Black cohosh and other herbal remedies associated with acute hepatitis

Luis Vitetta, Michael Thomsen and Avni Sali
Med J Aust 2003; 178 (8): . || doi: 10.5694/j.1326-5377.2003.tb05264.x
Published online: 21 April 2003

To the Editor: We wish to comment on the article by Whiting and colleagues1 on the proposed causal relationship between herbal remedies and severe acute hepatitis.


  • 1. Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Med J Aust 2002; 177: 440-443. <eMJA full text>
  • 2. Ernst E, Pittler MH. Risks associated with herbal medicinal products. Wien Med Wochenschr 2002; 152: 183-189.
  • 3. Fugh-Berman A. Herb–drug interactions. Lancet 2000; 355: 134-138.
  • 4. Corrigan D. Adverse reports — some first principles. Eur PhytoJournal 2001; 1. Available at: (accessed Mar 2003)
  • 5. Nortier JL, Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N Engl J Med 2000; 342: 1686-1692.
  • 6. Walker AM, Cavanaugh RJ. The occurrence of new hepatic disorders in a defined population. Post Marketing Surveillance 1992; 1: 107-111.
  • 7. Fasel-Felley J, Peitrequin R, Frei PC. Absence of circulating HBsAg in acute hepatitis B. Infection 1984; 12: 202-204.
  • 8. Lieberman S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause. J Womens Health 1998; 7: 525-529.


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