2745
46. Look R.M., Morris K.T., Homer L., et al. Randomized controlled trial of venlafaxine versus black cohosh as a treatment for menopausal symptoms in women with breast cancer [abstract]. Proc Am Soc Clin Oncol 20 (2001) 305b abstract 2973
47. Cook A., and Pennington G. Phytoestrogen and multiple vitamin/mineral effects on bone mineral density in early postmenopausal women: a pilot study. J Womens Health Gend Based Med 11 (2002) 53-60
48. Burke B.E., Olson R.D., and Cusack B.J. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother 56 (2002) 283-288
49. Liske E., Hanggi W., Henneicke-von Zepelin H.H., Boblitz N., Wustenberg P., and Rahlfs V.W. Physiological investigation of a unique extract of black cohosh (Cimicifugae racemosae rhizoma): a 6-month clinical study demonstrates no systematic estrogenic effect. J Womens Health Gend Based Med 11 (2002) 163-174
50. Wuttke W., Seidlová-Wuttke D., and Gorkow C. The Cimicifuga preparation BNO 1055 vs conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas 44 (2003) 67-77
51. Hernandez Munoz G., and Pluchino S. Cimicifuga racemosa for the treatment of hot flushes in women surviving breast cancer. Maturitas 44 (2003) 59-65
52. Morris K., Look R.M., Hudson V., et al. The efficacy and safety of black cohosh for managing menopausal symptoms in breast cancer survivors [abstract]. Breast Cancer Res Treat 82 suppl (2003) S159
53. Johnson B.M., and van Breemen R.B. In vitro formation of quinoid metabolites of the dietary supplement Cimicifuga racemosa (black cohosh). Chem Res Toxicol 16 (2003) 838-846
54. Pockaj B.A., Loprinzi C.L., Sloan J.A., et al. Pilot evaluation of black cohosh for the treatment of hot flashes in women. Cancer Invest 22 (2004) 515-521
55. Osmers R., Friede M., Liske E., Schnitker J., Freudenstein J., and Henneicke-von Zepelin H.H. Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms. Obstet Gynecol 105 (2005) 1074-1083
56. Frei-Kleiner S., Schaffner W., Rahlfs V.W., Bodmer C., and Birkhauser M. Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial. Maturitas 51 (2005) 397-404
57. Nappi R.E., Malavasi B., Brundu B., and Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 20 (2005) 30-35
58. Newton K.M., Reed S.D., Grothaus L., et al. The Herbal Alternatives for Menopause (HALT) study: background and study design. Maturitas 52 (2005) 134-146
59. Verhoeven M.O., van der Mooren M.J., van de Weijer P.H., et al., CuraTrial Research Group. Effect of a combination of isoflavones and Actaea racemosa Linnaeus on climacteric symptoms in healthy symptomatic perimenopausal women: a 12-week randomized, placebo-controlled, double-blind study. Menopause 12 (2005) 412-420
60. Smolinski D., Wollner D., Orlowski J., Curcio J., Nevels J., and Kim L.S. A pilot study to examine a combination botanical for the treatment of menopausal symptoms. J Altern Complement Med 11 (2005) 483-489
61. Schmidt M., Polasek W., and Kaufeler R. Wirksamkeit und Sicherheit von Traubensilberkerze (Cimicifuga racemosa, Cimifemin®) bei Menopausebeschwerden: therapiebeobachtung unter Praxisbedingungen. J Menopause 12 (2005) 27-32
62. Vermes G., Banhidy F., and Acs N. The effects of remifemin on subjective symptoms of menopause. Adv Ther 22 (2005) 148-154
63. Gurley B.J., Gardner S.F., Hubbard M.A., et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 77 (2005) 415-426
64. Briese V, Stammwitz U, Friede M, Stefenelly U, Hnneicke-von Zepelin HH. Climateric therapy without hormones: results of a current observational cohort study. Presented at: Annual meeting of the German Menopause-Society on June 17-18, 2005, Munster, Germany.
65. Julia M.D., Garcia Y., Cano A., Arriaza E., and Romeu A. A pilot study to assess changes in the quality of life in postmenopausal women after administration of Cimicifuga racemosa L., using the Cervantes scale. [abstract]. Climateric 8 (2005) 36
66. Fischer J, Bartsch HH, Mumm A, Salier R, Stammwitz U, Rostock M. Prospective observational cohort study with a Cimicifuga racemosa extract (Remifemin) in breast cancer patients with climateric complaints undr therapy with tamoxifen. Presented at: Annual meeting of the German Menopause-Society on June 17-18, 2005, Munster, Germany.
67. Henneicke-von Zepelin HH, Becher H, Schroder-Bernhardi D, Stammwith U. Pharmacoepidemiologic cohort study on the administration of Remifemin/Remifemin plus in patients with breast cancer, including hormone receptor-positive tumors. Presented at: Annual meeting of the German Menopause-Society on June 17-18, 2005, Munster, Germany.
68. Von Schoultz B, Henneicke-von Zepelin HH, Liske E, Friede M, Hirschberg A. Clinical study on the drug safety of Remifemin with regard to breast epithelium cell proliferation and mammographic breast tissue density in postmenopausal women. Presented at: Annual meeting of the German Menopause-Society on June 17-18, 2005, Munster, Germany.
69. Henneicke-von Zepelin H.H., Meden H., Schroder-Bernhardi D., Kostev K., and Becher H. Black cohosh and breast cancer recurrence-free survival. [abstract]. Maturitas 54 (2006) 58-59
70. Briese V., Stammwitz U., and Henneicke-von Zepelin H.H. One year treatment with isopropanolic black cohosh extract (iCR). [abstract]. Maturitas 54S (2006) 18S
71. Uebelhack R., Blohmer J.U., Graubaum H.J., Busch R., Gruenwald J., and Wernecke K.D. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstet Gynecol 107 (2006) 247-255
72. Bai W., Henneicke-von Zepelin H.H., Zheng S., et al. Black cohosh versus tibolone in menopausal symptoms relief in Chinese women. [abstract]. Maturitas 54 (2006) 17
73. Raus K., Brucker C., Gorkow C., and Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause 13 (2006) 678-691
74. Pockaj B.A., Gallagher J.G., Loprinzi C.L., et al. Phase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1. J Clin Oncol 24 (2006) 2836-2841
75. Wuttke W., Gorkow C., and Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Menopause 13 (2006) 185-196
76. Guiltinan J., Newton K., Reed S., LaCroix A., Grothaus L., and Ehrlich K. Results of the Herbal Alternatives for Menopause (HALT) study. Alterna Ther 12 (2006) 48-49
77. Gurley B.J., Barone G.W., Williams D.K., et al. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 34 (2006) 69-74
78. Gurley B., Hubbard M.A., Williams D.K., et al. Assessing the clinical significance of botanical supplementation on human cytochrome P450 3A activity: comparison of a milk thistle and black cohosh product to rifampin and clarithromycin. J Clin Pharmacol 46 (2006) 201-213
79. Newton K.M., Reed S.D., LaCroix A.Z., Grothaus L.C., Ehrlich K., and Guiltinan J. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med 145 (2006) 869-879
80. Radowicki S., Skorzewska K., Rudnicka E., Szlendak-Sauer K., and Wierzba W. Effectiveness and safety of the treatment of menopausal syndrome with Cimicifuga racemosa dry extract. Ginekol Pol 77 (2006) 678-683
81. Sammartino A., Tommaselli G.A., Gargano V., Di Carlo C., Attianese W., and Nappi C. Short-term effects of a combination of isoflavones, lignans and Cimicifuga racemosa on climacteric-related symptoms in postmenopausal women: a double-blind, randomized, placebo-controlled trial. Gynecol Endocrinol 22 (2006) 646-650
82. Hirschberg A.L., Edlund M., Svane G., Azavedo E., Skoog L., and Von Schoultz B. An isopropanolic extract of black cohosh does not increase mammographic breast density or breast cell proliferation in postmenopausal women. Menopause 14 (2007) 89-96
83. Zepelin H.H., Meden H., Kostev K., Schroder-Bernhardi D., Stammwitz U., and Becher H. Isopropanolic black cohosh extract and recurrence-free survival after breast cancer. Int J Clin Pharmacol Ther 45 (2007) 143-154
84. Verhoeven M.O., Teerlink T., Kenemans P., Zuijdgeest-Van Leeuwen S.D., and Van Der Mooren M.J. Effects of a supplement containing isoflavones and actaea racemosa l. on asymmetric dimethylarginine, lipids, and c-reactive protein in menopausal women. Fertil Steril 87 (2007) 849-857
85. Oktem M., Eroglu D., Karahan H.B., Taskintuna N., Kuscu E., and Zeyneloglu H.B. Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial. Adv Ther 24 (2007) 448-461
86. Chung D.J., Kim H.Y., Park K.H., et al. Black cohosh and St. John's wort (Gyno-Plus) for climacteric symptoms. Yonsei Med J 48 (2007) 289-294
87. Rebbeck T.R., Troxel A.B., Norman S., et al. A retrospective case-control study of the use of hormone-related supplements and association with breast cancer. Int J Cancer 120 (2007) 1523-1528
88. Briese V., Stammwitz U., Friede M., and Henneicke-Von Zepelin H.H. Black cohosh with or without St. John's Wort for symptom-specific climacteric treatment-results of a large-scale, controlled, observational study. Maturitas 57 (2007) 405-414
89. Van Der Sluijs C.P., Bensoussan A., Liyanage L., and Shah S. Women's health during mid-life survey: the use of complementary and alternative medicine by symptomatic women transitioning through menopause in Sydney. Menopause 14 (2007) 397-403
90. Spangler L., Newton K.M., Grothaus L.C., Reed S.D., Ehrlich K., and Lacroix A.Z. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas 57 (2007) 195-204
91. Bai W., Henneicke-Von Zepelin H.H., Wang S., et al. Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in chinese women with menopausal symptoms: a randomized, double blind, parallel-controlled study versus tibolone. Maturitas 58 (2007) 31-41
92. Anderson I.B., Mullen W.H., Meeker J.E., et al. Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of the literature. Ann Intern Med 124 (1996) 726-734
93. Whiting P.W., Clouston A., and Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 177 (2002) 440-443
94. Frempong W., Kiuru A., Ericsson J., and Farah M. Cimicifuga racemosa L Nutt (black cohosh) and anaphylactic reactions, including face and oral oedema. The Uppsala Monitoring Centre. www.who-ucm.org Accessed January 10, 2008
95. Ingraffea A., Donohue K., Wilkel C., and Falanga V. Cutaneous vasculitis in two patients taking an herbal supplement containing black cohosh. J Am Acad Dermatol 56 (2007) 124-126
96. Shuster J. ISMP adverse drug reactions. Hosp Pharm 31 (1996) 1553-1554
97. Lontos S., Jones R.M., Angus P.W., and Gow P.J. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 179 (2003) 390-391
98. Cohen S.M., O'Connor A.M., Hart J., Merel N.H., and Te H.S. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 11 (2004) 575-577
99. Levitsky J., Alli T.A., Wisecarver J., and Sorrell M.F. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 50 (2005) 538-539
100. Lynch C.R., Folkers M.E., and Hutson W.R. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl 12 (2006) 989-992
101. Minciullo P.L., Saija A., Patafi M., Marotta G., Ferlazzo B., and Gangemi S. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 13 (2006) 115-118
102. Meyer S., Vogt T., Obermann E.C., Landthaler M., and Karrer S. Cutaneous pseudolymphoma induced by Cimicifuga racemosa. Dermatology 214 (2007) 94-96
103. Dunbar K., and Solga S.F. Black cohosh, safety, and public awareness. Liver Int 27 (2007) 1017-1018
104. Order and Judgement 8: 05 CV 66, Grant and Beck vs Pharmavite LLC. United States District Court for the District of Nebraska. September 8, 2006.
105. Amercian Herbal Products Association. Press release: US District Court dismisses experts and lawsuit in black cohosh complaint. September 18, 2006.
106. Blumenthal M., Ferrier G.K.L., and Cavaliere C. Total sales of herbal supplements in United States show steady growth. HerbalGram 71 (2006) 64-66
107. Engel W. In vivo studies on the metabolism of the monoterpene pulegone in humans using the metabolism of ingestion-correlated amounts (MICA) approach: explanation for the toxicity differences between (S)-(-)- and (R)-(+)-pulegone. J Agric Food Chem 51 (2003) 6589-6597
108. Nelson S.D. Mechanisms of the formation and disposition of reactive metabolites that can cause acute liver injury. Drug Metab Rev 27 (1995) 147-177
109. Chatterjee P., and Franklin M.R. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 31 (2003) 1391-1397
110. Gordon E., and Devinsky O. Alcohol and marijuana: effects on epilepsy and use by patients with epilepsy. Epilepsia 42 (2001) 1266-1272
111. Miller L.G. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 158 (1998) 2200-2211
112. Thomsen M., Vitetta L., Sali A., and Schmidt M. Acute liver failure associated with the use of herbal preparations containing black cohosh. Med J Aust 180 (2004) 598-599
113. Thomsen M., and Schmidt M. Hepatotoxizität durch Cimicifuga racemosa?. Z Phytother 24 (2003) 11-14
114. Bone K. Phytotherapy review and commentary. Townsend Letter for Doctors and Patients (2006) 66-70 July
115. Freudenstein J., Dasenbrock C., and Nisslein T. Lack of promotion of estrogen-dependent mammary gland tumors in vivo by an isopropanolic Cimicifuga racemosa extract. Cancer Res 62 (2002) 3448-3452
116. Bodinet C., and Freudenstein J. Influence of Cimicifuga racemosa on the proliferation of estrogen receptor-positive human breast cancer cells. Breast Cancer Res Treat 76 (2002) 1-10
117. Hostanska K., Nisslein T., Freudenstein J., Reichling J., and Saller R. Evaluation of cell death caused by triterpene glycosides and phenolic substances from Cimicifuga racemosa extract in human MCF-7 breast cancer cells. Biol Pharm Bull 27 (2004) 1970-1975
118. Stromeier S., Petereit F., and Nahrstedt A. Phenolic esters from the rhizomes of Cimicifuga racemosa do not cause proliferation effects in MCF-7 cells. Planta Med 71 (2005) 495-500
119. Stute P., Nisslein T., Gotte M., Kamischke A., Kiesel L., and Klockenbusch W. Effects of black cohosh on estrogen biosynthesis in normal breast tissue in vitro. Maturitas 57 (2007) 382-391
120. Nisslein T., and Freudenstein J. Concomitant administration of an isopropanolic extract of black cohosh and tamoxifen in the in vivo tumor model of implanted RUCA-I rat endometrial adenocarcinoma cells. Toxicol Lett 150 (2004) 271-275
121. Hostanska K., Nisslein T., Freudenstein J., Reichling J., and Saller R. Cimicifuga racemosa extract inhibits proliferation of estrogen receptor-positive and negative human breast carcinoma cell lines by induction of apoptosis. Breast Cancer Res Treat 84 (2004) 151-160
122. Einbond L.S., Shimizu M., Nuntanakorn P., et al. Actein and a fraction of black cohosh potentiate antiproliferative effects of chemotherapy agents on human breast cancer cells. Planta Med 72 (2006) 1200-1206
123. Einbond L.S., Su T., Wu H.A., et al. The growth inhibitory effect of actein on human breast cancer cells is associated with activation of stress response pathways. Int J Cancer (2007) Epub ahead of print
124. Einbond L.S., Su T., Wu H.A., et al. Gene expression analysis of the mechanisms whereby black cohosh inhibits human breast cancer cell growth. Anticancer Res 27 (2007) 697-712
125. Rockwell S., Liu Y., and Higgins S.A. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat 90 (2005) 233-239
126. Tsukamoto S., Aburatani M., and Ohta T. Isolation of CYP3A4 inhibitors from the black cohosh (Cimicifuga racemosa). Evid Based Complement Alternat Med 2 (2005) 223-226