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Black CohoshAka: Cimicifuga racemosa, Remifemin

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  1. Mechanism
    1. Native North American plant
    2. Plant root contains Estrogenic steroids
      1. Triterpene glycosides (acetin, cimicifugoside)
      2. Isoflavonoid formononetin
    3. Effects
      1. Weak Estrogenic effects
        1. Some studies suggest no effect on uterus or vagina
      2. Anti-Estrogen effects
        1. Anti-proliferative effects on Breast Cancer cells
      3. Decreases leuteinizing hormone (LH) levels
      4. Oxytocin-like effect in pregnancy (contractions)
  2. Current Use
    1. Menopausal symptoms
      1. Post-menopausal Hot Flushes
      2. Insomnia
      3. Mood disturbance
    2. Dysmenorrhea
  3. Contraindications
    1. Pregnancy (due to uterine contractions)
    2. Use caution if risk factors for Breast Cancer
      1. Black Cohosh has unclear effect on Breast Cancer risk
  4. Efficacy
    1. No rigorous RCT studies to show efficacy to date
  5. Adverse Effects
    1. Gastrointestinal intolerance (Nausea, discomfort)
    2. Headache
    3. Dizziness
    4. Weight gain
  6. Cost
    1. Monthly: $12 to $30
  7. Dosing
    1. Remifemin (Standardized 1 mg terpene per 20 mg tablet)
      1. Typical dose: Two 20 mg tablets bid
      2. Effects anticipated at 2-4 weeks after starting
  8. References
    1. Jarry (1985) Planta Medica 4:316-9
    2. Rand (2001) CMEA Medicine Lecture, San Diego
    3. Kligler (2003) Am Fam Physician 68(1):114
    4. Morelli (2002) Am Fam Physician 66(1):129

Remifemin (C0650355)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121) , Biologically Active Substance (T123)
MSHC073419
EnglishRemifemin
SourcesMSH, NCI, PDQ
Derived from the NIH UMLS (Unified Medical Language System)


Black Cohosh Extract (C0771967)

Definition (PDQ)A triterpene-containing herb isolated from the roots and rhizomes of the plant Cimicifuga racemosa (also known as Actaea racemosa). While the mechanism of action of black cohosh is not completely understood, it appears to act as a selective estrogen receptor modulator. In vitro, this preparation has been shown to induce cell cycle arrest and caspase-dependent apoptosis of estrogen-sensitive breast cancer cells. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=302635&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=302635&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C26647" NCI Thesaurus)
Definition (NCI)A triterpene-containing herb isolated from the roots and rhizomes of the plant Cimicifuga racemosa (also known as Actaea racemosa). While the mechanism of action of black cohosh is not completely understood, it appears to act as a selective estrogen receptor modulator. In vitro, this preparation has been shown to induce cell cycle arrest and caspase-dependent apoptosis of estrogen-sensitive breast cancer cells. (NCI04)
ConceptsPharmacologic Substance (T121)
EnglishBlack cohosh, Black Cohosh Extract, BLACK COHOSH EXTRACT PREPARATION, Black cohosh preparation, Cimicifuga racemosa extract, Cimicifuga racemosa preparation
Spanishextracto de cimicifuga, extracto de Cimicifuga racemosa, extracto de raiz de culebra negra, preparacion con Cimicifuga racemosa
Parent ConceptsDietary Supplements (C0242295), Black Cohosh Extract (C0771967), Unclassified Ingredients (C1372954), Unclassified Ingredient Preparations (C1377282), Medicinal Herbs (C0025125), Plant product (C0032088), Over the counter healthfood/herbal products (C0361218), Drug allergen (C1320237), Herbal medicine agent (C1636187)
SourcesMTH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Cimicifuga racemosa (C0885226)

ConceptsPlant (T002)
MSHD031885
EnglishActaea racemosa, Black Cohosh, Cimicifuga racemosa
Parent ConceptsCimicifuga (C1082955)
SourcesMSH, MTH, NCBI
Derived from the NIH UMLS (Unified Medical Language System)



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