saw palmetto (generic name)

an herbal product - treats Underactive bladder, Prostatitis/chronic pelvic pain syndrome, Prostate cancer, Enlarged prostate, and Male-pattern ...
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Interactions

Interactions with Drugs

Saw palmetto may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). Some batches of the discontinued combination herbal preparation PC-SPES®, which contains saw palmetto and seven other herbs, has been found to contain several medications including the "blood thinner" warfarin.

Saw palmetto should not be taken with drugs that affect the levels of male sex hormones (androgens), such as finasteride (Proscar®, Propecia®) or flutamide (Eulexin®). In theory, saw palmetto may interfere with birth control pills or hormone replacement therapy in women. Tinctures may contain high levels of alcohol and may cause nausea or vomiting when taken with metronidazole (Flagyl®) or disulfiram (Antabuse®).

Study in normal volunteers reveals no effects of saw palmetto on cytochrome P450 3A4 or 2D6 activity.

Interactions with Herbs and Dietary Supplements

Based on at least two reports of serious bleeding, saw palmetto may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Because saw palmetto may have activity on the body's response to estrogen, the effects of other agents believed to have estrogen-like properties may be altered.

Tannins in saw palmetto may prevent iron absorption.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Ethan Basch, MD, MSc, MPhil (Memorial Sloan-Kettering Cancer Center); Heather Boon, B.Sc.Phm, PhD (University of Toronto); Wendy Chao, PhD (Natural Standard Research Collaboration); Michelle Corrado, PharmD (Harvard Vanguard Medical Associates); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Ivo Foppa, MD, ScD (University of South Carolina); Sadaf Hashmi MD, MPH (Johns Hopkins School of Hygiene and Public Health); Paul Hammerness, MD (Massachusetts General Hospital); Eileen Kingsbury, PharmD (University of Rhode Island); Michael Smith, M.R.PharmS, ND (Canadian College of Naturopathic Medicine); Philippe Szapary, MD (University of Pennsylvania); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Minney Varghese, BS (Northeastern University); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).

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