fenugreek

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

Constipation.
Diabetes.
Dyspepsia.
Hyperlipidemia.
Increase lactation.
Menstrual cramps.

Action ⬆ ⬇

Contains active compounds including saponins, trigonelline, flavonoids, galactomannan, mucilage, and 4-hydroxyisoleucine, which may ↓ blood sugar, ↑ breast milk supply, ↓ cholesterol, improve digestion, and have anti-inflammatory and antioxidant effects.

Therapeutic effects:

Improved blood sugar control.
Increased breast milk supply.
Reduced cholesterol levels.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	Unknown	Unknown	Unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Allergy to Fabaceae family (chickpeas, peanuts);
Bleeding disorders.

Use Cautiously in:

Asthma;
Diabetes;
Hormone-sensitive conditions;
Surgery (discontinue ≥2 wk before procedure);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

GI: bloating, diarrhea, flatulence

Endo: hypoglycemia

Misc: hypersensitivity reactions, maple syrup odor in sweat/urine

Interactions ⬆ ⬇

Natural-Drug Products:

May ↑ risk of hypoglycemia with antidiabetic drugs.
May ↑ risk of bleeding with anticoagulants and antiplatelets.
May ↓ effectiveness of estrogen-sensitive medications, including oral contraceptives and tamoxifen.

Natural-Natural Products:

May ↑ risk of hypoglycemia with berberine, ginseng, and gymnema.
May ↑ risk of bleeding with ginkgo, garlic, ginger, turmeric, fish oil/omega-3, and willow bark.
May have additive hormonal effects with black cohosh.

Route/Dosage ⬆ ⬇

Blood Sugar Control

PO (Adults ): Capsules/tablets: 2500–15,000 mg/day in divided doses. Powdered seed: 5–30 g/day.

Hyperlipidemia

PO (Adults ): Powdered seed: 10–15 g/day.

Digestive Support

PO (Adults ): Tea or powder: 1–2 teaspoons of crushed seed steeped in water, 2–3 times daily.

Lactation Support

PO (Adults ): Capsules: 1500–6000 mg/day in 3 divided doses.

Availability ⬆ ⬇

Capsules: ^OTC
Tablets: ^OTC
Powdered seed: ^OTC
Tea: ^OTC

Assessment ⬆ ⬇

Monitor for signs/symptoms of hypoglycemia.
Assess milk production in lactating women.

Lab Test Considerations:

Monitor blood sugar during therapy.
Monitor cholesterol level periodically during therapy.
Monitor coagulation studies periodically during therapy.

Implementation ⬆ ⬇

PO: Administer with food to ↓ nausea or bloating.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of herb to patient.
Advise patient to consult with health care provider before using any herbal supplement, especially when taken concurrently with Rx or OTC medications or vitamins.
Advise patient to observe for easy bruising and other signs of bleeding and report to health care provider if they occur.
Advise patient they may experience the harmless side effect of maple syrup body odor.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or breastfeeding before using this herb.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇