ArticleCurrent drug safety2010
Fukinolic acid derivatives and triterpene glycosides from black cohosh inhibit CYP isozymes, but are not cytotoxic to Hep-G2 cells in vitro.
Article in Current drug safety, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 39 citations in OpenAlex.
- Review of black cohosh-induced toxicity and adverse clinical effects.Journal of environmental science and health. Part C, Toxicology and carcinogenesis · 2025Review
- Hepatotoxicity of Herbal Supplements Mediated by Modulation of Cytochrome P450.International journal of molecular sciences · 2017Review
- Research and Development ofEvidence-based complementary and alternative medicine : eCAM · 2017Review
- Nitrogen-Containing Constituents of Black Cohosh: Chemistry, Structure Elucidation, and Biological Activities.Recent advances in phytochemistry · 2015Article
- Cytochrome P450 enzyme mediated herbal drug interactions (Part 2).EXCLI journal · 2014Review
- Drug interactions with herbal medicines.Clinical pharmacokinetics · 2012Review
- Variable inhibitory effect of herbal supplements of different brands on human P450 CYP1A2.EXCLI journal · 2012Article
- In vitro metabolic interactions between black cohosh (Cimicifuga racemosa) and tamoxifen via inhibition of cytochromes P450 2D6 and 3A4.Xenobiotica; the fate of foreign compounds in biological systems · 2011Article
- Pregnane X receptor-mediated induction of Cyp3a by black cohosh.Xenobiotica; the fate of foreign compounds in biological systems · 2011Article
- Estrogenic and serotonergic butenolides from the leaves of Piper hispidum Swingle (Piperaceae).Journal of ethnopharmacology · 2010Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
Black cohosh (Actaea racemosa L. [syn. Cimifuga racemosa L.]) extracts (BCE) are marketed worldwide for the management of menopausal symptoms. However, recently more than 75 cases of hepatotoxicity associated with black cohosh ingestion have been reported. While these cases have not been fully substantiated for causality, the data suggest that herb-drug interactions may be involved rather than a direct hepatotoxic event. This work describes the in vitro inhibition of four CYP450 enzymes (1A2, 2D6, 2C9, 3A4) by black cohosh extracts and identifies the active inhibitory constituents. Ethanol extracts (75 and 80% ethanol) and a 40% isopropanol extract induced a concentration-dependent inhibition of all CYP450 isozyme activities, with median inhibitory concentrations (IC(50)) ranging from 21.9 microg/ml to 65.0 microg/ml. Isolation of the active chemical constituents, showed that the triterpene glycosides were weakly active (IC(50) 25-100 microM), while fukinolic acid and cimicifugic acids A and B strongly inhibited all CYP isozymes (IC(50) 1.8-12.6 microM). None of the extracts inhibited the growth of Hep-G2 cells in concentrations up to 50 microg/ml. These data suggest that BCEs are not directly hepatotoxic, but may have the potential to induce herb-drug interactions, which may in turn explain the rare cases of hepatotoxicity observed in women using multiple medications and dietary supplements, including black cohosh.
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