Drug & supplement interaction

Cascara Sagrada + Bendroflumethiazide, Potassium

Bendroflumethiazide, Potassium brand names: Neo-NaClex-K, Centyl K.

Moderate Interaction
The bottom line Moderate

Cascara Sagrada has a moderate interaction with Bendroflumethiazide, Potassium. Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cascara Sagrada and Bendroflumethiazide, Potassium

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DIURETIC DRUGS

Why this applies to Bendroflumethiazide, Potassium

Bendroflumethiazide, Potassium falls under DIURETIC DRUGS — the group Cascara Sagrada interacts with.

Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Cascara sagrada has stimulant laxative effects, and long-term use has been associated with hypokalemia.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about this combo: your medicine pairs bendroflumethiazide, a thiazide-type 'water pill,' with added potassium. Thiazide diuretics tend to flush potassium out in your urine, which is exactly why potassium is bundled in to help offset that loss. Cascara sagrada, as a stimulant laxative, can also drain potassium through your gut, especially with frequent or long-term use.

Stack those two losses together and your potassium could dip too low (hypokalemia). That might show up as muscle cramps, weakness, fatigue, or an irregular heartbeat. To be fair, this is a theoretical concern based on how these work, not strong proof. Occasional, short-term laxative use is less worrisome, but please check with your pharmacist or doctor before combining them regularly.

References
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cascara Sagrada Also Interacts With Other Medications

Cascara Sagrada has 121 moderate, 623 minor known drug interactions in our database — the Bendroflumethiazide, Potassium one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cascara Sagrada

Covers the 2,830 medications we’ve checked against Cascara Sagrada. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Bendroflumethiazide, Potassium

This page covers Cascara Sagrada only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bendroflumethiazide, Potassium page lists 127 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Dolomite (major), Lithium (major) and Oleander (major).

By severity: 7 major · 103 moderate · 17 minor.

From our pharmacist’s overview on the Bendroflumethiazide, Potassium page

“Bendroflumethiazide with potassium (Neo-NaClex-K, Centyl K) is a water pill for blood pressure with built-in potassium replacement, and its interaction list warrants real care rather than a quick skim. Seven of the 127 supplement ingredients on file rate major, and they concentrate on two hazards: added kidney damage (Siberian cocklebu…”

Reviewed by 2 · Jul 18, 2026

Open the Bendroflumethiazide, Potassium interaction page

One more smart check

Taking Cascara Sagrada as Part of a Dietary Supplement Product? Check It for Interactions

We hold 849 real supplement products containing Cascara Sagrada, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cascara Sagrada. Your product may carry other ingredients that interact with Bendroflumethiazide, Potassium too, on top of Cascara Sagrada — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cascara Sagrada and Bendroflumethiazide, Potassium Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cascara Sagrada
Top 25%

#238 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Bendroflumethiazide, Potassium
Top 25%

#648 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cascara Sagrada

What is Cascara Sagrada?

Cascara Sagrada
  • Constipation
  • Bowel cleansing before procedures
  • Hemorrhoids
  • Traditional liver and gallbladder remedy

Cascara sagrada is a stimulant laxative made from the aged bark of a Pacific Northwest tree, used mainly for short-term relief of constipation. Because it can cause cramping, dehydration, and electrolyte problems—and was removed from over-the-counter laxative products in the U.S. due to safety concerns—it should only be used briefly, if at all, and with guidance from a pharmacist or doctor.

Read the full Cascara Sagrada monograph & all interactions
Keep checking

Other Drugs & Cascara Sagrada

Browse every other medication we’ve checked against Cascara Sagrada — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
121Moderate
623Minor
2,085No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Cascara Sagrada page.

Minor

623 interactions

Showing 60 of 623 minor interactions — see all 623 on the Cascara Sagrada page.

No interaction 2,085 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Cascara Sagrada and Bendroflumethiazide, Potassium Together: Common Questions

Can you take Cascara Sagrada with Bendroflumethiazide, Potassium?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cascara Sagrada and Bendroflumethiazide, Potassium interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.