Pregnant patients should avoid use because of the herb's potential abortifacient properties; alcohol and water extracts of the herb may stimulate uterine activity. Those with liver disease, peptic ulcers, or severe hypotension should avoid use because of the formation of nicotinic acid. Breast-feeding patients, and those who have had a previous allergic reaction to fenugreek or nicotinic acid, should also avoid use.

Clinical considerations

If patient is taking an anticoagulant, monitor PTT, INR, and PT. Monitor the patient for abnormal bleeding.

Appearance of rash or contact dermatitis may indicate sensitivity to fenugreek.

Nausea, vomiting, jaundice, or elevated bilirubin level may indicate liver damage and hepatotoxicity from nicotinic acid. If patient develops these signs or symptoms, he should immediately stop using the herb.

If patient is pregnant, planning to become pregnant, or breast-feeding, advise her not to use fenugreek.

Caution patient that a rash or abnormal skin change may indicate an allergy to fenugreek and that nausea, vomiting, and skin color changes may indicate liver damage. Tell patient to discontinue use if such signs and symptoms appear.

Remind patient not to take fenugreek at the same time as other drugs and to separate administration times by 2 hours.

Tell patient to remind pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription.

Advise patient to consult his health care provider before using an herbal preparation because a conventional treatment with proven efficacy may be available.

Research summary

Current studies continue to elucidate the mechanism of fenugreek's abilities to lower cholesterol and glucose levels. Recent studies also show the ability of the plant to decrease the quantity of calcium oxalate deposited in the kidneys.

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