Black Cohosh: Safety Information for Cocktails

Black cohosh/black bugbane/black snakeroot/fairy candle/rattleweed/macrotys/rheumatism weed 

This plant is used in herbal medicine and recommended to be used with label warnings. The United States FDA does not list it in their "Substances added to food" list. Given the list of complications of using the plant, it does not seem advisable to use this plant in cocktails. 

According to the US National Institutes of Health [link]:

• Today, black cohosh is most commonly used for menopausal symptoms, including hot flashes (also called hot flushes) and night sweats (together known as vasomotor symptoms), vaginal dryness, heart palpitations, tinnitus, vertigo, sleep disturbances, nervousness, and irritability.
• Preparations of black cohosh are made from its roots and rhizomes (underground stems). They are sold as dietary supplements in such forms as powdered whole herb, liquid extracts, and dried extracts in pill form.
• In 2007, the Australian Department of Health began requiring that products containing black cohosh carry the following label statement: “Warning: Black cohosh may harm the liver in some individuals. Use under the supervision of a healthcare professional”.
• In 2008, the U.S. Pharmacopeia (a nonprofit standard-setting organization for foods and drugs) recommended labeling black cohosh products with the following cautionary statement: “Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice”. However, the U.S. Food and Drug Administration does not require such a warning on black cohosh product labels.

The plant is often mis-identified when harvesting.