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CASCARA

Other Names:

Aulne Noir, Bitter Bark, Bois Noir, Bois à Poudre, Borzène, Bourgène, Buckthorn, California Buckthorn, Cáscara, Cascara Sagrada, Chittem Bark, Dogwood Bark, Écorce Sacrée, Frangula purshiana, Nerprun, Pastel Bourd, Purshiana Bark, Rhamni Purshia...
See All Names

Cascara Sagrada (CASCARA) Overview
Cascara Sagrada (CASCARA) Uses
Cascara Sagrada (CASCARA) Side Effects
Cascara Sagrada (CASCARA) Interactions
Cascara Sagrada (CASCARA) Dosing
Cascara Sagrada (CASCARA) Overview Information

Cascara is a shrub. The dried bark is used to make medicine.

Cascara used to be approved by the federal Food and Drug Administration (FDA) as an over-the-counter (OTC) drug for constipation. However, over the years, concerns were raised about cascara’s safety and effectiveness. The FDA gave manufacturers the chance to submit safety and effectiveness information to answer these concerns. But the companies decided the cost of conducting safety and effectiveness studies would likely be more than the profit they could expect from sales of cascara. So they didn’t comply with the request. As a result, the FDA notified manufacturers to remove or reformulate all OTC laxative products containing cascara from the U.S. market by November 5, 2002. Today, you can buy cascara as a “dietary supplement,” but not as a drug. “Dietary supplements” don’t have to meet the standards that the FDA applies to OTC or prescription drugs.

Cascara is used as a laxative for constipation, as well as a treatment for gallstones, liver ailments, and cancer. Some people use it as a “bitter tonic.”

In foods and beverages, a bitterless extract of cascara is sometimes used as a flavoring agent.

In manufacturing, cascara is used in the processing of some sunscreens.

How does it work?

Cascara contains chemicals that stimulate the bowel and have a laxative effect.

Cascara Sagrada (CASCARA) Uses & Effectiveness What is this?

Likely Effective for:

  • Use as a laxative in people with constipation.

Insufficient Evidence for:

  • Gallstones.
  • Liver disease.
  • Cancer.
  • Other conditions.
More evidence is needed to rate the effectiveness of cascara for these uses.


Cascara Sagrada (CASCARA) Side Effects & Safety

Cascara is POSSIBLY SAFE for most adults when used for only one or two weeks. Side effects include stomach discomfort and cramps.

But don’t use cascara for longer than two weeks. Long-term use can cause more serious side effects including dehydration; low levels of potassium, sodium, chloride, and other “electrolytes” in the blood; heart problems; muscle weakness; and others.

Don’t give cascara to children. They are more likely than adults to become dehydrated and also harmed by the loss of electrolytes, especially potassium.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the use of cascara during pregnancy. Stay on the safe side and avoid use if you are pregnant. Cascara is POSSIBLY UNSAFE during breast-feeding. Cascara can cross into breast milk and might cause diarrhea in a nursing infant.

Gastrointestinal (GI) disorders such as intestinal obstruction, Crohn’s disease, ulcerative colitis, appendicitis, stomach ulcers, or unexplained stomach pain: People with any of these conditions should not use cascara.

Cascara Sagrada (CASCARA) Interactions What is this?

Moderate Interaction Be cautious with this combination

  • Digoxin (Lanoxin) interacts with CASCARA

    Cascara is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects of digoxin (Lanoxin).

  • Medications for inflammation (Corticosteroids) interacts with CASCARA

    Some medications for inflammation can decrease potassium in the body. Cascara is a type of laxative that might also decrease potassium in the body. Taking cascara along with some medications for inflammation might decrease potassium in the body too much.

    Some medications for inflammation include dexamethasone (Decadron), hydrocortisone (Cortef), methylprednisolone (Medrol), prednisone (Deltasone), and others.

  • Medications taken by mouth (Oral drugs) interacts with CASCARA

    Cascara is a laxative. Laxatives can decrease how much medicine your body absorbs. Decreasing how much medicine your body absorbs can decrease the effectiveness of your medication.

  • Stimulant laxatives interacts with CASCARA

    Cascara is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the bowels. Taking cascara along with other stimulant laxatives could speed up the bowels too much and cause dehydration and low minerals in the body.

    Some stimulant laxatives include bisacodyl (Correctol, Dulcolax), castor oil (Purge), senna (Senokot), and others.

  • Warfarin (Coumadin) interacts with CASCARA

    Cascara can work as a laxative. In some people cascara can cause diarrhea. Diarrhea can increase the effects of warfarin and increase the risk of bleeding. If you take warfarin do not to take excessive amounts of cascara.

  • Water pills (Diuretic drugs) interacts with CASCARA

    Cascara is a laxative. Some laxatives can decrease potassium in the body. "Water pills" can also decrease potassium in the body. Taking cascara along with "water pills" might decrease potassium in the body too much.

    Some "water pills" that can decrease potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Microzide), and others.


Cascara Sagrada (CASCARA) Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • As a laxative for constipation: 20-30 mg per day of the active ingredient (hydroxyanthracene derivatives). A typical dose is 1 cup of tea, which is made by steeping 2 grams of finely chopped bark in 150 mL of boiling water for 5-10 minutes, and then straining. The cascara liquid extract is taken in a dose of 2-5 mL three times daily. The appropriate amount of cascara is the smallest dose that is needed to maintain soft stools.

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Conditions of Use and Important Information: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. © Therapeutic Research Faculty 2009.

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