Suggested Dosing
Whole berries: 1-2 g PO daily
Lipophilic extract: 320 mg/day PO qD OR 160 mg PO BID
Standardized extracts 100-400 mg PO BID
Suggested Uses
BPH, diuretic, a sedative, an anti-inflammatory, alopecia, prostate cancer (in combo with other herbs), and antiseptic
Efficacy
BPH: Saw palmetto fruit extract did not reduce lower urinary tract symptoms more than placebo 2 trial randomized controlled trials (JAMA. 2011 Sept 28;306[12]:1289-1395) (N Engl J Med. 2006;354[6]:557-566)
Insufficient reliable test results to determine efficacy for other suggested uses
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (33)
- antithrombin alfa
saw palmetto increases toxicity of antithrombin alfa by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- apixaban
saw palmetto increases toxicity of apixaban by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- argatroban
saw palmetto increases toxicity of argatroban by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- aspirin
saw palmetto increases toxicity of aspirin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- aspirin rectal
saw palmetto increases toxicity of aspirin rectal by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- bivalirudin
saw palmetto increases toxicity of bivalirudin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- dabigatran
saw palmetto increases toxicity of dabigatran by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- dalteparin
saw palmetto increases toxicity of dalteparin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- desirudin
saw palmetto increases toxicity of desirudin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- diclofenac
saw palmetto increases toxicity of diclofenac by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- diflunisal
saw palmetto increases toxicity of diflunisal by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- edoxaban
saw palmetto increases toxicity of edoxaban by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- enoxaparin
saw palmetto increases toxicity of enoxaparin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- etodolac
saw palmetto increases toxicity of etodolac by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- fenoprofen
saw palmetto increases toxicity of fenoprofen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- flurbiprofen
saw palmetto increases toxicity of flurbiprofen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- fondaparinux
saw palmetto increases toxicity of fondaparinux by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- heparin
saw palmetto increases toxicity of heparin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- ibuprofen
saw palmetto increases toxicity of ibuprofen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- ibuprofen IV
saw palmetto increases toxicity of ibuprofen IV by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- indomethacin
saw palmetto increases toxicity of indomethacin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- ketoprofen
saw palmetto increases toxicity of ketoprofen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- ketorolac
saw palmetto increases toxicity of ketorolac by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- meclofenamate
saw palmetto increases toxicity of meclofenamate by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- mefenamic acid
saw palmetto increases toxicity of mefenamic acid by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- meloxicam
saw palmetto increases toxicity of meloxicam by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- nabumetone
saw palmetto increases toxicity of nabumetone by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- naproxen
saw palmetto increases toxicity of naproxen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- oxaprozin
saw palmetto increases toxicity of oxaprozin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- piroxicam
saw palmetto increases toxicity of piroxicam by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- rivaroxaban
saw palmetto increases toxicity of rivaroxaban by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- sulindac
saw palmetto increases toxicity of sulindac by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- tolmetin
saw palmetto increases toxicity of tolmetin by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
Minor (10)
- danazol
saw palmetto decreases effects of danazol by pharmacodynamic antagonism. Minor/Significance Unknown.
- finasteride
saw palmetto increases effects of finasteride by pharmacodynamic synergism. Minor/Significance Unknown.
- fluoxymesterone
saw palmetto decreases effects of fluoxymesterone by pharmacodynamic antagonism. Minor/Significance Unknown.
- mesterolone
saw palmetto decreases effects of mesterolone by pharmacodynamic antagonism. Minor/Significance Unknown.
- methyltestosterone
saw palmetto decreases effects of methyltestosterone by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxandrolone
saw palmetto decreases effects of oxandrolone by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxymetholone
saw palmetto decreases effects of oxymetholone by pharmacodynamic antagonism. Minor/Significance Unknown.
- testosterone
saw palmetto decreases effects of testosterone by pharmacodynamic antagonism. Minor/Significance Unknown.
- testosterone buccal system
saw palmetto decreases effects of testosterone buccal system by pharmacodynamic antagonism. Minor/Significance Unknown.
- testosterone topical
saw palmetto decreases effects of testosterone topical by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
Nausea, headache (rare)
Diarrhea (high doses)
Hepatotoxic potential
Warnings
Contraindications
Pregnant women should avoid contact: potential for transdermal absorption, or exposure from semen
Pregnancy & Lactation
Pregnancy Category: avoid use
Lactation: avoid use
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Active constituents: sitosterols; anthranilic, caffeic, chlorogeneic acids
Inhibits 5-alpha-reductase conversion of testosterone to dihydrotestosterone
Anti-inflammatory inhibition of cycloxygenase, lipoxygenase pathways
Pharmacokinetics
Metabolism: N/A
Excretion: N/A