THE popular herbal remedy black cohosh, used to relieve the symptoms of menopause, has been linked to liver failure.

The Therapeutic Goods Administration said there had been 49 cases of liver toxicity linked to the herbal remedy worldwide, including 11 in Australia.

"In four cases the patient experienced hepatic [liver] failure requiring liver transplantation," the drug watchdog said in its monthly adverse drug reactions Bulletin.

More than 200 listed medicines on the market in Australia contain black cohosh and it has become a popular alternative treatment for menopause after the HRT scare.

The bulletin said serious cases of liver failure linked to the herbal remedy had occurred in patients using it for less than one month.

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