Overdose has produced nausea and vomiting, vertigo and visual disturbances. IDIOSYNCRATIC HEPATIC REACTIONS

In February 2006 the TGA announced that based on the appraisal of case reports, a causal association between black cohosh and serious hepatitis exists; however, the incidence is very low considering its widespread use. As a result, products available in Australia containing black cohosh will have to carry label warnings informing consumers of the risk by 2007.

The conclusion made by the TGA is considered controversial by some experts because numerous confounding factors were present in many of the case reports, such as the use of multiple ingredient preparations, concurrent use of at least one pharmaceutical medicine and the presence of other medical conditions.

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