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Health Canada is Advising
Consumers About a Possible Link Between Black
Cohosh and Liver Damage
August 18, 2006
Health Canada
is advising consumers about a possible link between
health products containing the herbal medicine
black cohosh and liver damage.
Black cohosh, also known as Actaea
racemosa or Cimicifuga racemosa, is a herbal remedy
that is often used to relieve menopausal and premenstrual
symptoms. Common names for black cohosh include
black snakeroot, black bugbane and rheumatism
weed. Black cohosh is available either as a single
ingredient product or in products that contain
other herbs.
There have been a number of international
case reports of liver damage suspected to be associated
with the use of black cohosh, including three
case reports in Canada and one published case
of death in the United States. Most of these cases
involved other medical problems and the use of
other medications that may have contributed to
the liver damage. The quality of the black cohosh
products involved in these cases is not known.
While case reports of liver damage
are rare and the link between black cohosh and
liver toxicity is unclear, Health Canada is taking
a precautionary approach and is currently reviewing
the safety and effectiveness of black cohosh.
To safeguard the health ofCanadians in the interim,
Health Canada is advising consumers and health
care practitioners of the following:
Consumers should exercise caution
in the use of products containing black cohosh,
and consult a health care practitioner if they
have concerns about its use.
Consumers should discontinue the use of products
containing black cohosh and consult a physician
if they have unusual fatigue, weakness, loss of
appetite, or if they develop symptoms suggestive
of liver injury such as yellowing of the skin
or whites of the eyes, dark urine or abdominal
pain. Canadian health care practitioners and consumers
will be advised if further precautionary measures
are necessary.
To report a suspected adverse reaction,
please contact the Canadian Adverse Drug Reaction
Monitoring Program (CADRMP) of Health Canada by
one of the following methods:
Telephone: 866-234-2345
Facsimile: 866-678-6789
CADRMP
Marketed Health Products Directorate
Health Protection Building, Tunney's Pasture,
AL 0701C Ottawa, Ontario K1A 0K9
Email: cadrmp@hc-sc.gc.ca
Consumers requiring more information
about this advisory can contact the Health Canada
public inquiries line at (613) 957-2991, or toll
free at 1-866-225-0709.
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