• weakness or fainting;

• black, bloody, or tarry stools;

• coughing up blood or vomit that looks like coffee grounds;

• pain or swelling in your breasts or testicles;

• chest pain;

• fast, slow, or uneven heart rate;

• easy bruising or bleeding; or

• nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• nausea, vomiting, stomach pain;

• diarrhea or constipation;

• bad breath;

• headache;

• dizziness;

• sleep problems (insomnia);

• muscle pain;

• depressed mood; or

• increased or decreased interest in sex;

This is not a complete list of side effects and others may occur. Tell doctor, pharmacist, or healthcare provider about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect saw palmetto?

• a blood thinner such as warfarin (Coumadin);

• flutamide (Eulexin);

• garlic or ginkgo biloba;

• birth control pills;

• iron supplements such as ferrous fumarate ferrous gluconate, or ferrous sulfate;

• hormone replacement therapy;

• estrogen or testosterone;

• an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others; or

• medication used to prevent blood clots, such as alteplase (Activase), anistreplase (Eminase), clopidogrel (Plavix), dipyridamole (Persantine), streptokinase (Kabikinase, Streptase), ticlopidine (Ticlid), and urokinase (Abbokinase).

There may be other drugs not listed that can affect saw palmetto. Tell your healthcare provider about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your healthcare provider.