Antipsychotics,Anxiolytics and Hypnotics 737
Clinical evidence,mechanism, importance and management
Saw palmetto 320mg daily, given to 12 subjects for 16 days, did not affect pharmacokinetics of a single 2mg dose of alprazolam given on day 14 day (See reference number 1). In another study in 12 healthy subjects who took saw palmetto,160 mg twice daily for 28 days,there was no change in metabolic ratio of a single 8mg dose of midazolam (See reference number 2). These findings suggest that saw palmetto does not alter activity of cytochrome P450 isoenzyme CYP3A4, and no dosage adjustments of these benzodiazepines would be expected to be needed on concurrent use.
Markowitz JS,Donovan JL, DeVane L, Taylor RM, Ruan Y, Wang J-S, Chavin KD. Multipledoses of saw palmetto (Serenoa repens) did not alter cytochrome P450 2D6 and 3A4 activity in normal volunteers. Clin Pharmacol Ther (2003) 74, 536–42.
Gurley BJ,Gardner SF, Hubbard MA, Williams DK, Gentry WB, Carrier J, Khan IA, EdwardsDJ, Shah A. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther (2004) 76, 428–40.