Can I take Black cohosh and Solifenacin together?

Why this happens

Both substances can have 'anticholinergic' effects (blocking a specific chemical messenger in the body), which can lead to additive side effects. Additionally, some studies suggest black cohosh may interfere with liver enzymes (specifically CYP3A4) that are responsible for clearing solifenacin from your system.

What you should do

Use this combination with caution. If you decide to take both, monitor yourself closely for increased side effects like severe constipation, difficulty urinating, or extreme dry mouth. It is best to inform your doctor or pharmacist before starting black cohosh if you are already prescribed solifenacin for overactive bladder.

Important precautions

Pregnancy

Do not use black cohosh during pregnancy. It may stimulate uterine contractions, potentially increasing the risk of miscarriage or premature labour.

Liver disease

Black cohosh has been linked to rare but serious cases of liver failure. You must stop taking it and see a doctor immediately if you develop yellowing of the skin or eyes, dark urine, or severe stomach pain.

Hormone-sensitive conditions (e.g. breast cancer)

Because black cohosh may act like the hormone oestrogen, you should not use it if you have a history of breast cancer, uterine cancer, or endometriosis without specialist medical supervision.

Glaucoma

Do not take solifenacin if you have narrow-angle glaucoma, as it can increase the pressure in your eyes and cause a medical emergency.

Urinary retention or Gastric retention

Do not use solifenacin if you have severe difficulty passing urine or if your stomach empties very slowly, as it can worsen these blockages.

Food and drink warnings

Alcohol

Black cohosh has been linked to rare but serious cases of liver damage. Because alcohol also puts strain on the liver, it is advisable to limit or avoid alcohol consumption while taking this supplement to reduce the risk of liver toxicity.

Solifenacin can cause sleepiness and blurred vision. Drinking alcohol while taking this medicine may increase these effects, making you feel more drowsy or dizzy. It is best to limit your alcohol intake until you know how the medicine affects you.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.