Cimicifugae racemosae rhizoma

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 20.07.2021

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Synonym(s)

bugweed, grape silver candle rootstock; Cimcifuga; Women's Root

Definition
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Extract from the root (rhizome+roots) of the black cohosh (Cimicifuga racemosa) used for medicinal purposes. The root extracts of black cohosh, which is also called women's root, were used to treat gynecological disorders as early as the 18th century.

HMPC monograph: Well-established use: menopausal symptoms, hot flushes, excessive sweating.
Approved, supported by clinical data: Psychological and neurovegetative complaints of menopause.
ESCOP monograph: menopausal symptoms such as hot flushes, profuse sweating, sleep disturbances, nervous irritabilityCommission
E monograph: premenstrual, dysmenorrhea, menopausal neurovegetative symptoms.

Pharmacodynamics (Effect)
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The active ingredients of the root extracts are actein, a glycoside with hypotensive effect, as well as the terpene derivative (tetracyclic triterpene), cymogonol monoxyloside (cimicifugoside), cimiracemoside and cimegenol-3-O-alpha-L-arabinoside = typical lead substance for Cimicifuga racemosa). Furthermore, the root extract contains tannins, salicylic and gallic acid as well as various alkaloids (cytiside). Alkaloids (cytisine) are also contained in the root extract.

The use of finished preparations is strongly recommended, no tea infusions!

Spectrum of action
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The extract shows a weak estrogenic effect; it also has anti-inflammatory and antipyretic and sedative effects.

The ingredients bind to oestrogen receptors (competition with estradiol and hence the name "Phyto-SERMs").

Indication
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Dysmenorrhoea, climacteric complaints

Limited indication
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Mammary carcinoma only after medical consultation, liver dysfunction, vaginal bleeding while taking,

Pregnancy/nursing period
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Do not use during pregnancy or while breastfeeding.

Undesirable effects
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Liver toxicity, allergic skin reactions (urticaria, pruritus, exanthema), facial edema, peripheral edema, gastrointestinal disorders: dyspepsia, diarrhea.

Contraindication
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Combination with oestrogens, pregnancy and lactation in the absence of data; allergy to one of the ingredients.

Preparations
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Femikliman® uno Film coated tablets (ED 6.5mg), 1-0-0

Feminon C® hard capsules (ED 6.5mg), 1-0-0

Klimadybin uno ® Flimtablets (ED 6.5mg), 1-0-0

Remifemin Tablets (ED 2.5mg), 1-0-1

Combination preparation:

Remifemin plus® Film coated tablets, 1(2)-0-1(2)

Literature
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  1. https://arzneipflanzenlexikon.info/index.php?en_pflanzen=22
  2. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-cimicifuga-racemosa-l-nutt-rhizome-revision-1_en.pdf