| Fenugreek has been used for millennia both as a | | | | bleeding, when fenugreek is taken with anticoagulants |
| medicine and as a spice in Egypt, India, and the Middle | | | | such as aspirin, NSAIDS, heparin, low-molecular-weight |
| East. Traditional medicinal uses include the treatment | | | | heparins, and warfarin. Fenugreek also has the |
| of wounds, bronchitis, digestive problems, arthritis, | | | | potential to decrease blood glucose levels when |
| kidney problems, male reproductive conditions, boils, | | | | administered to those taking hypoglycemics, including |
| diabetes, cellulitis, tuberculosis, and GI problems. | | | | insulin. A decreased uricosuric effect is noted with |
| Investigations in animals have found the seeds to | | | | probencid and sulfinpyrazone. Because of the fibrous |
| reduce serum cholesterol and glucose levels.Active | | | | content in fenugreek seeds and its binding potential, |
| components in fenugreek include mucilages, proteins, | | | | absorption of drugs may be altered. Advise patient to |
| steroid saponins, flavonoids, and volatile oils. Trigonelline, | | | | avoid using fenugreek within 2 hours of other |
| an alkaloid found in fenugreek, is degraded to nicotinic | | | | drugs.Pregnant patients should avoid use because of |
| acid (niacin), which may partially explain its ability to | | | | the herb's potential abortifacient properties; alcohol and |
| lower serum cholesterol levels. Steroid saponins may | | | | water extracts of the herb may stimulate uterine |
| also lower blood glucose and plasma glucagon levels | | | | activity. Those with liver disease, peptic ulcers, or |
| and enhance food consumption and appetite. The | | | | severe hypotension should avoid use because of the |
| seeds contain up to 50% mucilaginous fiber that, | | | | formation of nicotinic acid. Breast-feeding patients, and |
| because of their ability to absorb and expand, are | | | | those who have had a previous allergic reaction to |
| commonly used to treat diarrhea and constipation. The | | | | fenugreek or nicotinic acid, should also avoid use.Clinical |
| seeds also contain coumarin compounds. Fenugreek is | | | | considerationsIf patient is taking an anticoagulant, |
| available as capsules, paste, powder, ripe seeds, dried | | | | monitor PTT, INR, and PT. Monitor the patient for |
| seeds, and as a spice.Reported usesFenugreek is | | | | abnormal bleeding.Appearance of rash or contact |
| used to treat GI complaints and to relieve upper | | | | dermatitis may indicate sensitivity to fenugreek.Nausea, |
| respiratory tract congestion and allergies. It's also used | | | | vomiting, jaundice, or elevated bilirubin level may |
| to lower cholesterol, blood glucose, insulin, and | | | | indicate liver damage and hepatotoxicity from nicotinic |
| hemoglobin AlC levels, to improve glucose tolerance, | | | | acid. If patient develops these signs or symptoms, he |
| and as an appetite stimulant.Topically, a preparation of | | | | should immediately stop using the herb.If patient is |
| fenugreek is applied to treat skin inflammation, muscle | | | | pregnant, planning to become pregnant, or |
| pain, and gout, and to aid in the healing of wounds or | | | | breast-feeding, advise her not to use |
| skin ulcers.AdministrationExternal: A poultice is | | | | fenugreek.Caution patient that a rash or abnormal skin |
| prepared by mixing 50 g of powdered fenugreek with | | | | change may indicate an allergy to fenugreek and that |
| 1 qt (1 L) of water, and applied topically to the affected | | | | nausea, vomiting, and skin color changes may indicate |
| area, as neededInternal: An infusion is prepared by | | | | liver damage. Tell patient to discontinue use if such |
| steeping 0.5 g of fenugreek in cold water for 3 hours, | | | | signs and symptoms appear.Remind patient not to |
| and then straining. Honey may be used to sweeten the | | | | take fenugreek at the same time as other drugs and |
| infusion. The dosage is 6 g by mouth, or a cup of tea | | | | to separate administration times by 2 hours.Tell patient |
| taken several times a day.HazardsAdverse reactions | | | | to remind pharmacist of any herbal or dietary |
| to fenugreek include maple-syrup odor to urine, | | | | supplement that he's taking when obtaining a new |
| hepatotoxicity, jaundice, nausea, vomiting, increased | | | | prescription.Advise patient to consult his health care |
| bilirubin level, hypoglycemia, contact dermatitis (with | | | | provider before using an herbal preparation because a |
| external use), flushing, wheezing, watery eyes, | | | | conventional treatment with proven efficacy may be |
| numbness, rash, and angioedema (after inhalation, | | | | available.Research summaryCurrent studies continue |
| ingestion, or topical anesthesia).When taken with | | | | to elucidate the mechanism of fenugreek's abilities to |
| adrenergic blockers, there is an additive vasodilating | | | | lower cholesterol and glucose levels. Recent studies |
| effect that may lead to hypotension. There is risk of | | | | also show the ability of the plant to decrease the |
| increased prothrombin time (PT) and International | | | | quantity of calcium oxalate deposited in the kidneys. |
| Normalized Ratio (INR), and potential risk of abnormal | | | | |