saw palmetto

Therapeutic Classification: benign prostatic hyperplasia bph agents

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Benign prostatic hyperplasia

Exerts antiandrogenic, anti-inflammatory, and antiproliferative properties in prostate tissue resulting in improvement in BPH symptoms such as frequent urination, hesitancy, urgency, and nocturia.
Comparable in efficacy to finasteride but may be less effective than prazosin.

Therapeutic effects:

Decreased urinary symptoms of BPH.

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

ROUTE	ONSET	PEAK	DURATION
PO	1–2 mo	unknown	48 wk (longest studied treatment duration)

Contraindicated in:

Pregnancy and lactation.

Use Cautiously in:

Prior to surgery (discontinue 2 wk before to prevent bleeding).

Natural-Drug Products:

Hormonal action may interfere with other hormonal therapies (testosterone, hormonal contraceptives).
Avoid use with antiplatelet or anticoagulant drugs (may ↑ bleeding risk).

Natural-Natural Products:

Concomitant use with herbs that affect platelet aggregation such as ginger, garlic, gingko, and ginseng may ↑ bleeding risk.

PO (Adults ): Lipophilic extract (80–90% fatty acids): 160 mg twice daily or 320 mg once daily. Whole berries: 1–2 g daily. Liquid extract from berry pulp: 1–2 mL three times daily. Tea (efficacy is questionable due to lipophilicity of active constituents): 1 cup three times daily. Tea is prepared by steeping 0.5–1 g dried berry in 150 mL boiling water for 5–10 min.

Lipophilic extract (80-90% fatty acids): ^OTC
Whole berries: ^OTC
Liquid extract: ^OTC

Assess patient for symptoms of benign prostatic hypertrophy (BPH) (urinary hesitancy, feeling of incomplete bladder emptying, interruption in urinary stream, impairment in size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy.
Perform rectal exams prior to and periodically during therapy to assess prostate size are recommended.

Take on a full stomach to minimize GI effects.

Advise patients to start therapy with saw palmetto only after evaluation by a health care professional who will provide continued follow-up care.
Inform patients that saw palmetto does not alter the size of the prostate but still should relieve the symptoms associated with BPH.
Advise patient that taking saw palmetto with food may reduce GI effects and improve tolerability.

Decrease in urinary symptoms of BPH.

American Dwarf Palm Tree, Cabbage Palm, Ju-Zhong, Palmier Nain, Sabal, Sabal Fructus, Saw Palmetto Berry, Serenoa repens

NDC Code

0220- Boiron
- 0220-4503- Sabal serrulata
  - 0220-4503-41- 200 [kp_C] in 1 TUBE (0220-4503-41)

0220- Boiron
- 0220-4506- Sabal serrualata
  - 0220-4506-41- 3 [hp_C] in 1 TUBE (0220-4506-41)

0220- Boiron
- 0220-4507- Sabal serrulata
  - 0220-4507-41- 6 [hp_C] in 1 TUBE (0220-4507-41)

0220- Boiron
- 0220-4508- Sabal serrulata
  - 0220-4508-41- 30 [hp_C] in 1 TUBE (0220-4508-41)

62106- Seroyal USA
- 62106-8812- SABAL SERRULATA
  - 62106-8812-4- 10 TUBE in 1 CARTON (62106-8812-4) > 140 GRANULE in 1 TUBE

64117- Natural Health Supply
- 64117-177- Painful Urination
  - 64117-177-01- 1.875 mL in 1 BOTTLE, GLASS (64117-177-01)

64117- Natural Health Supply
- 64117-177- Painful Urination
  - 64117-177-02- 7.5 mL in 1 BOTTLE, GLASS (64117-177-02)

68428- Washington Homeopathic Products
- 68428-611- Sabal
  - 68428-611-03- 75 PELLET in 1 VIAL, GLASS (68428-611-03)

68428- Washington Homeopathic Products
- 68428-611- Sabal
  - 68428-611-05- 150 PELLET in 1 VIAL, GLASS (68428-611-05)

68428- Washington Homeopathic Products
- 68428-611- Sabal
  - 68428-611-06- 1200 PELLET in 1 BOTTLE, GLASS (68428-611-06)

68428- Washington Homeopathic Products
- 68428-611- Sabal
  - 68428-611-11- 300 PELLET in 1 BOTTLE, GLASS (68428-611-11)

68428- Washington Homeopathic Products
- 68428-611- Sabal
  - 68428-611-12- 600 PELLET in 1 BOTTLE, GLASS (68428-611-12)

71919- Washington Homeopathic Products
- 71919-597- Sabal serrulata
  - 71919-597-07- 15 mL in 1 VIAL, GLASS (71919-597-07)

71919- Washington Homeopathic Products
- 71919-597- Sabal serrulata
  - 71919-597-08- 30 mL in 1 VIAL, GLASS (71919-597-08)

71919- Washington Homeopathic Products
- 71919-597- Sabal serrulata
  - 71919-597-09- 50 mL in 1 BOTTLE, GLASS (71919-597-09)

71919- Washington Homeopathic Products
- 71919-597- Sabal serrulata
  - 71919-597-10- 100 mL in 1 BOTTLE, GLASS (71919-597-10)

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

Assessment ⬆ ⬇

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Code ⬆