Pronunciation: BLEW KOE hawsh

What is the most important information I should know about blue cohosh?

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is blue cohosh?

Blue cohosh is a plant also known as Actée à Grappes Bleu, Blue Ginseng, Caulophylle, Caulophyllum, Cohosh Azul, Cohosh Bleu, Graines à Chapelet, Léontice Faux-Pigamon, Papoose Root, Squaw Root, or Yellow Ginseng.

Blue cohosh has been used in alternative medicine as an aid in stimulating the uterus in pregnant women to induce labor, or in non-pregnant women to cause a menstrual period. However, these uses have not been proven with research and blue cohosh may not be effective when used for these conditions.

Other uses not proven with research have included seizure (convulsions), stomach cramps, constipation, sore throat, hiccups, and other conditions.

It is not certain whether blue cohosh is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Blue cohosh should not be used in place of medication prescribed for you by your doctor.

Blue cohosh is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Blue cohosh may also be used for purposes not listed in this product guide.

What should I discuss with my health care provider before taking blue cohosh?

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

  • heart disease, angina (chest pain);
  • high blood pressure;
  • diabetes;
  • a history of endometriosis or uterine fibroids; or
  • past or present cancer of the breast, uterus, or ovary.

Blue cohosh is considered likely unsafe to use during pregnancy. Some of the chemicals in blue cohosh can cause birth defects. Do not use this product without medical advice if you are pregnant.

It is not known whether blue cohosh passes into breast milk or if it could harm a nursing baby. Do not use this product without medical advice if you are breast-feeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

How should I take blue cohosh?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use blue cohosh, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Call your doctor if the condition you are treating with blue cohosh does not improve, or if it gets worse while using this product.

Standardized extracts, tinctures, and solid formulations of herbal/health supplements may provide a more reliable dose of the product.

Take the pill forms of blue cohosh with a full glass of water.

To ensure the correct dose, measure the liquid forms of blue cohosh with a dropper or a dose-measuring spoon or cup.

Some forms of blue cohosh can be brewed to form a tea for drinking.

Do not use different formulations (e.g., tablets, liquids, teas, and others) of blue cohosh at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose of blue cohosh.

Store blue cohosh as directed on the package. In general, blue cohosh should be protected from light and moisture.

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra blue cohosh to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking blue cohosh?

Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.

What are the possible side effects of blue cohosh?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using blue cohosh and call your doctor at once if you have:

  • new or worsening chest pain;
  • pale skin, blue lips or fingernails;
  • a light-headed feeling, like you might pass out;
  • high blood sugar --increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or
  • dangerously high blood pressure --severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats.

Common side effects may include:

  • diarrhea, stomach pain;
  • chest pain;
  • increased blood pressure; or
  • increased blood sugar.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect blue cohosh?

Do not take blue cohosh without medical advice if you are using any of the following medications:

  • blood pressure medicine; or
  • insulin or oral diabetes medicine.

This list is not complete. Other drugs may interact with blue cohosh, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this product guide.

Where can I get more information?

Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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