Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

Saw Palmetto Combination #1 Ingredients & Drug Interactions

by Genestra Brands

Saw Palmetto Combination #1 label
See full label image
Liquid Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Saw Palmetto Combination #1 against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Saw Palmetto Combination #1 is a dietary supplement by Genestra Brands with 6 active ingredients. Its ingredients are commonly taken for benign prostatic hyperplasia (bph) symptoms, urinary problems, hair loss.Based on those ingredients, 1,391 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Eleuthero (Eleutherococcus senticosus) root extract, Alfalfa (Medicago sativa) aerial parts extract, Calendula (Calendula officinalis) flower extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Saw Palmetto Combination #1 by Genestra Brands

Ask about any prescription or over-the-counter medication and we check it for interactions with Saw Palmetto Combination #1 by Genestra Brands — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Saw Palmetto Combination #1 by Genestra Brands

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 10, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 6 of its 6 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Saw Palmetto Combination #1 contains 6 active herbal extracts. The blend includes saw palmetto fruit extract, damiana leaf extract, eleuthero root extract, alfalfa aerial parts extract, American spikenard root extract, and calendula flower extract.

The product is delivered in liquid form and also contains purified water and ethanol as inactive ingredients.

Does it work?

Leans against
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Leans against

The strongest graded evidence we hold for the stated purpose leans against a benefit.

Why this rating?
  • The label markets this product for: Prostate and urinary health support.
  • We looked for evidence on: Benign prostatic hyperplasia (BPH), Non-neurogenic lower urinary tract symptoms (LUTS), Prostatitis, Chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS), prostate function, urinary flow.
  • The closest evidence on file: Saw Palmetto is rated "Possibly Ineffective" for Benign prostatic hyperplasia (BPH) (Natural Medicines).
  • Also on file: Calendula is rated "Insufficient Reliable Evidence To Rate" for Chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS).
  • Also on file: Saw Palmetto is rated "Insufficient Reliable Evidence To Rate" for Chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS), Prostatitis, Non-neurogenic lower urinary tract symptoms (LUTS).

The evidence for this product's uses isn't well established in the data we hold. Saw palmetto is rated possibly ineffective for benign prostatic hyperplasia (enlarged prostate) and possibly effective only for transurethral resection of the prostate (TURP); for other claimed uses like hair loss and urinary symptoms, evidence is insufficient to rate.

Damiana, eleuthero, alfalfa, American spikenard, and calendula all have insufficient evidence for their listed uses — meaning the research simply hasn't answered whether they work. If you're considering this for a specific condition, talk with your doctor or pharmacist about what the evidence actually supports.

The evidence, ingredient by ingredient Saw Palmetto Damiana Eleuthero Alfalfa American Spikenard Calendula

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 5 of the 6 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 6 of 6.
  • General safety write-ups exist for 6 of 6.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Saw palmetto is generally well tolerated, though mild side effects like abdominal pain, constipation, headache, nausea, and dizziness can occur. Rare cases of heart rhythm problems and skin reactions have been reported.

Damiana, eleuthero, alfalfa, and American spikenard are generally well tolerated in small amounts, but human safety data are limited — eleuthero may cause nervousness or anxiety at higher doses and raise blood pressure in some people. Calendula can trigger allergic reactions, especially in people sensitive to ragweed or related plants.

The product is not safe in pregnancy: saw palmetto, American spikenard, and calendula are rated possibly or likely unsafe during pregnancy, and damiana and eleuthero lack safety data. For breastfeeding, safety data are insufficient for all ingredients except alfalfa, which is cautioned against at supplement doses.

Side effects, ingredient by ingredient Saw Palmetto Damiana Eleuthero Alfalfa American Spikenard Calendula

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 6 of the 6 matched ingredients can interact with medications — Alfalfa, Calendula, American Spikenard, Damiana, Saw Palmetto, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,392 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your doctor or pharmacist if you take warfarin or other blood thinners (anticoagulants or antiplatelet drugs), birth control pills or estrogen therapy, diabetes medications, digoxin or other heart medications, drugs metabolized by your liver (ask your pharmacist if you're unsure), immunosuppressants, or diuretics (water pills). No interactions are documented for calendula beyond a minor theoretical effect with sedating drugs.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with graded evidence leaning against its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This combination product carries real interaction risks — especially if you take warfarin, birth control, diabetes medications, blood thinners, heart medications, or immunosuppressants. Before you start, have your own pharmacist or doctor review your current medications against the full list of interactions above.

The evidence for its effectiveness isn't strong across its ingredients, so be clear about what you're hoping it will do and whether there's science behind it. If you're pregnant or breastfeeding, avoid this product.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 6 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Feb 23, 2016.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Saw Palmetto Combination #1, straight from the product label.

Brand Genestra Brands
Barcode (UPC) 88319614040
Net contents 2 fl. Oz.; 60 mL
Market status On market
Date entered into DSLD Feb 23, 2016
DSLD ID 56481
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Saw Palmetto Combination #1 by Genestra Brands, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1.5 mL
Maximum serving Sizes:
1.5 mL
Servings per container
40
UPC/BARCODE
88319614040
IngredientAmount% DV
Saw Palmetto (Serenoa repens) fruit extract0.53 mL--
Damiana (Turnera diffusa) leaf extract0.3 mL--
Eleuthero (Eleutherococcus senticosus) root extract0.3 mL--
Alfalfa (Medicago sativa) aerial parts extract0.15 mL--
American Spikenard (Aralia racemosa) root extract0.15 mL--
Calendula (Calendula officinalis) flower extract0.08 mL--

Other ingredients: purified Water, Ethanol

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Recommended Adult Dose: Take 30 drops three times daily or as recommended by your healthcare practitioner.Take with food to minimize gastric disturbances.

Precautions

Risk Information: If you are pregnant or breastfeeding; if you are allergic to plants of the Asteraceae/Compositae/Daisy family; if you have heart disease, high or low blood pressure, kidney or liver disorder, diabetes, edema (swelling of hands, face and feet), intestinal disorders, abdominal pain of unknown origin, severe dehydration or a history of systemic lupus erythematosus; or if you are taking other diuretic products, do not use.

Risk Information: If you are pregnant or breastfeeding; if you are allergic to plants of the Asteraceae/Compositae/Daisy family; if you have heart disease, high or low blood pressure, kidney or liver disorder, diabetes, edema (swelling of hands, face and feet), intestinal disorders, abdominal pain of unknown origin, severe dehydration or a history of systemic lupus erythematosus; or if you are taking other diuretic products, do not use.

Stop use and seek medical attention immediately if you experience dizziness, confusion, muscle weakness or pain, abnormal heartbeat and/or difficulty breathing.

Hypersensitivity/allergy to calendula has been known to occur; in which case, discontinue use.

Quality Assurance: Safety-sealed for your protection and for product freshness. Do not use if outer seal is missing or broken.

Formulation

Guaranteed to contain no added starch, soy, sodium, sugar, artificial coloring or flavoring, dairy or animal products.

Ideal for vegans.

Storage

Store in a cool, dry place.

General

V2.0 731

FDA Statement of Identity

HERBAL SUPPLEMENT

Seals/Symbols

Seroyal

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Saw Palmetto Combination #1 by Genestra Brands label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Saw Palmetto Combination #1 label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Saw Palmetto Combination #1 by Genestra Brands

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1.5 mL Dosage formLiquid Servings per container40 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Saw Palmetto (Serenoa repens) fruit extract

Interacts with
174 drugs
0.53 mL per serving

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 bett...

Saw Palmetto (Serenoa repens) fruit extract monograph & interactions

Damiana (Turnera diffusa) leaf extract

Interacts with
86 drugs
0.3 mL per serving

Damiana is a traditional herb most famous as an aphrodisiac and mild mood-lifter, but solid human evidence for any of its uses is very limited. It is...

Damiana (Turnera diffusa) leaf extract monograph & interactions

Eleuthero (Eleutherococcus senticosus) root extract

Interacts with
1,140 drugs
0.3 mL per serving

Eleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence beh...

Eleuthero (Eleutherococcus senticosus) root extract monograph & interactions

Alfalfa (Medicago sativa) aerial parts extract

Interacts with
583 drugs
0.15 mL per serving

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of...

Alfalfa (Medicago sativa) aerial parts extract monograph & interactions

American Spikenard (Aralia racemosa) root extract

Interacts with
75 drugs
0.15 mL per serving

American spikenard is a traditional North American herb used mainly as an expectorant and to ease coughs and colds, but there is no reliable human res...

American Spikenard (Aralia racemosa) root extract monograph & interactions

Calendula (Calendula officinalis) flower extract

Interacts with
248 drugs
0.08 mL per serving

Calendula is a flowering plant whose petals are used mainly in skin creams, oils, and ointments to soothe minor irritation and support wound healing....

Calendula (Calendula officinalis) flower extract monograph & interactions

Other (inactive) ingredients: Purified Water, Ethanol. These complete the product’s ingredient list but are not active constituents.

Interaction report

Saw Palmetto Combination #1 by Genestra Brands Drug Interactions

Want to check YOUR meds against Saw Palmetto Combination #1?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,391Drugs
2 Major 916 Moderate 473 Minor

Ingredients driving the most interactions

Eleuthero (Eleutherococcus senticosus) root extract 1,140
Alfalfa (Medicago sativa) aerial parts extract 583
Calendula (Calendula officinalis) flower extract 248
Saw Palmetto (Serenoa repens) fruit extract 174
Damiana (Turnera diffusa) leaf extract 86

Individual Drug Interactions

The ingredients in Saw Palmetto Combination #1 interact with 1,391 drugs. Click any drug to see the details.

6 of the 6 ingredients in Saw Palmetto Combination #1 interact with drugs. Each result below shows which ingredient is responsible. Eleuthero (Eleutherococcus senticosus) root extract Alfalfa (Medicago sativa) aerial parts extract Calendula (Calendula officinalis) flower extract Saw Palmetto (Serenoa repens) fruit extract Damiana (Turnera diffusa) leaf extract American Spikenard (Aralia racemosa) root extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Saw Palmetto Combination #1 with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Eleuthero (Eleutherococcus senticosus) root extract10 drug types · 1,140 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, eleuthero may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro and animal research shows that a constituent of eleuthero, dihydroxybenzoic acid, appears to inhibit platelet aggregation. Concomitant use with anticoagulant or antiplatelet drugs might increase the risk of bleeding. This effect has not been reported in humans.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, eleuthero might have additive effects when used with antidiabetes drugs.
Animal research suggests that certain constituents of eleuthero have hypoglycemic activity in both healthy and diabetic animals. A small study in adults with type 2 diabetes also shows that taking eleuthero for 3 months can lower blood glucose levels. However, one very small study in healthy individuals shows that taking powdered eleuthero 3 grams, 40 minutes prior to a 75-gram oral glucose tolerance test, significantly increases postprandial blood glucose levels when compared with placebo. These contradictory findings might be due to patient-specific variability and variability in active ingredient ratios.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, eleuthero might increase levels of drugs metabolized by CYP1A2.
In vitro and animal research suggest that standardized extracts of eleuthero inhibit CYP1A2. This effect has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, eleuthero might increase levels of drugs metabolized by CYP2C9.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2C9. This effect has not been reported in humans.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Eleuthero might increase serum digoxin levels and increase the risk of side effects.
In one case report, a 74-year-old male who was stabilized on digoxin presented with an elevated serum digoxin level after starting an eleuthero supplement, without symptoms of toxicity. After stopping the supplement, serum digoxin levels returned to normal. It is not clear whether this was due to a pharmacokinetic interaction or to interference with the digoxin assay. Although the product was found to be free of digoxin and digitoxin, it was not tested for other contaminants.

Likelihood Unlikely Evidence D
Immunosuppressants

Theoretically, eleuthero might interfere with immunosuppressive drugs because of its immunostimulant activity.
Animal and in vitro research shows that eleuthero extracts have immunomodulatory effects, including increasing cellular and humoral activity.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

Theoretically, eleuthero might increase levels of P-glycoprotein substrates.
In vitro research suggests that eleuthero can inhibit the multi-drug transporter protein, P-glycoprotein. However, it is too soon to tell if this is clinically important. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, eleuthero might increase levels of drugs metabolized by CYP2D6.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP2D6. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP2D6 drug metabolism.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.

Likelihood Unlikely Evidence B
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Theoretically, eleuthero might decrease levels of drugs metabolized by OATP.
In vitro research suggests that eleuthero inhibits OATP2B1, which might reduce the bioavailability of oral drugs that are substrates of OATP2B1. Due to the weak inhibitory effect identified in this study, this interaction is not likely to be clinically significant.

Likelihood Possible Evidence D
Eleuthero (Eleutherococcus senticosus) root extract full monograph & interactions

Alfalfa (Medicago sativa) aerial parts extract6 drug types · 583 drugs

Warfarin (Coumadin)

Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Alfalfa contains a large amount of vitamin K. This could theoretically interfere with the activity of warfarin.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that alfalfa decreases blood sugar in diabetic mice. Also, in one case report, a diabetic patient experienced hypoglycemia after consuming alfalfa extract. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, alfalfa might interfere with the activity of contraceptive drugs.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Estrogens

Theoretically, alfalfa might interfere with hormone therapy.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
In vitro research and human case reports suggest that alfalfa may have immunostimulant effects.

Likelihood Possible Evidence D
Photosensitizing Drugs

Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.

Likelihood Possible Evidence D
Alfalfa (Medicago sativa) aerial parts extract full monograph & interactions

Calendula (Calendula officinalis) flower extract1 drug type · 248 drugs

Cns Depressants

Theoretically, calendula might have additive effects when used with CNS depressants, although this appears to be unlikely.
Although some animal research has suggested that a saponoside constituent in calendula may have sedative effects, calendula has been used for over 30 years without reports of sedation in humans.

Likelihood Unlikely Evidence D
Calendula (Calendula officinalis) flower extract full monograph & interactions

Saw Palmetto (Serenoa repens) fruit extract3 drug types · 174 drugs

Anticoagulant/Antiplatelet Drugs

Saw palmetto might increase the risk of bleeding with anticoagulant or antiplatelet drugs.
Saw palmetto is reported to prolong bleeding time. Theoretically, it might increase the risk of bleeding when used concomitantly with anticoagulant or antiplatelet drugs.

Likelihood Possible Evidence D
Contraceptive Drugs

Saw palmetto might reduce the effectiveness of contraceptive drugs.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with contraceptive drugs taken concomitantly.

Likelihood Possible Evidence B
Estrogens

Saw palmetto might reduce the effectiveness of estrogens.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with estrogens taken concomitantly.

Likelihood Possible Evidence B
Saw Palmetto (Serenoa repens) fruit extract full monograph & interactions

Damiana (Turnera diffusa) leaf extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking damiana with antidiabetes drugs might increase the risk of hypoglycemia.
Animal research shows that taking damiana lowers blood glucose level.

Likelihood Possible Evidence D
Damiana (Turnera diffusa) leaf extract full monograph & interactions

American Spikenard (Aralia racemosa) root extract1 drug type · 75 drugs

Diuretic Drugs

American spikenard is purported to have diaphoretic properties. Diaphoretic substances can increase sweating and fluid loss from the body, which may enhance the effects of diuretics. This interaction could potentially lead to excessive fluid loss and electrolyte imbalance, especially in individuals taking diuretic medications. Healthcare providers need to monitor patients closely for signs of dehydration or electrolyte disturbances if they are using both Aralia racemosa and diuretic drugs concurrently.

Likelihood Possible Evidence D
American Spikenard (Aralia racemosa) root extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Saw Palmetto Combination #1, from the product label.

Genestra Brands

Name
Seroyal USA
City
Pittsburgh
State
PA
ZipCode
15275
Phone Number
1-888-737-6925
Web Address
seroyal.com
Pharmacist Counseling Corner

Saw Palmetto Combination #1 by Genestra Brands: Common Questions

Does Saw Palmetto Combination #1 by Genestra Brands interact with any medications?
Yes. Based on its ingredients, Saw Palmetto Combination #1 has a known interaction with 1,391 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Saw Palmetto Combination #1 contains 6 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm on birth control?
Not without checking first. Saw palmetto and alfalfa in this product may reduce how well your birth control works because they have hormone-like effects. Talk to your pharmacist or doctor before adding this to your routine.
What if I take a blood thinner like warfarin?
You need to avoid this product or clear it with your doctor first. Alfalfa is high in vitamin K, which directly reduces warfarin's effectiveness. Saw palmetto and eleuthero may also increase bleeding risk. This is a serious interaction.
Does this product actually work for prostate health?
Saw palmetto, the main ingredient, is rated possibly ineffective for benign prostatic hyperplasia based on the evidence we hold. The other herbs haven't been rated as effective for prostate symptoms either. The science doesn't back strong claims here.
Can I take this while breastfeeding?
Not recommended. Most ingredients lack enough safety data, and American spikenard is specifically advised against. Talk with your doctor or pharmacist about whether it's safe for your situation.
What are the most common side effects?
Saw palmetto may cause abdominal pain, constipation, diarrhea, dizziness, headache, nausea, or fatigue. Eleuthero at higher doses can cause nervousness or anxiety. Alfalfa often causes gas, bloating, and looser stools. Most side effects are mild and reversible.
Is this safe to take long-term?
Long-term safety data are limited for most of these herbs. Eleuthero and American spikenard are best used short-term. If you plan to take this regularly, discuss it with your pharmacist or doctor first.

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

Not sure if Saw Palmetto Combination #1 is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Saw Palmetto Combination #1 label
Go deeper

The Full Monographs Behind Saw Palmetto Combination #1’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Saw Palmetto

Interacts with 174 drugs

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 i...

Read the full Saw Palmetto monograph → Herb & supplement monograph

Damiana

Interacts with 86 drugs

Damiana is a traditional herb most famous as an aphrodisiac and mild mood-lifter, but solid human evidence for any of its uses is very limited. It is generally well tolerated in the small am...

Read the full Damiana monograph → Herb & supplement monograph

Eleuthero

Interacts with 1,140 drugs

Eleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so...

Read the full Eleuthero monograph → Herb & supplement monograph

Alfalfa

Interacts with 583 drugs

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoid...

Read the full Alfalfa monograph → Herb & supplement monograph

American Spikenard

Interacts with 75 drugs

American spikenard is a traditional North American herb used mainly as an expectorant and to ease coughs and colds, but there is no reliable human research to confirm it works. If you choose...

Read the full American Spikenard monograph → Herb & supplement monograph

Calendula

Interacts with 248 drugs

Calendula is a flowering plant whose petals are used mainly in skin creams, oils, and ointments to soothe minor irritation and support wound healing. Some early research is promising for ski...

Read the full Calendula monograph →
Sources

Sources & How We Checked

Saw Palmetto Combination #1's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 90 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Saw Palmetto 22 references
  1. 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
  2. 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
  3. 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
  4. 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.
  5. 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
  6. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2. PubMed
  7. 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
  8. 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
  9. 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
  10. 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.
  11. 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
  12. 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
  13. 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.
  14. Mantovani, F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol.Nefrol. 2010;62(4):335-340.
  15. 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
  16. 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.
  17. 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
  18. Jipescu D, Patel A, Bohra H, Pientka A. Rare case of saw palmetto induced heart block. JACC 2017;69(11) supplement:2310.
  19. 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.
  20. 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.
  21. 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
  22. 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

See these in context on the Saw Palmetto monograph →

Damiana 2 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Alarcon-Aquilar FJ, Roman-Ramos R, Perez-Gutierrez S, et al. Study of the anti-hyperglycemic effect of plants used as antidiabetics. J Ethnopharmacol 1998;61:101-10. PubMed

See these in context on the Damiana monograph →

Eleuthero 24 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ 1996;155:293-5.
  3. Awang DVC. Siberian ginseng toxicity may be case of mistaken identity (letter). CMAJ 1996;155:1237.
  4. Mills S, Bone K. Principles and Practice of Phytotherapy. London: Churchill Livingstone, 2000.
  5. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  6. Hikino H, Takahashi M, Otake K, Konno C. Isolation and hypoglycemic activity of eleutherans A, B, C, D, E, F, and G: glycans of Eleutherococcus senticosus roots. J Nat Prod 1986;49:293-7. PubMed
  7. Yun-Choi HS, Kim JH, Lee JR. Potential inhibitors of platelet aggregation from plant sources, III. J Nat Prod 1987;50:1059-64. PubMed
  8. Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. PubMed
  9. Hartz AJ, Bentler S, Noyes R et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med 2004;34:51-61. PubMed
  10. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr 2004;23:248-58. PubMed
  11. Dasgupta A, Wu S, Actor J, et al. Effect of Asian and Siberian ginseng on serum digoxin measurement by five digoxin immunoassays. Significant variation in digoxin-like immunoreactivity among commercial ginsengs. Am J Clin Pathol 2003;119:298-303. DOI
  12. Takahashi T, Kaku T, Sato T, et al. Effects of Acanthopanax senticosus HARMS extract on drug transport in human intestinal cell line Caco-2. J Nat Med. 2010;64(1):55-62. PubMed
  13. Fuchikami H, Satoh H, Tsujimoto M, Ohdo S, Ohtani H, Sawada Y. Effects of herbal extracts on the function of human organic anion-transporting polypeptide OATP-B. Drug Metab Dispos 2006;34:577-82. PubMed
  14. Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. PubMed
  15. Molokovskii, D. S., Davydov, V. V., and Tiulenev, V. V. [The action of adaptogenic plant preparations in experimental alloxan diabetes]. Probl.Endokrinol.(Mosk) 1989;35(6):82-87.
  16. Schmolz, M. W., Sacher, F., and Aicher, B. The synthesis of Rantes, G-CSF, IL-4, IL-5, IL-6, IL-12 and IL-13 in human whole-blood cultures is modulated by an extract from Eleutherococcus senticosus L. roots. Phytother.Res 2001;15(3):268-270.
  17. Huang, D. B., Ran, R. Z., and Yu, Z. F. [Effect of Acanthopanax senticosus injection on the activities of human tumor necrosis factor and natural killer cell in blood in the patients with lung cancer]. Zhongguo Zhong.Yao Za Zhi. 2005;30(8):621-624.
  18. Niu, H. S., Hsu, F. L., Liu, I. M., and Cheng, J. T. Increase of beta-endorphin secretion by syringin, an active principle of Eleutherococcus senticosus, to produce antihyperglycemic action in type 1-like diabetic rats. Horm.Metab Res 2007;39(12):894-898
  19. Watanabe, K., Kamata, K., Sato, J., and Takahashi, T. Fundamental studies on the inhibitory action of Acanthopanax senticosus Harms on glucose absorption. J Ethnopharmacol. 10-28-2010;132(1):193-199. PubMed
  20. Bazaz'ian, G. G., Liapina, L. A., Pastorova, V. E., and Zvereva, E. G. [Effect of Eleutherococcus on the functional status of the anticoagulation system in older animals]. Fiziol.Zh.SSSR Im I.M.Sechenova 1987;73(10):1390-1395.
  21. Kaloeva, Z. D. [Effect of the glycosides of Eleutherococcus senticosus on the hemodynamic indices of children with hypotensive states]. Farmakol.Toksikol. 1986;49(5):73.
  22. Martinez, B. and Staba, E. J. The physiological effects of Aralia, Panax and Eleutherococcus on exercised rats. Jpn J Pharmacol 1984;35(2):79-85. DOI
  23. Medon, P. J., Thompson, E. B., and Farnsworth, N. R. Hypoglycemic effect and toxicity of Eleutherococcus senticosus following acute and chronic administration in mice. Zhongguo Yao Li Xue.Bao. 1981;2(4):281-285.
  24. Freye E, GLeske J. Siberian ginseng results in beneficial effects on glucose metabolism in diabetes type 2 patients: a double blind placebo-controlled study in comparison to panax ginseng. Int J Clin Nutr. 2013;1(1):11-17.

See these in context on the Eleuthero monograph →

Alfalfa 32 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  4. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  5. Farber JM, Carter AO, Varughese PV, et al. Listeriosis traced to the consumption of alfalfa tablets and soft cheese [Letter to the Editor]. N Engl J Med 1990;322:338. PubMed
  6. Molgaard J, von Schenck H, Olsson AG. Alfalfa seeds lower low density lipoprotein cholesterol and apolipoprotein B concentrations in patients with type II hyperlipoproteinemia. Atherosclerosis 1987;65:173-9. PubMed
  7. Light TD, Light JA. Acute renal transplant rejection possibly related to herbal medications. Am J Transplant 2003;3:1608-9. PubMed
  8. Prete PE. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum 1985;28:1198-200. PubMed
  9. Alcocer-Varela J, Iglesias A, Llorente L, Alarcon-Segovia D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis Rheum 1985;28:52-7. PubMed
  10. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308:1361. DOI
  11. Feingold, R. M. Should we fear "health foods"? Arch Intern Med 7-12-1999;159(13):1502. PubMed
  12. Taormina, P. J., Beuchat, L. R., and Slutsker, L. Infections associated with eating seed sprouts: an international concern. Emerg.Infect.Dis 1999;5(5):626-634. PubMed
  13. Backer, H. D., Mohle-Boetani, J. C., Werner, S. B., Abbott, S. L., Farrar, J., and Vugia, D. J. High incidence of extra-intestinal infections in a Salmonella Havana outbreak associated with alfalfa sprouts. Public Health Rep. 2000;115(4):339-345. PubMed
  14. Mohle-Boetani J, Werner B, Polumbo M, and et al. From the Centers for Disease Control and Prevention. Alfalfa sprouts-- Arizona, California, Colorado, and New Mexico, February-April, 2001. JAMA 2-6-2002;287(5):581-582.
  15. Howard, M. B. and Hutcheson, S. W. Growth dynamics of Salmonella enterica strains on alfalfa sprouts and in waste seed irrigation water. Appl.Environ.Microbiol. 2003;69(1):548-553.
  16. Winthrop, K. L., Palumbo, M. S., Farrar, J. A., Mohle-Boetani, J. C., Abbott, S., Beatty, M. E., Inami, G., and Werner, S. B. Alfalfa sprouts and Salmonella Kottbus infection: a multistate outbreak following inadequate seed disinfection with heat and chl
  17. Strapp, C. M., Shearer, A. E., and Joerger, R. D. Survey of retail alfalfa sprouts and mushrooms for the presence of Escherichia coil O157:H7, Salmonella, and Listeria with BAX, and evaluation of this polymerase chain reaction-based system with experimen
  18. Akaogi, J., Barker, T., Kuroda, Y., Nacionales, D. C., Yamasaki, Y., Stevens, B. R., Reeves, W. H., and Satoh, M. Role of non-protein amino acid L-canavanine in autoimmunity. Autoimmun.Rev 2006;5(6):429-435. PubMed
  19. Burden and causes of foodborne disease in Australia: Annual report of the OzFoodNet network, 2005. Commun.Dis Intell. 2006;30(3):278-300.
  20. Shemesh, M., Lindner, H. R., and Ayalon, N. Affinity of rabbit uterine oestradiol receptor for phyto-oestrogens and its use in a competitive protein-binding radioassay for plasma coumestrol. J Reprod.Fertil. 1972;29(1):1-9. PubMed
  21. Elakovich, S. D. and Hampton, J. M. Analysis of coumestrol, a phytoestrogen, in alfalfa tablets sold for human consumption. J Agric.Food Chem. 1984;32(1):173-175. PubMed
  22. Malinow, M. R., Bardana, E. J., Jr., Pirofsky, B., Craig, S., and McLaughlin, P. Systemic lupus erythematosus-like syndrome in monkeys fed alfalfa sprouts: role of a nonprotein amino acid. Science 4-23-1982;216(4544):415-417. PubMed
  23. Malinow, M. R., McLaughlin, P., and Stafford, C. Alfalfa seeds: effects on cholesterol metabolism. Experientia 5-15-1980;36(5):562-564. PubMed
  24. Farnsworth, N. R. Alfalfa pills and autoimmune diseases. Am J Clin Nutr. 1995;62(5):1026-1028. DOI
  25. Herbert, V. and Kasdan, T. S. Alfalfa, vitamin E, and autoimmune disorders. Am J Clin Nutr 1994;60(4):639-640.
  26. Mahon, B. E., Ponka, A., Hall, W. N., Komatsu, K., Dietrich, S. E., Siitonen, A., Cage, G., Hayes, P. S., Lambert-Fair, M. A., Bean, N. H., Griffin, P. M., and Slutsker, L. An international outbreak of Salmonella infections caused by alfalfa sprouts grow
  27. Gray, A. M. and Flatt, P. R. Pancreatic and extra-pancreatic effects of the traditional anti- diabetic plant, Medicago sativa (lucerne). Br J Nutr. 1997;78(2):325-334.
  28. Van Beneden, C. A., Keene, W. E., Strang, R. A., Werker, D. H., King, A. S., Mahon, B., Hedberg, K., Bell, A., Kelly, M. T., Balan, V. K., Mac Kenzie, W. R., and Fleming, D. Multinational outbreak of Salmonella enterica serotype Newport infections due to
  29. Rubenstein AH, Levin NW, and Elliott GA. Manganese-induced hypoglycemia. Lancet 1962;1348-1351.
  30. Kaufman W. Alfalfa seed dermatitis. JAMA 1954;155(12):1058-1059. PubMed
  31. Ponka A, Andersson Y, Siitonen A, and et al. Salmonella in alfalfa sprouts. Lancet 1995;345:462-463. PubMed
  32. Puschner B, Chen X, Read D, Affolter VK. Alfalfa hay induced primary photosensitization in horses. Vet J. 2016 May;211:32-8. PubMed

See these in context on the Alfalfa monograph →

American Spikenard 1 reference
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

See these in context on the American Spikenard monograph →

Calendula 9 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Reider N, Komericki P, Hausen BM, et al. The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.). Contact Dermatitis 2001;45:269-72..
  3. Gol'dman II. [Anaphylactic shock after gargling with an infusion of Calendula]. Klin Med (Mosk) 1974;52:142-3.
  4. Paulsen E. Contact sensitization from Compositae-containing herbal remedies and cosmetics. Contact Dermatitis 2002;47:189-98. PubMed
  5. Bojadjiev C. On the sedative and hypotensive effect of preparations from the plant Calendula officinalis. Nauch Trud Visshi Med Inst Sof 1964;43:15-20.
  6. Samochowiec L. Pharmacological study of saponosides from Aralia mandshurica Rupr. et Maxim and Calendula officinalis L. Herba Pol. 1983;29:151-155.
  7. Madisetti M, Kelechi TJ, Mueller M, Amella EJ, Prentice MA. Feasibility, acceptability, and tolerability of RGN107 in the palliative wound care management of chronic wound symptoms. J Wound Care. 2017;26(Sup1):S25-S34. PubMed
  8. Final Assessment report on Calendula officinalis L., flos. European Medicines Agency: Committee on Herbal Medicinal Products (HMPC). 2018. EMA/HMPC/603409/2017. Available at: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-cal
  9. Puaratanaarunkon T, Washrawirul C, Chuenboonngarm N, Noppakun N, Asawanonda P, Kumtornrut C. Efficacy and safety of a facial serum containing snail secretion filtrate, Calendula officinalis, and Glycyrrhiza glaba root extract in the treatment of maskne: A

See these in context on the Calendula monograph →

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

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team