CASCARA SAGRADA

OTHER NAME(S):

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 Purshianae Cortex, Rhamnus purshiana, Rhubarbe des Paysans, Sacred Bark, Sagrada Bark, Yellow Bark.

Overview

Overview Information

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

Cascara sagrada used to be approved by the U.S. Food and Drug Administration (FDA) as an over-the-counter (OTC) drug for constipation. However, over the years, concerns were raised about cascara sagrada'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 sagrada. 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 sagrada from the U.S. market by November 5, 2002. Today, you can buy cascara sagrada 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 sagrada is commonly used by mouth as a laxative for constipation.

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

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

How does it work?

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

Uses

Uses & Effectiveness?

Possibly Effective for

  • Constipation. Cascara sagrada has laxative effects and may help relieve constipation in some people.

Possibly Ineffective for

  • Emptying the colon before a colonoscopy. Most research shows that taking cascara sagradaalong with magnesium sulfate or milk of magnesia does not improve bowel cleansing in people who are undergoing a colonoscopy.

Insufficient Evidence for

  • Disorders affecting bile flow in the liver such as gallstones.
  • Liver disease.
  • Cancer.
  • Other conditions.
More evidence is needed to rate the effectiveness of cascara sagrada for these uses.

Side Effects

Side Effects & Safety

When taken by mouth: Cascara sagrada is POSSIBLY SAFE for most adults when taken for less than one week. Side effects include stomach discomfort and cramps.

Cascara sagrada is POSSIBLY UNSAFE when used for more than one week. This could 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.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There isn't enough reliable information to know if cascara sagrada is safe to use when pregnant. Stay on the safe side and avoid use. Cascara sagrada is POSSIBLY UNSAFE when taken by mouth while breast-feeding. Cascara sagrada can cross into breast milk and might cause diarrhea in a nursing infant.

Children: Cascara sagrada is POSSIBLY UNSAFE in children when taken by mouth. Don't give cascara sagrada to children. They are more likely than adults to become dehydrated and also harmed by the loss of electrolytes, especially potassium.

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

Interactions

Interactions?

Moderate Interaction

Be cautious with this combination

!

  • Digoxin (Lanoxin) interacts with CASCARA SAGRADA

    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 SAGRADA

    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 SAGRADA

    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 SAGRADA

    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 SAGRADA

    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 SAGRADA

    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.

Dosing

Dosing

The appropriate dose of cascara sagrada depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for cascara sagrada. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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View References

REFERENCES:

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