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What is saw palmetto?
Saw palmetto comes from a palm-like plant that grows in the southeast United States. The berries of this plant are used to make the capsule form of saw palmetto. Saw palmetto blocks certain effects of certain hormones in the body and also has some anti-inflammatory actions. Saw palmetto has been used to treat symptoms of enlarged prostate (benign prostatic hypertrophy, or BPH), such as increased night-time urination or decreased urinary flow. Saw palmetto has been used historically to treat stomach or intestinal problems, bladder irritation, and bronchitis.

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What are the possible side effects of saw palmetto?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using saw palmetto and call your doctor at once if you have any of these serious side effects:

• weakness or fainting;

• black, bloody, or tarry stools;

• coughing up blood or vomit that looks like coffee grounds;

• pain or swelling in your breasts or testicles;

• chest pain;

• fast, slow, or uneven heart rate;

• easy bruising or bleeding; or

• nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• nausea, vomiting, stomach pain;

• diarrhea or constipation;

• bad breath;

• headache;

• dizziness;

• sleep problems (insomnia);

• muscle pain;

• depressed mood; or

• increased or decreased interest in sex;

This is not a complete list of side effects and others may occur. Tell doctor, pharmacist, or healthcare provider about any side effect that seems unusual or that is especially bothersome.

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How should I take saw palmetto?
When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements. If you choose to take saw palmetto, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label. Saw palmetto is available in a capsule formulation. Other forms of saw palmetto may also be available, such as teas, tinctures, and topical forms. Do not use many different forms of saw palmetto together at the same time, unless you healthcare provider instructs you to. Using different forms together may increase your risk of an overdose of saw palmetto.

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What is the most important information I should know about saw palmetto?
Talk to a doctor, pharmacist, herbalist, or other healthcare provider before taking saw palmetto. You may not be able to use this product if you have certain medical conditions or take other medications. Saw palmetto has not been approved by the FDA to treat any disease, and it should not be substituted for prescription medications. Saw palmetto has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of saw palmetto may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. Some marketed herbal supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

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What happens if I miss a dose?
No information is available about missing a dose of saw palmetto. Consult your doctor, pharmacist, or healthcare provider for instructions if you miss a dose.

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What other drugs will affect saw palmetto?
Do not take saw palmetto without the advice of a doctor if you are using any of the following medications: a blood thinner such as warfarin (Coumadin); flutamide (Eulexin); garlic or ginkgo biloba; birth control pills; iron supplements such as ferrous fumarate ferrous gluconate, or ferrous sulfate; hormone replacement therapy; estrogen or testosterone; an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others; or

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Do not take saw palmetto without telling your doctor if you are pregnant or plan to become pregnant during treatment. Saw palmetto may be harmful to an unborn baby.

It is not known whether saw palmetto passes into breast milk or if it could harm a nursing baby. Do not use this product without telling your doctor if you are breast-feeding a baby.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a saw palmetto overdose are not known.

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What should I discuss with my health care provider before taking saw palmetto?
You should not use this medication if you are allergic to saw palmetto, or have certain conditions. Be sure your doctor knows if you have: a bleeding or blood clotting disorder (such as hemophilia); stomach ulcer with active bleeding; or ulcerative colitis or Crohn's disease. Before taking saw palmetto, talk to your doctor, pharmacist, herbalist, or other healthcare provider. You may not be able to use this product if you have: liver disease; heart disease; a heart rhythm disorder; a history of stomach ulcer; or

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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