Black cohosh has been used for symptoms of menopause (such as hot flashes).

Some herbal/diet supplement products have been found to contain possibly harmful impurities/additives. Check with your pharmacist for more details about the brand you use.

The FDA has not reviewed this product for safety or effectiveness. Consult your doctor or pharmacist for more details.

Take this product by mouth as directed. Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

This herbal product should not be used for more than 6 months.

If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away.

Headache, stomach upset, nausea, vomiting, weight gain, vaginal spotting/bleeding, and dizziness may occur. If any of these effects last or get worse, contact your doctor promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Tell your doctor right away if you have any serious side effects, including:

• muscle pain/weakness

This product may rarely cause serious (possibly fatal) liver disease. Stop taking this product and consult your doctor right away if you develop symptoms of liver injury, including nausea that doesn't stop, loss of appetite, unusual tiredness, stomach/abdominal pain, pale stools, dark urine, yellowing eyes/skin.

A very serious allergic reaction to this product is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking black cohosh, tell your doctor or pharmacist if you are allergic to it; or to salicylates (such as aspirin); or if you have any other allergies. This product contains salicylates. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

If you have any of the following health problems, consult your doctor or pharmacist before using this product:

• hormone-sensitive cancer (such as breast, ovarian, endometrial)
• high risk of breast cancer
• clotting problems (such as protein S deficiency, stroke)
• heart problems (such as heart attack, heart failure)
• high blood pressure
• liver problems
• problems of the uterus (such as endometriosis, fibroids)

This product may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Liquid preparations of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Black cohosh is not recommended for use during pregnancy. It may cause premature labor. Consult your doctor before using this product.

It is unknown if this product passes into breast milk. Breastfeeding is not recommended while using this product. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some drugs that may interact with this product include:

• cisplatin
• warfarin

Check the labels on all your pain relievers/fever reducers because they may contain aspirin (which is like an ingredient in this product). If your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: slow heartbeat, vision problems, severe dizziness, increased sweating, seizure.

Tell your doctor that you are taking black cohosh. Lab and/or medical tests (such as liver function) may be done while you are taking this product. Keep all medical and lab appointments.

Check product labeling carefully. Some products may contain a combination of both black and blue cohosh. Blue cohosh has different effects and is used for different purposes.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist. Keep all medications and herbal products away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.