Concern that black cohosh, a popular alternative to prescription hormonal therapy for treating menopausal symptoms, can cause liver toxicity has prompted agencies in the U.K. and Australia to require manufacturers to add safety warnings to their labels.

Philip Routledge, chair of the U.K. Herbal Medicines Advisory Committee, said the association between black cohosh consumption and liver disorders was rare but “can be serious.”

Black cohosh products sold in Australia are required to carry the following statement: “Warning: Black cohosh may harm the liver in some individuals. Use under the supervision of a healthcare professional.”

Liver damage and liver failure have been reported with the use of black cohosh containing products, with liver transplantation required in some patients. This blog reported on this previously. Safety and efficacy data for black cohosh beyond six months are not available.

7/26/06 09:28 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.