Two other products have been identified as being unauthorized and their contents are as yet unknown.
Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) is typically used to alleviate menopausal symptoms. Black cohosh products have been required to carry warnings about potential liver reactions.
Health Canada reported the adverse events occurred between January, 2005 and March, 2009. Four of the products have been voluntarily withdrawn from the market.
“Health Canada continues to monitor the situation, and further recalls by other manufacturers are possible,” Health Canada said. “Health care professionals are encouraged to report any adverse reactions suspected of being associated with the use of products containing black cohosh to Health Canada.”
Health Canada considers a serious adverse event as: "a noxious and unintended response to a natural health product that occurs at any dose and that requires in-patient hospitalization or prolongation of existing hospitalization, that causes congenital malformation, that results in persistent or significant disability or incapacity, is life-threatening or results in death."
“…these domestic cases demonstrate that products not containing authentic black cohosh may be associated with liver adverse reactions.”