Actée à Grappes Bleu, Blue Ginseng, Caulophylle, Caulophylle Faux-Pigamon, Caulophyllum, Caulophyllum thalictroides, Cohosh Azul, Cohosh Bleu, Graines à Chapelet, Léontice Faux-Pigamon, Papoose Root, Cohosh Azul, Squaw Root, Yellow Ginseng.


Overview Information

Blue cohosh is a plant. "Cohosh" is from the Algonquin Indian word meaning "rough," and it refers to the appearance of the roots. The root is used to make medicine. Blue cohosh is not a safe plant. However, it still is available as a supplement. Sometimes the supplements do not include warnings.

Blue cohosh is used for stimulating the uterus and starting labor; starting menstruation; stopping muscle spasms; as a laxative; and for treating colic, sore throat, cramps, hiccups, epilepsy, hysterics, inflammation of the uterus, infection of the female organs (pelvic inflammatory disease), over-growth of uterine tissue (endometriosis), and joint conditions.

In foods, the roasted seeds of blue cohosh are used as a coffee substitute.

How does it work?

It is thought that blue cohosh might have effects similar to the hormone estrogen. It also may narrow the vessels that carry blood to the heart that can decrease oxygen in the heart.


Uses & Effectiveness?

Insufficient Evidence for

More evidence is needed to rate the effectiveness of blue cohosh for these uses.

Side Effects

Side Effects & Safety

Blue cohosh is LIKELY UNSAFE for adults when taken by mouth. It can cause diarrhea, stomach cramps, chest pain, increased blood pressure, increased blood sugar, and other severe side effects.

Special Precautions & Warnings:

Pregnancy and breast-feeding: It is LIKELY UNSAFE to take blue cohosh by mouth during pregnancy. Some of the chemicals in blue cohosh can cause birth defects. When taken by the mother late in pregnancy, blue cohosh can cause severe heart problems in the newborn baby. It can also be toxic to the mother.

Many midwives still use blue cohosh to make childbirth easier, because blue cohosh causes the uterus to contract. But this is a dangerous practice, and it should be avoided.

Heart conditions: There is concern that blue cohosh might worsen some heart conditions. These conditions include chest pain (angina) and high blood pressure. Blue cohosh might cause blood vessels in the heart to become smaller and decrease oxygen flow to the heart. It might also increase blood pressure and cause rapid heartbeat. Don't use blue cohosh if you have a heart condition.

Diabetes: There is some concern that blue cohosh might make diabetes worse. It can raise blood sugar levels in some people who have diabetes.

Diarrhea: Blue cohosh might make diarrhea symptoms worse.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Blue cohosh might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use blue cohosh.



Moderate Interaction

Be cautious with this combination

  • Medications for diabetes (Antidiabetes drugs) interacts with BLUE COHOSH

    Blue cohosh might increase blood sugar. Diabetes medications are used to lower blood sugar. By increasing blood sugar, blue cohosh might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
    Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

  • Medications for high blood pressure (Antihypertensive drugs) interacts with BLUE COHOSH

    Blue cohosh seems to increase blood pressure. By increasing blood pressure blue cohosh might decrease the effectiveness of medications for high blood pressure.
    Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

  • Nicotine interacts with BLUE COHOSH

    Blue cohosh contains chemicals that work similarly to nicotine. Taking blue cohosh with nicotine might increase the effects and side effects of nicotine.



The appropriate dose of blue cohosh depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for blue cohosh. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

View References


  • Ganzera, M., Dharmaratne, H. R., Nanayakkara, N. P., and Khan, I. A. Determination of saponins and alkaloids in Caulophyllum thalictroides (blue cohosh) by high-performance liquid chromatography and evaporative light scattering detection. Phytochem.Anal. 2003;14(1):1-7. View abstract.
  • Gunn, T. R. and Wright, I. M. The use of black and blue cohosh in labour. N.Z Med J 10-25-1996;109(1032):410-411. View abstract.
  • Jhoo, J. W., Sang, S., He, K., Cheng, X., Zhu, N., Stark, R. E., Zheng, Q. Y., Rosen, R. T., and Ho, C. T. Characterization of the triterpene saponins of the roots and rhizomes of blue cohosh (Caulophyllum thalictroides). J.Agric.Food Chem. 2001;49(12):5969-5974. View abstract.
  • Kennelly, E. J., Flynn, T. J., Mazzola, E. P., Roach, J. A., McCloud, T. G., Danford, D. E., and Betz, J. M. Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. J.Nat.Prod. 1999;62(10):1385-1389. View abstract.
  • Low, D. T. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
  • Rao, R. B. and Hoffman, R. S. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222. View abstract.
  • Scott, C. C. and Chen, K. K. The pharmacological action of N-methylcytisine. The Journal of Pharmacology and Experimental Therapuetics 1943;79:334-339.
  • Baillie N, Rasmussen P. Black and blue cohosh in labour. N Z Med J 1997;110:20-1.
  • Datta S, Mahdi F, Ali Z, et al. Toxins in botanical dietary supplements: blue cohosh components disrupt cellular respiration and mitochondrial membrane potential. J Nat Prod. 2014;77(1):111-7. View abstract.
  • Dugoua JJ, Perri D, Seely D, et al. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. Can J Clin Pharmacol. 2008;15(1):e66-73. View abstract.
  • Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
  • Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int Midwife 1999;52:34-5. View abstract.
  • Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  • Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004;351:302-3. View abstract.
  • Gunn TR, Wright IM. The use of black and blue cohosh in labour. N Z Med J 1996;109:410-1.
  • Irikura B, Kennelly E. American Health Consultants. Blue Cohosh: a word of caution. 1999. Available at:
  • Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2. View abstract.
  • Lee Y, Jung JC, Ali Z, et al. Anti-Inflammatory Effect of Triterpene Saponins Isolated from Blue Cohosh (Caulophyllum thalictroides). Evid Based Complement Alternat Med. 2012;2012:798192. View abstract.
  • Madgula VL, Ali Z, Smillie T, et al. Alkaloids and saponins as cytochrome P450 inhibitors from blue cohosh (Caulophyllum thalictroides) in an in vitro assay. Planta Med. 2009;75(4):329-32. View abstract.
  • McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery 1999;44:205-16. View abstract.
  • Rader JI, Pawar RS. Primary constituents of blue cohosh: quantification in dietary supplements and potential for toxicity. Anal Bioanal Chem. 2013;405(13):4409-17. View abstract.
  • Reichert, R. Neonatal congestive heart failure associated with maternal use of blue cohosh. Quarterly Review of Natural Medicine 1998;Winter:265-267.
  • Sirtori CR, Triolo M, Bosisio R, et al. Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals. Br J Nutr 2012;107:1176-83. View abstract.
  • Wright IM. Neonatal effects of maternal consumption of blue cohosh. J Pediatr 1999;134:384-5. View abstract.

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