Drug & supplement interaction

Saw Palmetto + Levonorgestrel

Levonorgestrel brand names: Plan B, Mirena, Levonelle One Step, Levonelle 1500, Norgeston, and others.

Moderate Interaction
The bottom line Moderate

Saw Palmetto has a moderate interaction with Levonorgestrel. Saw palmetto might reduce the effectiveness of contraceptive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Saw Palmetto and Levonorgestrel

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CONTRACEPTIVE DRUGS

Why this applies to Levonorgestrel

Levonorgestrel falls under CONTRACEPTIVE DRUGS — the group Saw Palmetto interacts with.

Saw palmetto might reduce the effectiveness of contraceptive drugs.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with contraceptive drugs taken concomitantly.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: Levonorgestrel (like Plan B or your Mirena IUD) is a progestin, and the concern on file is that saw palmetto may have mild antiestrogen-type activity that could, in theory, make your contraceptive work a little less well. In practice, that might mean a higher chance of the method not fully doing its job, whether that's preventing pregnancy after unprotected sex or providing steady protection.

I want to be straight with you, though: this is mostly a theoretical worry built on weaker evidence, not strong human studies. It's worth a quick chat with your pharmacist or doctor, especially if you rely on this for ongoing birth control, but please don't stop anything on your own.

References
  1. 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

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Saw Palmetto Also Interacts With Other Medications

Saw Palmetto has 173 moderate known drug interactions in our database — the Levonorgestrel one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Saw Palmetto

Covers the 2,830 medications we’ve checked against Saw Palmetto. Pick one to open its full report.

From our Q&A

Questions About Saw Palmetto or Levonorgestrel

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 Levonorgestrel, 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:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Levonorgestrel

This page covers Saw Palmetto only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levonorgestrel page lists 191 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 142 moderate · 43 minor.

From our pharmacist’s overview on the Levonorgestrel page

“St. John's wort tops my worry list for anyone using levonorgestrel (Plan B, Mirena, and other birth control).”

Reviewed by 2 · Jul 18, 2026

Open the Levonorgestrel interaction page

One more smart check

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. Your product may carry other ingredients that interact with Levonorgestrel too, on top of Saw Palmetto — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Saw Palmetto and Levonorgestrel 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.

Supplement Saw Palmetto
Top 10%

#75 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Levonorgestrel
Top 25%

#395 of 2,830 medications looked up here in the last 7 days

29 days ago today

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.

Supplement

About Saw Palmetto

What is Saw Palmetto?

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.

Read the full Saw Palmetto monograph & all interactions
Medication

About Levonorgestrel

What Is Levonorgestrel Used For?

Brand names: Plan B, Mirena, Levonelle One Step, Levonelle 1500, Norgeston, Skyla, Liletta, Kyleena

Levonorgestrel is used in two very different ways depending on the product. As an intrauterine system (IUS), Mirena and Liletta prevent pregnancy for up to 8 years and also treat heavy menstrual bleeding for up to 5 years in people who choose intrauterine contraception. Kyleena prevents pregnancy for up to 5 years, and Skyla prevents pregnancy for up to 3 years — neither Kyleena nor Skyla is indicated for heavy menstrual bleeding.

As an oral tablet, products such as AfterPill, AfterPlan, Amazon Basic Care Levonorgestrel, Econ Morning After, Emergency Contraceptive, and Empowered Choice are used as emergency (backup) contraception to reduce the chance of pregnancy after unprotected sex or contraceptive failure. The oral tablet is not intended for routine birth control.

See full Levonorgestrel drug information
Keep checking

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.

0Major
173Moderate
0Minor
2,656No known interaction
Moderate

173 interactions

Showing 60 of 173 moderate interactions — see all 173 on the Saw Palmetto page.

No interaction 2,656 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Saw Palmetto and Levonorgestrel Together: Common Questions

Can you take Saw Palmetto with Levonorgestrel?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Saw Palmetto and Levonorgestrel interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Levonorgestrel and Saw Palmetto?

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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.