Black Cohosh Dosage


Most of the clinical studies that relate to black cohosh dosage have used Remifemin,  a standardized extract that contains triterpene glycosides calculated at 27-deoxyactein (1 mg/tablet).  The usual dosage has been 2 tablets,  twice a day,  equivalent to 4 mg triterpene glycosides per day.  A black cohosh dosage up to 3 times this amount has been used in some studies.

Recent statements from the makers of Remifemin state that half of the normal dosage is just as effective (1 tablet/day instead of 2),  for a total of 2 mg triterpene glycosides per day.

An important thing to keep in mind is that black cohosh dosage can vary quite a bit, and when using a standardized black cohosh extract,  you should always follow the instructions provided by the manufacturer,  or consult a doctor specially trained in holistic and herbal therapies.  Remifemin is also available in a liquid extract.  40 drops are equivalent to 40 mg of the herbal drug and contain in total 2 mg triterpene glycosides,  the same as 2 tablets.  Most studies using the liquid form of the black cohosh extract used 40 drops twice a day for a total daily dose equal to 80 mg of the herbal extract,  and containing 4 mg triterpene glycosides.

It was reported in a randomized,  double blind clinical study that a special isopropanolic black cohosh extract from the rootstock showed similar effectiveness from a dosage of 40 mg daily as was observed in a doses of 127 mg per day for six months,  noting that Kupperman-Menopausal Index values (an index that measures psychological parameters) had shown improvement after only two weeks of treatment.

The British Herbal Compendium recommends a dosage between 40 and 200 mg of the dried rhizome,  or 0.4-2ml of a 10:1 60% ethanol tincture.  However, the British Pharmacopoeial Compendium recommends a dosage range of 2-4 ml for this tincture extract.

How Much Black Cohosh Extract Should I Take?

The information I’ve provided above about the doses commonly used with black cohosh extract,  whether it be in the form of tablet,  tincture,  or the whole herb,  is for informational purposes only.  This is not meant to be a resource for an untrained person to put together his or her own formulation.  The amount of black cohosh extract that can be used safely and effectively varies quite a bit.  And black cohosh side effects are rare when taken in the proper dosage.  It is always recommended that you take a standardized black cohosh extract,  and follow the instructions by the manufacturer very carefully.  The best option is to consult with a doctor trained in holistic and herbal therapies.

Most Common Dosages

To make a black cohosh tea,  boil 34 oz of water.  Then reduce to a simmer and add 20 g of dried root.  Let simmer for 20-30 minutes so that liquid is reduced by a third.  Strain,  cover,  and then store in refrigerator for up to 48 hrs.  Drink 1 cup three times a day.  But a standardized extract is a much better option.

The most common dosage for a standardized black cohosh extract is between 40 and 80 mg per day.  This may vary in a liquid or tea preparation,  but I’ve found the recommended dosage listed by the manufactures to be quite accurate.

The important thing is that you follow them,  or consult a trained professional.

References: Mckenna D., Jones K., Hughes K., w/Humphrey S., Botanical Medicines : The Desk Reference for Major Herbal Supplements-Second Edition, New York, London, Oxford, 2002 37-64