Serenoa repens


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Related to Serenoa repens: Pygeum africanum

saw palmetto

,

American Dwarf Palm Tree

(trade name),

Cabbage Palm

(trade name),

Ju-Zhong

(trade name),

Palmier Nain

(trade name),

Sabal

(trade name),

Sabal Fructus

(trade name),

Saw Palmetto Berry

(trade name),

Serenoa repens

(trade name)

Classification

Therapeutic: benign prostatic hyperplasia bph agents
Benign prostatic hyperplasia

Action

Exerts antiandrogenic, anti-inflammatory and antiproliferative properties in prostate tissue resulting in improvement in BPH symptoms such as frequent urination, hesitancy, urgency and nocturia.
Comparable in efficacy to finasteride but may be less effective than prazosin.

Therapeutic effects

Decreased urinary symptoms of BPH.

Pharmacokinetics

Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile

ROUTEONSETPEAKDURATION
PO1–2 mosunknown48 wk (longest studied treatment duration)

Contraindications/Precautions

Contraindicated in: Pregnancy and lactation.
Use Cautiously in: Prior to surgery (discontinue 2 weeks before to prevent bleeding).

Adverse Reactions/Side Effects

Central nervous system

  • dizziness
  • headache

Gastrointestinal

  • nausea
  • vomiting
  • constipation and diarrhea

Interactions

Hormonal action may interfere with other hormonal therapies (testosterone, hormonal contraceptives ).Avoid use with antiplatelet or anticoagulant drugs (may ↑ bleeding risk).Concomitant use with herbs that affect platelet aggregation such as ginger, garlic, gingko, and ginseng may ↑ bleeding risk.
Oral (Adults) Lipophilic extract (80–90% fatty acids)—160 mg twice daily or 320 mg once daliy. Whole berries—1–2 grams daily. Liquid extract from berry pulp—1–2 mL three times daily. Tea (efficacy is questionable due to lipophilicity of active constituents)—1 cup three times daily. Tea is prepared by steeping 0.5–1 gram dried berry in 150 mL boiling water for 5–10 minutes.

Availability

Lipophilic extract (80-90% fatty acids): OTC
Whole berries: OTC
Liquid extract: OTC

Nursing implications

Nursing assessment

  • Assess patient for symptoms of benign prostatic hypertrophy (BPH) (urinary hesitancy, feeling of incomplete bladder emptying, interruption in urinary stream, impairment in size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy.
  • Rectal exams prior to and periodically throughout therapy to assess prostate size are recommended.

Potential Nursing Diagnoses

Impaired urinary elimination (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Take on a full stomach to minimize GI effects.

Patient/Family Teaching

  • Advise patients to start therapy with this herbal supplement only after evaluation by a health care professional who will provide continued follow up care.
  • Inform patients that saw palmetto does not alter the size of the prostate but still should relieve the symptoms associated with BPH.
  • Tell patients that taking this herbal supplement with food should reduce the GI effects and make it easier to tolerate.

Evaluation/Desired Outcomes

  • Decrease in urinary symptoms of BPH.

Serenoa repens,

References in periodicals archive ?
Wyllie, "Not All Brands are Created Equal: A Comparison of Selected Components of Different Brands of Serenoa repens Extract," Prostate Cancer Prostatic Dis.
comparison of Finasteride (Proscar) and Serenoa repens (Permixon) in the inhibition of 5-alpha reductase in healthy male volunteers.
Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients.
Serenoa repens is a southeastern endemic that is the only member of its genus (Henderson et al.
Sabal Wood Sabal Seeds Serenoa repens (Bartram) Small Seeds cf.
densa (Pinales: Pinaceae), some hardwoods, and a shrub layer of saw palmetto, Serenoa repens (Bartram) J.
Serenoa repens (Bartram) Small (Palmaceae): Allotrichoma abdominalis, Ceropsilopa adjuncta, Discocerina obscurella, Ochthera exsculpta, Mimapsilopa cressoni, Psilopa dupla, Ptilomyia mabelae, Typopsilopa sp.
Saw palmetto, which comes from the berries of the fan palm, Serenoa repens, has remained a mainstay in the area of men's health over the years due to its long track record in reducing the severity of BPH.