Overview

Cascara sagrada (Frangula purshiana) is a shrub. The dried bark used to be FDA approved as an OTC laxative for constipation. It's now used in supplements.

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

People use cascara sagrada for constipation, emptying the colon before a colonoscopy, and other conditions, but there is no good scientific evidence to support these uses.

Cascara sagrada used to be approved by the US FDA as an over-the-counter (OTC) drug for constipation, but this approval was taken away in 2002 due to a lack of evidence. Today, you can buy cascara sagrada as a dietary supplement, but not as a drug

Uses & Effectiveness ?

Possibly Ineffective for

There is interest in using cascara sagrada for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Cascara sagrada is possibly safe when used for less than one week. Side effects include stomach discomfort and cramps. But cascara sagrada is possibly unsafe when used for more than one week. This could cause more serious side effects, including dehydration, low levels of electrolytes, heart problems, muscle weakness, and others.

Special Precautions and Warnings

When taken by mouth: Cascara sagrada is possibly safe when used for less than one week. Side effects include stomach discomfort and cramps. But cascara sagrada is possibly unsafe when used for more than one week. This could cause more serious side effects, including dehydration, low levels of electrolytes, heart problems, muscle weakness, and others.
Pregnancy: 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.

Breast-feeding: 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 when taken by mouth in children. Don't give cascara sagrada to children. They are more likely than adults to have serious side effects, including dehydration and low potassium levels.

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 ?

    Moderate Interaction

    Be cautious with this combination

  • Digoxin (Lanoxin) interacts with CASCARA SAGRADA

    Cascara sagrada 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 from digoxin.

  • Medications for inflammation (Corticosteroids) interacts with CASCARA SAGRADA

    Cascara sagrada is a type of laxative called a stimulant laxative. Stimulant laxatives can cause diarrhea and decrease potassium levels. Some medications for inflammation, called corticosteroids, can also decrease potassium levels. Taking these products together might cause potassium levels to drop too low.

  • Stimulant laxatives interacts with CASCARA SAGRADA

    Cascara sagrada is a type of laxative called a stimulant laxative. Stimulant laxatives can cause diarrhea and decrease potassium levels. Taking cascara sagrada with other stimulant laxatives might cause more diarrhea and very low potassium levels.

  • Warfarin (Coumadin) interacts with CASCARA SAGRADA

    Cascara sagrada can work as a laxative. In some people, cascara sagrada can cause diarrhea. Diarrhea can increase the effects of warfarin and increase the risk of bleeding. If you take warfarin, do not take large doses of cascara sagrada.

  • Water pills (Diuretic drugs) interacts with CASCARA SAGRADA

    Cascara sagrada is a laxative. Some laxatives can cause diarrhea and decrease potassium levels. "Water pills" can also decrease potassium levels. Taking cascara sagrada along with "water pills" might make potassium levels drop too low.

    Minor Interaction

    Be watchful with this combination

  • Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with CASCARA SAGRADA

    Some medications are changed and broken down by the liver. Cascara sagrada might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Dosing

Cascara sagrada used to be approved by the US FDA as an over-the-counter (OTC) drug for constipation, but this approval was taken away in 2002 due to a lack of evidence. Today, you can buy cascara sagrada as a dietary supplement, but not as a drug.

There isn't enough reliable information to know what an appropriate dose of cascara sagrada might be. 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 a healthcare professional before using.
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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 2020.