Concerns Taking Metoprolol With Saw Palmetto
In our latest question and answer, the pharmacist discusses combining metoprolol with saw palmetto, a supplement for BPH.
Can saw palmetto be taken with metoprolol? The girl at the doctor’s office who ordered the metoprolol told me that I shouldn't take my saw palmetto with it for my prostate, but she didn’t say why. I've taken saw palmetto for years, and it’s been effective. I've spent a day looking for a metoprolol / saw palmetto interaction and couldn’t find anything online. Is there one, and if so, what kind and to what degree? Thanks.
Sep 23, 2025- Metoprolol does not have any clinically significant interaction with saw palmetto based on available interaction databases and research.
- Metoprolol works primarily on the heart and does not meaningfully affect the prostate or bladder, so it is unlikely to cause or worsen urinary symptoms.
- If saw palmetto has been helping you, there is no clear interaction reason to stop taking it with metoprolol, though you may want to confirm this applies to your specific health situation with your doctor.
Answer
Hello! It is exactly these situations where you are having trouble finding clear information on a drug topic that we try to be most helpful. I appreciate you reaching out.
Metoprolol does not appear to have any clinically significant interaction with saw palmetto. Our own interaction database (Saw Palmetto - Metoprolol Interaction Details | HelloPharmacist) does not list an interaction between them.
In fact, saw palmetto is one of the safer over the counter supplements where it concerns interactions because it shows little activity on major drug metabolizing enzymes (such as the CYP enzymes) at usual doses.
Our interaction database, at this time, only flags potential interactions between saw palmetto and:
- Anticoagulant or antiplatelet drugs
- Estrogens
- Hormonal contraceptives
In addition to investigating a direct interaction between metoprolol and saw palmetto, we also have to ask, does metoprolol cause prostate related problems? Perhaps this is what the individual at the doctor's office was referring to. The answer is generally, no.
- What metoprolol targets: Metoprolol is a cardio-selective beta blocker. That means it mostly works on beta-1 receptors in the heart to lower heart rate and blood pressure. It has very little effect on the receptors that drive prostate or bladder symptoms.
- What drives prostate and bladder symptoms: Trouble with urine flow comes mainly from alpha-1 receptors in the prostate, and bladder urgency is influenced by beta-3 receptors in the bladder muscle. Metoprolol does not block alpha-1, and it does not meaningfully affect beta-3.
- Beta receptor confusion: Some bladder medicines like Myrbetriq (mirabegron) and Gemtesa (vibegron) are beta-3 agonists that relax the bladder for overactive bladder. Seeing the word beta there can make it sound like a beta blocker would do the opposite, but metoprolol is focused on beta-1 in the heart, so its effect on the bladder is minimal in real life.
Additional Thoughts
I do not see solid evidence that saw palmetto interacts with metoprolol, and I do not see evidence that metoprolol makes BPH symptoms worse. If saw palmetto has been helping you, there is no clear interaction reason to stop it because of metoprolol.
Having said that, I do not know your full medical history, so it is reasonable to ask your prescriber why they suggested avoiding saw palmetto in your specific case. From an evidence point of view, there is no clear interaction signal here, but your clinician may be considering details that are not visible to us.
Thanks again for reaching out, and feel free to do so any time.
References & sources
Glossary — Terms in This Answer
- Metoprolol
- A heart medication that belongs to a class of drugs called beta blockers, used to lower heart rate and blood pressure.
- Saw palmetto
- An over-the-counter supplement commonly used to help with prostate-related symptoms.
- Drug interaction
- A situation where two substances affect each other's effectiveness or safety when taken together.
- CYP enzymes
- Proteins in your body that break down most medications, allowing them to be processed and eliminated.
- Beta blocker
- A type of medication that works on certain nerve receptors to reduce heart rate and blood pressure.
- Beta-1 receptors
- Nerve receptor sites found primarily in the heart that control heart rate and force of contraction.
- Alpha-1 receptors
- Nerve receptor sites found in the prostate that control the flow of urine.
- BPH
- Benign prostatic hyperplasia, a common condition in older men where the prostate gland becomes enlarged.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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