Saw Palmetto (Herb/Suppl)

Brand and Other Names:American dwarf palm tree, cabbage palm (saw palmetto), more...dwarf palm, juzhong, palmier nain, sabal fructus, sabal serrulata, serenoa repens, serenoa serrulata

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

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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

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Interactions

Interaction Checker

and Saw Palmetto

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            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.

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                Adverse Effects

                Nausea, headache (rare)

                Diarrhea (high doses)

                Hepatotoxic potential

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                Warnings

                Contraindications

                Pregnant women should avoid contact: potential for transdermal absorption, or exposure from semen

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                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.

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                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

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.