Medicinal Plant Lexicon

Medicinal Plant Lexicon

Saw Palmetto

Saw Palmetto
Photo: Sertürner Bildarchiv

Botanical name

Serenoa repens (W. Bartram) Small [Syn. Sabal serrulata (Michx.) Nutt.]

Family

Arecaceae

Common name

Saw palmetto, Scrub palmetto

Information about the plant

Saw palmetto is native to coastal southern North America, and its main distribution area is in South Carolina and Florida, where it grows on sandy soils in dunes and pine forests. Saw palmetto is also found in tropical Central and South America. It is a short-stemmed bush palm with large, fan-shaped, blue-green leaves that are divided into 18 to 24 segments. Their fine, saw-like serrations are characteristic. The 1 to 1.5 m long leaf stalks bear this serration. This feature is reflected in the common name "Saw palmetto". The epithet serrata of the synonym, from the Latin "serra" (= saw) and "serratus" (= serrate, serrated), also expresses this. The epithet repens of the currently accepted botanical name refers to the creeping rhizome of the saw palmetto (Lat. "repens" = creeping). The small flowers are arranged in branched axillary panicles. From these develop 3 cm long, ovate, one-seeded, nearly black fruits.

Medicinally used parts of plants (herbal drug)

The dried, ripe fruits (saw palmetto fruits – Sabalis serrulatae fructus) are used.

The commercially available herbal drug comes from the wild resources of the coastal southern United States and Central America.

Constituents of the herbal drug

Saw palmetto fruits contain fatty oil, free fatty acids, and sterols.

Quality of the drug

The quality of the following drugs and drug preparations is specified in the European Pharmacopoeia (Ph. Eur.):

  • Saw palmetto fruit (Sabalis serrulatae fructus)
  • Saw palmetto fruit extract (Sabalis serrulatae extractum)

Medical applications

Recognised medical use

The HMPC has accepted the use of saw palmetto fruit in the form of soft extracts (DER 7-11:1, extracted with hexane) for the symptomatic treatment of benign prostatic hyperplasia (BPH) as ‘well-established use’. Other extracts have been classified as traditional herbal medicinal products (see “Traditional use”).

ESCOP: Symptomatic treatment of micturition complaints (painful and difficult urination, frequent urination, nocturia, urinary retention) in benign prostatic hyperplasia (BPH, also benign prostatic syndrome, BPS) – Stage I to II (according to Alken) or Stage II and III according to Vahlensieck.

Traditional use

Saw palmetto fruit in the form of soft extracts (DER 7.5–14.3:1, extracted with 90–96% ethanol) has been classified by the HMPC as a traditional herbal medicinal product (Article 16a of Directive 2001/83/EC). Based upon long-standing use, these extracts may be used to relieve the symptoms of benign prostatic hyperplasia (BPH) provided that a serious medical condition has been ruled out by a doctor (see also ‘well-established use’).

Herbal drug preparations in finished dosage forms

  • Dry extracts of saw palmetto fruit in tablets and capsules
  • Concentrated extracts in capsules
  • Alcoholic extracts in drops
  • Serenoa repens homeopathic mother tincture in drops

Dosage

Finished medicinal products: see patient information leaflet.

Tea: Preparing a tea is not useful, as the fat-soluble constituents of saw palmetto fruits are only minimally released into the tea. To ensure efficacy in the treatment of benign prostatic hyperplasia (BPH), it is recommended to use them in the form of finished medicinal products. The dosage can be found in the patient information leaflet.

Preparation of a tea

Not applicable.

Notes

As saw palmetto fruits only alleviate the symptoms of an enlarged prostate, but do not address the enlargement itself (symptomatic treatment), regular check-ups with a doctor are necessary.

Benign prostatic hyperplasia (BPH) does not occur in children and adolescents, so use in this age group is not recommended.

Side effects

Saw palmetto fruits can occasionally cause gastric problems.

Interactions

Increased effects of anticoagulant medicines such as phenprocoumon (Marcumar) and warfarin have been occasionally observed. Elevated blood clotting levels have also been reported.

References

Herbal drug monographs

HMPC (2016, 2021), ESCOP (2003), WHO Vol.

Further literature

Commentary on the European Pharmacopoeia (saw palmetto fruit, No. 1848; saw palmetto fruit extract, No. 2579).

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