Integrative Therapies
Disclaimer: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified healthcare provider.

B: Good scientific evidence
- Cranberry: Cranberry seems to work for urinary tract infection prophylaxis by preventing bacteria from sticking to cells that line the bladder. Contrary to prior belief, urine acidification (urine that is concentrated and has a lower-than-normal pH) does not appear to play a role. Notably, many studies have been sponsored by the cranberry product manufacturer Ocean Spray®. Additional research is needed in this area before a conclusion can be made.
- Avoid if allergic to cranberries, blueberries, or other plants of the Vaccinium species. Sweetened cranberry juice may affect blood sugar levels. Use cautiously with a history of kidney stones. Avoid more than the amount usually found in foods if pregnant or breastfeeding.
- Lactobacillus acidophilus: Multiple human studies report that Lactobacillus acidophilus vaginal suppositories are effective in the treatment of bacterial vaginosis. Additional research is necessary before a firm conclusion can be reached. Patients with persistent vaginal discomfort are advised to seek medical attention.
- It may be difficult to tolerate Lactobacillus acidophilus if allergic to dairy products containing Lactobacillus acidophilus. Avoid with history of an injury or illness of the intestinal wall, immune-disease or heart valve surgery. Avoid with prescription drugs, like corticosteroids, because of the risk of infection. Use cautiously with heart murmurs. Antibiotics or alcohol may destroy Lactobacillus acidophilus. Therefore, it is recommended that Lactobacillus acidophilus be taken three hours after taking antibiotics or drinking alcohol. Some individuals can use antacids (like famotidine (Pepcid®), esomeprazole (Nexium®)) to decrease the amount of acid in the stomach one hour before taking Lactobacillus acidophilus.
- Psychotherapy: Psychotherapy is an interactive process between a person and a qualified mental health professional (psychiatrist, psychologist, clinical social worker, licensed counselor, or other trained practitioner). Its purpose is the exploration of thoughts, feelings, and behavior for the purpose problem solving or achieving higher levels of functioning. Psychotherapy may be helpful for sexual abuse in both child and adult survivors. Group therapy and individual therapy may be equally effective, although individual therapy may address post-traumatic stress symptoms more effectively.
- Psychotherapy cannot always fix mental or emotional conditions. Psychiatric drugs are sometimes needed. In some cases, symptoms may worsen if the proper medication is not taken. Not all therapists are qualified to work with all problems. Use cautiously with serious mental illness or some medical conditions because some forms of psychotherapy may stir up strong emotional feelings and expression.
- Vitamin C: Vitamin C may decrease the risk of developing a urinary tract infection during pregnancy. Further research is needed to confirm early study findings.
- Avoid if allergic or sensitive to vitamin C product ingredients. Vitamin C is generally considered safe in amounts found in foods. Vitamin C supplements are also generally considered safe in most individuals if taken in recommended doses. Avoid high doses of vitamin C with glucose 6-phosphate dehydrogenase deficiency, kidney disorders or stones, cirrhosis (inflammation of the liver), gout, or paroxysmal nocturnal hemoglobinuria (bleeding disorder). Vitamin C intake from food is generally considered safe if pregnant or breastfeeding. It is not clear if vitamin C supplements in doses higher than Dietary Reference Intake recommendations are safe for pregnant or breastfeeding women. Vitamin C is naturally found in breast milk.
C: Unclear or conflicting scientific evidence
- Acupressure, shiatsu: Results from preliminary study suggest a benefit of vaginal acupressure/pelvic massage in the treatment of sexual dysfunction. Additional studies are needed.
- With proper training, acupressure appears to be safe if self-administered or administered by an experienced therapist. Serious long-term complications have not been reported, according to scientific data. Hand nerve injury and herpes zoster (“shingles”) cases have been reported after shiatsu massage. Forceful acupressure may cause bruising.
- Acupuncture: The practice of acupuncture originated in China 5,000 years ago. Today it is widely used throughout the world and is one of the main pillars of Chinese medicine. It involves the insertion of needles in various point of the body to help move the “chi” or energy. A few clinical studies have suggested that acupuncture may help individuals suffering from erectile dysfunction (ED). The results found that acupuncture can be an effective treatment option in more than two-thirds of patients with ED caused by psychological factors including stress, anxiety, and depression. Subjective observations in limited available study suggest a possible role of acupuncture in the treatment of vulvodynia symptoms (chronic burning or stinging sensation of the vulva in the vagina). However, there is currently insufficient evidence on which to base recommendations. There is also insufficient available evidence to recommend either for or against the use of acupuncture in prostatitis. Early study in women with a urinary tract infection suggests a reduced recurrence over six months and reduced residual urine (urine retained in the bladder after urination). Better-designed studies are needed to determine recommendations.
- Needles must be sterile in order to avoid disease transmission. Avoid with valvular heart disease, medical conditions of unknown origins, or infections. Acupuncture should not be applied to the chest in patients with lung diseases or on any area that may rely on muscle tone to provide stability. Avoid use in infants, young children, or in patients with needle phobias. Use cautiously with bleeding disorders, neurological disorders, seizure disorders, or diabetes. Use cautiously in elderly or medically compromised patients. Use cautiously in patients who will drive or operate heavy machinery after acupuncture. Use cautiously if taking anticoagulants. Avoid if pregnant.
- Arginine: L-arginine, or arginine, is considered a semi-essential amino acid, because although it is normally synthesized in sufficient amounts by the body, supplementation is sometimes required. Early studies found that men with low nitrate levels (a cause of erectile dysfunction) in their blood or urine may find arginine supplements to be useful for managing erectile dysfunction. A randomized, controlled clinical trial reported improvements in patients with ED following use of a combination of L-arginine, glutamate, and yohimbine hydrochloride. Notably, yohimbine hydrochloride is an U.S. Food and Drug Administration (FDA) approved drug therapy for ED, and the effects caused by arginine alone in this combination therapy are difficult to determine. It is not clear what doses of arginine may be safe or effective in treating this condition, and comparisons have not been made with other agents used for ED. Larger, high-quality studies are needed.
- L-arginine is generally safe in recommended dosages, although drug interactions may be seen, especially with drugs to lower high blood pressure. Avoid if allergic to arginine, or with a history of stroke, or liver or kidney disease. Avoid if pregnant or breastfeeding. Use caution if taking blood-thinning drugs (like warfarin or Coumadin®) and blood pressure drugs or herbs or supplements with similar effects. Blood potassium levels should be monitored. L-arginine may worsen symptoms of sickle cell disease. Caution is advised in patients taking prescription drugs to control sugar levels.
- Boron: Boron is a trace element, which is found throughout the global environment. Inorganic boron (boric acid, borax) has been used as an antiseptic based on proposed antibacterial and antifungal properties. It is proposed that boric acid may have effects against candidal and non-candidal vulvovaginitis. A limited amount of poor-quality research reports that boric acid capsules used in the vagina may be effective for vaginitis. Further evidence is needed before a recommendation can be made.
- Avoid if allergic or sensitive to boron, boric acid, borax, citrate, aspartate or glycinate. Avoid with a history of diabetes, seizure disorder, kidney disease, liver disease, depression, anxiety, high blood pressure, skin rash, anemia, asthma, or chronic obstructive pulmonary disease (COPD). Avoid with hormone-sensitive conditions like breast cancer or prostate cancer. Avoid if pregnant or breastfeeding.
- Bromelain: Bromelain is an herb that contains a digestive enzyme, which comes from the stem and the fruit of the pineapple plant. Additional research is needed to determine if bromelain can help treat urinary tract infections (UTIs).
- Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, birch pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, wheat flour, or members of the Bromeliaceae family. Use cautiously with a history of bleeding disorders, stomach ulcers, heart disease, liver disease, or kidney disease. Use cautiously two weeks before and immediately after dental or surgical procedures. Use cautiously while driving or operating machinery. Avoid if pregnant or breastfeeding.
- Chamomile: Chamomile douche may improve symptoms of vaginitis with few side effects. Better research is needed before a conclusion can be drawn regarding the role of chamomile in the management of this condition. Because infection (including sexually transmitted diseases), poor hygiene, or nutritional deficiencies can cause vaginitis, medical attention should be sought by patients with this condition.
- Avoid if allergic to chamomile or any related plants, such as aster, chrysanthemum, mugwort, ragweed, or ragwort. Avoid with heart disease, breathing disorders, hormone-sensitive conditions, or central nervous system disorders. Avoid if taking cardiac depressive agents, central nervous system depressants, respiratory depressive agents, or anticoagulants. Use cautiously if taking benzodiazepines, anti-arrhythmic medications, calcium channel blockers, alcohol, sedative agents, anxiolytic medications, spasmolytic drugs, oral medications, or agents that are broken down by the liver. Use cautiously if driving or operating machinery. Avoid if pregnant or breastfeeding.
- Clove: A small amount of human research reports that a combination cream with clove and other herbs may be helpful in the treatment of premature ejaculation. However, well-designed studies of the effectiveness of clove alone are needed before a conclusion can be drawn.
- Avoid if allergic to Balsam of Peru, clove, eugenol, or some licorice and tobacco (clove cigarette) products. Avoid with bleeding disorders and in pediatric patients. Avoid use of undiluted clove oil on the skin. Use cautiously with seizure disorders and kidney or liver dysfunction. Avoid if pregnant or breastfeeding.
- Coenzyme Q10: There is early evidence that supports the use of CoQ10 for increasing sperm count and motility in patients with idiopathic asthenozoospermia. Better studies are needed before a conclusion can be made.
- Allergy associated with Coenzyme Q10 supplements has not been documented in the available literature, although rash and itching have been reported rarely. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk and do not use immediately after these procedures. Use caution with a history of blood clots, diabetes, high blood pressure, heart attack, or stroke, or with anticoagulants (blood thinners) or antiplatelet drugs (like aspirin, warfarin), or blood pressure, blood sugar, cholesterol, or thyroid drugs. Avoid if pregnant or breastfeeding.
- Coleus: Coleus (Coleus forskohlii) has been used in Asian traditional medicine for over 2,000 years. A component of coleus, called forskolin, was studied in humans in addition to prostaglandin E1, a drug commonly used in erectile dysfunction. Positive effects were seen with forskolin and progstaglandin when the prostaglandin alone did not work for erectile dysfunction.
- Caution is advised when taking coleus supplements, as numerous adverse effects including drug interactions with blood pressure lowering medications are possible. Coleus should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.
- Cordyceps: Cordyceps sinensis is a fungus found mainly in China, Nepal, and Tibet. There is currently not enough available scientific evidence regarding the use of Cordyceps for sexual dysfunction. High quality clinical research is needed in this area.
- Avoid if allergic or hypersensitive to cordyceps, mold, or fungi. Use cautiously with diabetes, prostate conditions, bleeding disorders, or if taking anticoagulant medications, immunosuppressive medications, or if on hormonal replacement therapy or oral contraceptives. Avoid with myelogenous-type cancers. Avoid if pregnant or breastfeeding.
- Cranberry: Well-designed human studies of cranberry for urinary tract infection treatment are currently lacking. Laboratory research suggests that cranberry may not be an effective treatment when used alone, although it may be helpful as an adjunct to other therapies such as antibiotics. In large quantities, cranberry juice may lower urine pH, making it more acidic.
- Avoid if allergic to cranberries, blueberries, or other plants of the Vaccinium species. Sweetened cranberry juice may affect blood sugar levels. Use cautiously with a history of kidney stones. Avoid more than the amount usually found in foods if pregnant or breastfeeding.
- Danshen: Danshen (Salvia miltiorrhiza) is widely used in traditional Chinese medicine (TCM), often in combination with other herbs. Early studies have found that danshen in combination with routine western medicine was not as effective as warming needle moxibustion for prostatitis. More studies are warranted in this area.
- Avoid if allergic or hypersensitive to danshen. Use cautiously if taking sedatives, hypolipidemics, cardiac glycosides, CYP-metabolized agents, nitrate ester, steroidal agents, or some anti-inflammatories (e.g. ibuprofen). Use cautiously with altered immune states, arrhythmia, compromised liver function, or a history of glaucoma, stroke, or ulcers. Stop use two weeks before and immediately after surgery/dental/diagnostic procedures with bleeding risks. Use cautiously if driving or operating heavy machinery. Avoid if taking blood thinners (anticoagulants), digoxin, or hypotensives, including ACE inhibitors (e.g. captopril), or Sophora subprostrata root or herba serissae. Avoid use after cerebral ischemia.
- DHEA (dehydroepiandosterone): DHEA is an endogenous hormone (made in the human body) secreted by the adrenal gland. DHEA serves as forerunner to male sex hormones (androgens) and female sex hormones (estrogens). DHEA levels in the body begin to decrease after age 30. Although some human studies report positive benefits on erectile dysfunction and sexual function while using DHEA in both men and women, better research is necessary before a clear conclusion can be drawn. Preliminary evidence suggests that DHEA may offer some benefit for increasing libido in premenopausal women. Well designed clinical trials are required before recommendations can be made.
- Caution is advised when taking DHEA supplements, as numerous adverse effects including drug interactions are possible.
- Echinacea: When echinacea is used at the same time as the prescription cream econazole nitrate (Spectazole®), vaginal yeast infections (Candida) may occur less frequently. However, further research is needed to confirm this.
- Caution is advised when taking echinacea supplements, as numerous adverse effects including drug interactions are possible. Echinacea should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.
- Ephedra: Early small studies suggest that ephedra may increase sexual arousal in women. Further well-designed research is needed to confirm these results.
- The U.S. Food and Drug Administration (FDA) has collected more than 800 reports of serious toxicity, including more than 22 deaths from the use of ephedra and/or ephedra containing products. Avoid use in individuals younger than 18 years old. Avoid use for prolonged periods (longer than seven days) due to risk of abuse or toxicity. Discontinue use at least one week prior to major surgery or diagnostic procedures. Use cautiously with cardiovascular disease, including structural heart disease, arrhythmia, coronary artery disease, high blood pressure, cerebrovascular disease, and a history of stroke or transient ischemic attack. Use cautiously with depression, anxiety disorders, anorexia/bulimia, a history of suicidal ideation, insomnia, tremors, urinary retention, enlarged prostate, diabetes, kidney disease, glaucoma, thyroid disease, and peptic ulcer disease. Use cautiously with monoamine oxidase inhibitor (MAOI) or stimulant use. Avoid if pregnant or breastfeeding.
- Ginkgo: Ginkgo (Ginkgo biloba) has been used medicinally for thousands of years, and is one of the top selling herbs in the United States. Ginkgo is commonly used for decreased blood flow. Ginkgo has been reported in animal and human models as having vascular (blood vessel) relaxant properties, which may act on corpus cavernosum tissue of the penis and improve penile blood flow in patients with ED. Ginkgo has also been reported to be effective in treating antidepressant-induced decreased libido and erectile dysfunction.
- Ginkgo may increase the chances of bleeding in sensitive individuals, such as those taking blood thinning drugs like warfarin (Coumadin®). Avoid if allergic or hypersensitive to members of the Ginkgoaceae family. If allergic to mango rind, poison sumac, poison ivy, poison oak, or cashews, then allergy to ginkgo is possible. Ginkgo should be stopped two to three weeks before surgical procedures. Use cautiously with seizures or in children. Ginkgo seeds are dangerous and should be avoided. Skin irritation and itching may also occur due to ginkgo allergies. Do not use ginkgo in supplemental doses if pregnant or breastfeeding.
- Ginseng: Asian ginseng, or Panax ginseng, has been used for more than 2,000 years in Chinese medicine for various health conditions. Preliminary evidence indicates that ginseng may be effective in improving the signs and symptoms of erectile dysfunction (ED). Early studies suggest that applying an herbal combination containing Panax ginseng on the penis may help treat premature ejaculation. However, because ginseng was tested with other herbs, its individual effects on sexual function and libido are unclear. Early studies also suggest that a product containing Panax ginseng, L-arginine, Ginkgo biloba, damiana, and multivitamin/minerals may improve sexual arousal in women with decreased sex drives and menopausal women. Studies with Panax ginseng alone are needed before strong conclusions can be made.
- Avoid ginseng with known allergy to plants in the Araliaceae family. There has been a report of a serious life-threatening skin reaction, possibly caused by contaminants in ginseng formulations.
- Horny goat weed: Horny goat weed has been traditionally used to increase fertility. Early study suggests that horny goat weed may be of benefit for sexual dysfunction in renal failure patients. Additional study is needed in this area.
- Avoid if allergic/hypersensitive to horny goat weed (Epimedium grandiflorum), its constituents, or related plants in the Berberidaceae family. Use cautiously with tachyarrhythmia, decreased blood pressure, frequent nosebleeds, musculoskeletal disorders, bipolar disorder, immune function disorders, homocysteine disorders, hypothyroid conditions, and cardiovascular disease. Use cautiously if taking anticoagulant or antiplatelet (blood thinning) medications, antihypertensive (blood pressure) medications, antidepressants (MAOIs), interleukins, or cholesterol-lowering medications. Avoid with hormone-sensitive conditions or if taking estrogen or oral contraception. According to traditional Chinese medicine (TCM), avoid in patients with “fire from yin deficiency” (people with too much “yang” or heat, masculinity, and activity, based on Chinese philosophy). Avoid if pregnant or breastfeeding.
- Horseradish: Horseradish (Armoracia rusticana) is a hardy perennial plant of the Brassicaceae family, which includes mustard and cabbage. Several laboratory studies suggest that horseradish has antibiotic activity. Limited available human study used a combination product made from horseradish root and nasturtium herb to treat common bacterial infections, including urinary tract infections. Researchers found that the combination product was as effective as standard antibiotic therapy. However, further studies evaluating horseradish alone are needed.
- Intravenous horseradish should be used cautiously. Use cautiously with bleeding disorders, high blood pressure, thyroid disorders, kidney disorders, gastrointestinal conditions, or ulcers. Use cautiously if taking anticoagulants, anti-platelet drugs, blood pressure drugs, anti-inflammatories, thyroid hormones, or if receiving cancer treatment. Avoid medicinal amounts of horseradish if pregnant or breastfeeding.
- Hydrotherapy: There is currently insufficient evidence to determine the safety or effectiveness of hydrotherapy for treatment of pelvic inflammatory disease (PID). PID is a potentially serious medical condition that should be evaluated by a qualified, licensed healthcare provider.
- Avoid sudden or prolonged exposure to extreme temperatures in baths, wraps, or saunas, particularly with heart disease, lung disease, or if pregnant. Avoid with implanted medical devices like pacemakers, defibrillators, or hepatic (liver) infusion pumps. Vigorous use of water jets should be avoided with fractures, known blood clots, bleeding disorders, severe osteoporosis, open wounds, or during pregnancy. Use cautiously with Raynaud’s disease, chilblains, acrocyanosis, erythrocyanosis, and impaired temperature sensitivity, such as neuropathy. Use cautiously if pregnant or breastfeeding. Hydrotherapy should not delay the time to diagnosis or treatment with more proven techniques or therapies, and should not be used as the sole approach to illnesses. Patients with known illnesses should consult their physician(s) before starting hydrotherapy.
- Hypnotherapy, hypnosis: There is inconclusive evidence from preliminary research on the use of hypnotherapy for erectile dysfunction. Additional study is needed before a firm conclusion can be drawn.
- Use cautiously with mental illnesses like psychosis/schizophrenia, manic depression, multiple personality disorder or dissociative disorders. Use cautiously with seizure disorders.
- Lactobacillus acidophilus: Lactobacillus acidophilus taken by mouth or as a vaginal suppository has not been adequately assessed for the prevention or treatment of vaginal candidiasis. More research is needed in this area a before a conclusion can be drawn.
- It may be difficult to tolerate Lactobacillus acidophilus if allergic to dairy products containing Lactobacillus acidophilus. Avoid with history of an injury or illness of the intestinal wall, immune-disease or heart valve surgery. Avoid with prescription drugs, like corticosteroids, because of the risk of infection. Use cautiously with heart murmurs. Antibiotics or alcohol may destroy Lactobacillus acidophilus. Therefore, it is recommended that Lactobacillus acidophilus be taken three hours after taking antibiotics or drinking alcohol. Some individuals can use antacids (like famotidine (Pepcid®), esomeprazole (Nexium®)) to decrease the amount of acid in the stomach one hour before taking Lactobacillus acidophilus.
- L-carnitine: L-carnitine, carnitine, or acetyl-L-carnitine, is an amino acid (building block for proteins). High concentrations of carnitine are found in muscle tissue. Preliminary studies suggest that addition of acetyl-L-carnitine (in combination with propionyl-L-carnitine, another form of carnitine) helped sildenafil (Viagra®) work better for patients with erectile dysfunction (ED). However, more rigorous trials should be performed. Additionally, although early evidence is promising, more study is needed before a firm recommendation can be made for Peyronie’s disease.
- Caution is advised when taking L-carnitine supplements, as adverse effects including drug interactions are possible. Avoid with known allergy or hypersensitivity to carnitine. Use cautiously with peripheral vascular disease, hypertension (high blood pressure), alcohol-induced liver cirrhosis, and diabetes. Use cautiously in low birth weight infants and individuals on hemodialysis. Use cautiously if taking anticoagulants (blood thinners), beta-blockers, or calcium channel blockers. Avoid if pregnant or breastfeeding.
- Lingonberry: Cranberry juice is commonly used to prevent and treat urinary tract infections. Clinical study using a combination of cranberry and lingonberry juice found that this was more effective than cranberry juice alone. Higher quality research comparing lingonberry juice or cranberry-lingonberry juice to cranberry juice alone is needed before a recommendation can be made for the use of lingonberry for urinary tract infection prevention.
- Avoid if allergic or hypersensitive to lingonberry (Vaccinium vitis-idaea), its constituents, or members of the Ericaceae family. Use cautiously in male patients in couples who are trying to become pregnant. Avoid if pregnant or breastfeeding.
- Maca: Maca (Lepidium meyenii) is a vegetable that has been cultivated as a root crop for at least 2,000 years. It can be found wild in Peru, Bolivia, Paraguay, and Argentina, but has primarily been cultivated in the highlands of the Peruvian Andes. Traditionally in Peru, maca has been used as a male aphrodisiac to increase sexual desire. Maca may improve sexual desire in healthy men independent of changes in mood, or serum testosterone (male hormone), and estradiol (female hormone) levels. Higher quality studies are needed in this area, in both men and women.
- Avoid if allergic/hypersensitive to maca (Lepidium meyenii), any of its constituents, or other members of the Brassicaceae family, formerly Cruciferae (broccoli, brussel sprouts, cabbage, or cauliflower). Use cautiously with anticoagulation therapy, hypertension, hormone responsive cancers such as breast cancer, or prostate cancer, and if using oral contraceptives or stimulants. Avoid if pregnant or breastfeeding.
- Moxibustion: There is preliminary evidence suggesting that moxibustion combined with acupuncture may help reduce urological symptoms in women with urethritis. However, more studies are needed before definitive recommendations for or against this approach can be made.
- Avoid with aneurysms, any kind of “heat syndrome,” heart disease, convulsions, cramps, diabetic neuropathy, extreme fatigue, anemia, fever, or inflammatory conditions. Avoid over allergic skin conditions, ulcerated sores, skin adhesions, or inflamed areas or organs. Do not use over the face, genitals, head, or nipples. Use cautiously over large blood vessels and thin or weak skin. It is not advisable to bathe or shower for up to 24 hours after a moxibustion treatment. Avoid if pregnant or breastfeeding.
- Muira puama: Muira puama (Ptychopetalum olacoides) has been used historically for enhancement of libido and as a treatment for erectile dysfunction by Brazilian native people. Well-designed human trials of muira puama, as well as safety data, are necessary. Additional study is also needed regarding the use of muira puama for female sexual dysfunction.
- Use cautiously with steroidal drug therapy, hormone-sensitive conditions (breast cancer, endometriosis, ovarian cancer, prostate cancer), high blood pressure, or heart disease. Use cautiously if taking medications acting on the central nervous system (CNS). Avoid if allergic/hypersensitive to muira puama (Ptychopetalum olacoides), any of its components or any related members of the Olacaeae family. Avoid if pregnant or breastfeeding.
- Para-aminobenzoic acid: Potassium para-aminobenzoate may be useful in the treatment of Peyronie’s disease. High quality clinical research is needed to make a conclusion.
- Avoid oral use in children and pregnant or nursing women. PABA must be used with caution in patients with renal disease. Abnormalities of liver function tests have been noted in patients taking PABA. Discontinue use if rash, nausea, or anorexia occurs. PABA should not be given concurrently with sulfonamides. Anyone with known hypersensitivity to PABA or its derivatives. Use cautiously in patients with bleeding disorders or taking anticoagulants. Use cautiously in patients with diabetes or hypoglycemia.