Saw Palmetto + Apalutamide
Apalutamide brand name: Erleada.
We found no known interaction between Saw Palmetto and Apalutamide in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.
Saw Palmetto and Apalutamide
We checked these two against our interaction database. Here is what we found.
No Known Interaction Found
We did not find a documented interaction between Apalutamide and Saw Palmetto in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.
If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.
Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.
Saw Palmetto safety at a glance
Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
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On the whole, saw palmetto has very few reported drug interactions due to its lack of effects on liver metabolizing enzymes (e.g., CYP P450 enzymes).
There have been some reports of minor interactions with anticoagulants, estrogens, and contraceptives due to saw palmetto's purported effects on blood clotting and various hormones in the body. However, these interactions have generally only been seen in lab studies and for most individuals, are not considered clinically significant.
As always, however, be sure to talk to your doctor before starting any new medications or supplements so you can be appropriately monitored.
Comprehensive analysis does not indicate a significant interaction.
Why No Interaction Is Listed for Apalutamide
Interactions in our licensed database are recorded against drug classes, not just single drug names. Apalutamide is filed under 6 classifications — including cytochrome p450 2c8 (cyp2c8) substrates, cytochrome p450 2c9 (cyp2c9) inducers, cytochrome p450 2c19 (cyp2c19) inducers. Saw Palmetto has documented interactions with 3 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), contraceptive drugs (moderate) and estrogens (moderate) — and none of Apalutamide’s classifications are among them.
Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.
Saw Palmetto Does Interact With Other Medications
Saw Palmetto has 174 moderate known drug interactions in our database — Apalutamide isn’t one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Saw Palmetto
We haven’t checked that one against Saw Palmetto yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Saw Palmetto. Pick one to open its full report.
Saw Palmetto in Pregnancy & Breastfeeding
When used orally. Saw palmetto has hormonal activity; avoid using.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center
What Apalutamide Is Prescribed For, and What Saw Palmetto Has Been Studied For
These two come up together because they touch the same health topic — not because they do the same job. Apalutamide is a prescription medicine with approved uses on its FDA label. Saw Palmetto is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.
Apalutamide is prescribed for: Erleada (apalutamide) is used to treat two types of prostate cancer. The first is metastatic castration-sensitive prostate cancer (mCSPC) — prostate cancer that has spread to other parts of the body and still responds to hormone-lowering therapy. The second is non-metastatic castration-resistant prostate cancer (nmCRPC) — prostate cancer that has stopped responding to standard hormone therapy but has not yet spread to other organs. Erleada is always used alongside a gonadotropin-releasing hormone (GnRH) analog — a medicine that lowers testosterone — or in patients who have already had surgery to remove the testicles.
Saw Palmetto has been studied for:
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Prostate cancer studied, not established Saw Palmetto has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows
Saw Palmetto for prostate cancer
Small preliminary studies suggest that saw palmetto does not reduce prostate cancer risk or symptoms associated with prostate cancer.
Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Apalutamide on your own; if you are taking Saw Palmetto for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.
Questions About Saw Palmetto or Apalutamide
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Saw Palmetto or Apalutamide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
- What Is the Highest Safe Daily Dose of Saw Palmetto for BPH? ›
- Saw Palmetto With Junel Interaction ›
- Concerns Taking Metoprolol With Saw Palmetto ›
- Does Saw Palmetto Interact With Estradiol? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Apalutamide
This page covers Saw Palmetto only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Apalutamide page lists 155 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).
By severity: 3 major · 113 moderate · 39 minor.
From our pharmacist’s overview on the Apalutamide page
“Apalutamide (Erleada) treats prostate cancer, and it only works when its blood level stays where it should, so approach this list with genuine care. Three of the 155 ingredients on file are rated major: grapefruit can push apalutamide levels up, St.”
Reviewed by 2 · Jul 18, 2026
Taking Saw Palmetto as Part of a Dietary Supplement Product? Check It for Interactions
We hold 3,466 real supplement products containing Saw Palmetto, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Saw Palmetto. Even though Saw Palmetto itself has no known interaction with Apalutamide, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:
Where Saw Palmetto and Apalutamide Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#75 of 1,452 supplements looked up here in the last 7 days
#1,904 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
Where does our data come from?
- Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
- Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Saw Palmetto reference on this page ↓
- Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Saw Palmetto and Apalutamide records this page draws on were last updated July 10, 2026.
- What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
About Saw Palmetto
What is Saw Palmetto?
- Benign prostatic hyperplasia (BPH) symptoms
- Urinary problems
- Hair loss
- Prostate health
- Inflammation
Saw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no better than a placebo for most men, though it is generally well tolerated. Talk to your doctor or pharmacist before using it, especially for prostate or urinary problems that need proper evaluation.
Serenoa repens · Arecaceae · Fruit (berries) · Capsules, softgels, tablets, liquid extracts, dried berries, tea
An interaction check asks whether these two react with each other — it does not ask whether Saw Palmetto is a good idea for someone in your situation. Here is what our Saw Palmetto record says about it on its own.
Saw Palmetto: dosing
There is no official, agreed-upon dose for saw palmetto. Products vary in strength and how they are prepared, and many are standardized to a certain percentage of fatty acids.The safest approach is to follow the dosing directions on the product label and not exceed them. They can help you decide whether it is appropriate and what dose is reasonable for you.
From our Saw Palmetto monograph — the full record covers uses, side effects and every documented interaction.
About Apalutamide
What Is Apalutamide Used For?
Brand name: Erleada
Erleada (apalutamide) is used to treat two types of prostate cancer. The first is metastatic castration-sensitive prostate cancer (mCSPC) — prostate cancer that has spread to other parts of the body and still responds to hormone-lowering therapy. The second is non-metastatic castration-resistant prostate cancer (nmCRPC) — prostate cancer that has stopped responding to standard hormone therapy but has not yet spread to other organs.
Erleada is always used alongside a gonadotropin-releasing hormone (GnRH) analog — a medicine that lowers testosterone — or in patients who have already had surgery to remove the testicles.
Most-Reported Side Effects for Apalutamide
From FAERS, the FDA’s public side-effect reporting system (11,688 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.
Other Drugs & Saw Palmetto
Browse every other medication we’ve checked against Saw Palmetto — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
174 interactions
- Diclofenac Sodium ›
- Ibuprofen ›
- Aspirin ›
- Naproxen ›
- Estradiol ›
- Minocycline ›
- Levonorgestrel ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Conjugated Estrogens ›
- Ketoprofen ›
- Bivalirudin ›
- Warfarin Sodium ›
- Bromfenac Sodium ›
- Dabigatran ›
- Diclofenac Epolamine ›
- Esterified Estrogens ›
- Estropipate ›
- Iloprost ›
- Norgestrel ›
- Piroxicam ›
- Streptokinase ›
- Ticlopidine ›
- Treprostinil (oral) ›
- Abciximab ›
- Abrocitinib ›
- Acenocoumarol ›
- Acetylsalicylic Acid ›
- Anacaulase-bcdb ›
- Anagrelide ›
- Anisindione ›
- Antithrombin Iii ›
- Apixaban ›
- Argatroban ›
- Betrixaban ›
- Birth Control Pills ›
- Cablivi ›
- Cangrelor ›
- Cilostazol ›
- Clopidogrel ›
- Dalteparin ›
- Danaparoid ›
- Defibrotide Sodium ›
- Diclofenac ›
- Dicumarol ›
- Drospirenone ›
- Edoxaban ›
- Effient ›
- Enoxaparin ›
- Eptifibatide ›
- Estrogen ›
- Estrone ›
- Ethinyl Estradiol ›
- Etonogestrel ›
- Fish Oil Triglycerides ›
- Fondaparinux ›
- Gestodene ›
- Heparin ›
- Ibrutinib ›
- Ibuprofen Lysine ›
Showing 60 of 174 moderate interactions — see all 174 on the Saw Palmetto page.
No interaction 2,655 drugs checked — show the list
We also checked Saw Palmetto against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Metoprolol ›
- Ivermectin ›
- Rosuvastatin ›
- Escitalopram ›
- Tadalafil ›
- Acetaminophen ›
- Valacyclovir ›
- Atorvastatin ›
- Docusate ›
- Hydroxyurea ›
- Abemaciclib ›
- Methamphetamine ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Prednisone ›
- Propranolol ›
- Lisdexamfetamine ›
- Acyclovir ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Bendamustine ›
- Amitriptyline ›
- Doxycycline ›
- Lamotrigine ›
- Fluoxetine ›
- Methotrexate ›
- Acetaminophen, Codeine ›
- Gabapentin ›
- Amphetamine ›
- Pregabalin ›
- Isotretinoin ›
- Dextroamphetamine ›
- Azithromycin ›
- Clonazepam ›
- Quetiapine ›
- Omeprazole ›
- Amlodipine Besylate ›
- Methylene Blue ›
- Duloxetine ›
- Letrozole ›
- Buspirone ›
- Citalopram ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Acetaminophen, Oxycodone ›
- Dapsone ›
- Diazepam ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
Showing the 60 most looked-up of 2,655 medications checked with no known interaction — see the full Saw Palmetto list.
Saw Palmetto References
The 22 references that drive our Saw Palmetto monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.
- Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280:1604-9. PubMed
- Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40. DOI
- Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Urol 1992;21:309-14. PubMed
- Stepanov VN, Siniakova LA, Sarrazin B, Raynaud JP. Efficacy and tolerability of the lipidosterolic extract of Serenoa repens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens. Adv Ther 1999;16:231-41.
- Cheema P, El-Mefty O, Jazieh AR. Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. J Intern Med 2001;250:167-9. PubMed
- Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2. PubMed
- Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med 2002
- Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med 2008;16:147-54. PubMed
- Morgia, G., Mucciardi, G., Gali, A., Madonia, M., Marchese, F., Di, Benedetto A., Romano, G., Bonvissuto, G., Castelli, T., Macchione, L., and Magno, C. Treatment of chronic prostatitis/chronic pelvic pain syndrome category IIIA with Serenoa repens plus
- Aliaev, IuG, Vinarov, A. Z., Lokshin, K. L., and Spivak, L. G. [Efficiency and safety of prostamol-Uno in patients with chronic abacterial prostatitis]. Urologiia. 2006;(1):47-50.
- Agbabiaka, T. B., Pittler, M. H., Wider, B., and Ernst, E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf 2009;32(8):637-647. PubMed
- Wargo, K. A., Allman, E., and Ibrahim, F. A possible case of saw palmetto-induced pancreatitis. South.Med.J. 2010;103(7):683-685. PubMed
- Lapi, F., Gallo, E., Giocaliere, E., Vietri, M., Baronti, R., Pieraccini, G., Tafi, A., Menniti-Ippolito, F., Mugelli, A., Firenzuoli, F., and Vannacci, A. Acute liver damage due to Serenoa repens: a case report. Br.J.Clin.Pharmacol. 2010;69(5):558-560.
- Mantovani, F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol.Nefrol. 2010;62(4):335-340.
- Hanaka, M., Yoshii, C., Yatera, K., Ito, C., Chojin, Y., Nagata, S., Yamasaki, K., Nishida, C., Kawanami, T., Kawanami, Y., Ishimoto, H., and Mukae, H. [A case of rhabdomyolysis caused by saw palmetto of healthy foods]. J.UOEH. 6-1-2012;34(2):193-199. PubMed
- Miroddi, M., Carni, A., Mannucci, C., Moleti, M., Navarra, M., and Calapai, G. Hot flashes in a young girl: a wake-up call concerning Serenoa repens use in children. Pediatrics 2012;130(5):e1374-e1376.
- Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Current Therapeutic Research 1994;55(7):776-785. DOI
- Jipescu D, Patel A, Bohra H, Pientka A. Rare case of saw palmetto induced heart block. JACC 2017;69(11) supplement:2310.
- Morabito P, Miroddi M, Giovinazzo S, Spina E, Calapai G. Serenoa repens as an endocrine disruptor in a 10-year-Old young girl: a new case report. Pharmacology. 2015;96(1-2):41-3. doi: 10.1159/000431327.
- Gammoudi R, Ameur K, Ouni B, et al. Fixed drug eruption to Serenoa repens: first case report and consideration of the use of herbal medicine. Dermatol Ther 2020 Aug 29:e14247.
- Paulis G, Paulis A, Perletti G. Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials. Arch Ital Urol Androl 2021;93(4):475-480. PubMed
- Venkateswaran S, Declet-Bauzo R, Shodeinde M, Gilford P. Postoperative Retroperitoneal Hematoma: A Case of Saw Palmetto and the Importance of Primary Care Intervention. HCA Healthc J Med 2020;1(5):279-282. PubMed
Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
Taking Saw Palmetto and Apalutamide Together: Common Questions
Is it safe to take Saw Palmetto with Apalutamide?
Do Saw Palmetto and Apalutamide have any of the same side effects?
Are Saw Palmetto and Apalutamide used for the same thing?
How was the Saw Palmetto and Apalutamide combination checked?
Does Saw Palmetto interact with any other medications?
Does Apalutamide interact with any supplements?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.