Drug interactions
Black cohosh + Nevirapine
Severity: Moderate
Black cohosh and Nevirapine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both nevirapine and black cohosh have been associated with liver injury, so combined use could add to hepatotoxicity risk. Evidence for black cohosh hepatotoxicity is mostly case reports, and nevirapine carries a boxed warning for severe hepatotoxicity.
What this interaction means in plain words
Black cohosh and Nevirapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive potential for hepatotoxicity; the mechanism of black cohosh liver injury is not well established.
What to do
Advise patients to avoid black cohosh while taking nevirapine. If used, monitor liver enzymes and counsel to report jaundice, dark urine or abdominal pain.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Black cohosh and Nevirapine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Black cohosh with Nevirapine?
MediHelp rates the interaction as moderate. Black cohosh and Nevirapine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both nevirapine and black cohosh have been associated with liver injury, so combined use could add to hepatotoxicity risk. Evidence for black cohosh hepatotoxicity is mostly case reports, and nevirapine carries a boxed warning for severe hepatotoxicity.
How serious is the interaction between Black cohosh and Nevirapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid black cohosh while taking nevirapine. If used, monitor liver enzymes and counsel to report jaundice, dark urine or abdominal pain.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
