Drug Interaction Report

Talk to your doctor before using black cohosh together with disulfiram. 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 disulfiram may increase that risk. 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, dark-colored urine, light-colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. In addition, tincture (liquid) preparations of black cohosh may contain large amounts of alcohol. Since disulfiram can affect the breakdown of alcohol, using the tincture may lead to what is known as a "disulfiram reaction". This condition produces unpleasant side effects such as flushing, throbbing in head and neck, throbbing headache, difficulty breathing, nausea, vomiting, sweating, thirst, chest pain, fast or pounding heartbeats, low blood pressure, dizziness, lightheadedness, blurred vision, and confusion. More severe reactions may include heart attack, heart failure, unconsciousness, and convulsions. Do not drink alcohol while you are being treated with disulfiram. Always check your food and medicine labels to be sure those products do not contain alcohol. 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.

You should not drink alcoholic beverages or use medicines that contain ethanol (alcohol) during treatment with disulfiram. This can cause flushing, nausea and vomiting, blurred vision, shortness of breath, rapid heart beat, and low blood pressure. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor.