Black cohosh and other herbal remedies associated with acute hepatitis

Peter W Whiting, Andrew Clouston and Paul Kerlin
Med J Aust 2002; 177 (8): 440-443.

Six patients presented with clinical, biochemical and histological evidence of severe hepatitis after taking herbal remedies. One patient required urgent liver transplantation for fulminant hepatic failure after the brief use of black cohosh. Five patients took a combination of herbs and presented with jaundice, fatigue and pruritus. Healthcare providers and members of the public should be aware of the potential adverse effects of these remedies. (MJA 2002; 177: 432-435)

There has been a steady rise in the use of complementary medicine throughout the world. In 1997 it was estimated that 57% of Australians used complementary medicines, with an annual expenditure of $621 million.1,2 Self-medication is common, with 62%–72% of patients not disclosing the use of herbal preparations to their family doctors.3 This reluctance may be due to a perceived conflict between practitioners of conventional and alternative medicine.

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  • Peter W Whiting1
  • Andrew Clouston2
  • Paul Kerlin3

  • Princess Alexandra Hospital, Woolloongabba, QLD.


Competing interests:

None identified.

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