Black Cohosh and Motrin Tablets
Determining the interaction of Black Cohosh and Motrin Tablets and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Talk to your doctor before using ibuprofen together with black cohosh. Products containing black cohosh have been reported to cause liver damage in rare cases, and taking it with other medications that can also affect the liver such as ibuprofen may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Professional:GENERALLY AVOID: Concomitant use of black cohosh (Cimicifuga racemosa rhizome) with other agents that are known to induce hepatotoxicity may theoretically increase the risk of liver injury. Black cohosh has been suspected in rare cases of liver toxicity ranging from abnormal liver function tests and jaundice to various forms of hepatitis and hepatic failure requiring transplantation. The onset has typically been within the first 3 months after initiation of black cohosh. Although approximately half of the cases resulted in hospitalization, most improved or resolved following discontinuation of the product. Many of the cases were not well documented with respect to the specific herbal formulation and dose used or timeframe of treatment in relation to onset of reaction, or they were complicated by multiple confounding factors. Some of the cases also involved products containing multiple herbal or other medicinal substances. Nevertheless, the European Medicines Agency (EMEA) and the Committee on Herbal Medicinal Products (HMPC) reviewed 42 such cases and released an assessment statement in 2006 indicating a potential connection between products containing Cimicifuga racemosa rhizome and human hepatotoxicity. The Medicines and Healthcare products Regulatory Agency (MHRA) in the U.K. also issued an assessment report supporting a causal association after reviewing data from over 40 cases received through their reporting system and similar systems in other countries, as well as in the published literature. Hepatotoxicity warnings are currently required on products containing black cohosh marketed in many European countries and Australia.
MANAGEMENT: Until more information is available, patients should consider avoiding the use of black cohosh if they are receiving other potentially hepatotoxic agents (e.g., acetaminophen; alcohol; androgens and anabolic steroids; antituberculous agents; azole antifungal agents; ACE inhibitors; cyclosporine (high dosages); disulfiram; endothelin receptor antagonists; interferons; ketolide and macrolide antibiotics; kinase inhibitors; minocycline; nonsteroidal anti-inflammatory agents; nucleoside reverse transcriptase inhibitors; proteasome inhibitors; retinoids; sulfonamides; tamoxifen; thiazolidinediones; tolvaptan; vincristine; zileuton; anticonvulsants such as carbamazepine, hydantoins, felbamate, and valproic acid; lipid-lowering medications such as fenofibrate, lomitapide, mipomersen, niacin, and statins; other herbals and nutritional supplements such as chaparral, comfrey, DHEA, kava, pennyroyal oil, and red yeast rice). Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice.
- Whiting PW, Clouston A, Kerlin P "Black cohosh and other herbal remedies associated with acute hepatitis." Med J Aust 177 (2002): 440-3
- Low Dog T "Menopause: a review of botanical dietary supplements." Am J Med 118(12 Suppl 2) (2005): 98-108
- Therapeutic Research Faculty "Natural Medicines Comprehensive Database. Available from: URL: http://www.naturaldatabase.com." ([1995-2008...]):
- MHRA UKPAR "Black Cohosh: UK Public Assessment Report. Available from: URL: http://www.mhra.gov.uk/home/groups/es-herbal/documents/websiteresources/con2024279.pdf." ([cited 2008]):
- Lee WM "Drug-induced hepatotoxicity." N Engl J Med 349 (2003): 474-85
- Westphal JF, Vetter D, Brogard JM "Hepatic side-effects of antibiotics." J Antimicrob Chemother 33 (1994): 387-401
Generic Name: ibuprofen
Brand name: Motrin, Advil, Advil Liqui-Gels, Midol, Motrin IB, Motrin Migraine Pain, Proprinal, Smart Sense Children's Ibuprofen, PediaCare Children’s Pain Reliever/Fever Reducer, PediaCare Infant’s Pain Reliever/Fever Reducer, Caldolor, NeoProfen, Genpril, Ibu, Midol IB, Children's Motrin, Motrin Junior Strength
Synonyms: Motrin
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
- Black Cohosh-Movantik
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- Black Cohosh-Moxetumomab pasudotox
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- Black Cohosh-Moxetumomab pasudotox-tdfk Intravenous
- Motrin Tablets-Black Draught
- Motrin Tablets-Blenoxane
- Motrin Tablets-Bleo 15k
- Motrin Tablets-Bleomycin
- Motrin Tablets-Bleomycin Injection
- Motrin Tablets-Bleomycin Sulfate