Drug & supplement interaction

Cascara Sagrada + Ethacrynic Acid

Ethacrynic Acid brand name: Edecrin.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Cascara Sagrada has a moderate interaction with Ethacrynic Acid. 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 Ethacrynic Acid

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

Moderate

DIURETIC DRUGS

Why this applies to Ethacrynic Acid

Ethacrynic Acid 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 to keep in mind if you're taking ethacrynic acid (Edecrin) and thinking about cascara sagrada. Both can lower your potassium. Ethacrynic acid is a strong loop diuretic, and pushing out extra water and salt naturally drags potassium along with it. Cascara, as a stimulant laxative, can do the same thing through the gut, especially with regular or long-term use. Stack them together and the worry is your potassium dropping too low (hypokalemia), which can cause muscle cramps, weakness, tiredness, or an irregular heartbeat.

To be fair, this concern is theoretical, based on how these two work rather than firm studies. Occasional, short-term cascara use is less of an issue than daily use. Still, please run it by your pharmacist or doctor first, and don't change your water pill on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Ethacrynic Acid one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 Minor 623 No known interaction 2,086 (incl. Ethacrynic Acid)
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.

From our Q&A

Questions About Cascara Sagrada or Ethacrynic Acid

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cascara Sagrada or Ethacrynic Acid, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ethacrynic Acid

This page covers Cascara Sagrada only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethacrynic Acid page lists 201 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 170 moderate · 24 minor.

From our pharmacist’s overview on the Ethacrynic Acid page

“Ethacrynic acid (Edecrin) is a potent loop diuretic, a water pill used to pull off serious fluid buildup, and its supplement list deserves genuine care, starting with the seven entries rated major. Most of the 201 interactions on file either stack with its blood-pressure-lowering effect, risking dizziness or faintness, or work against…”

Reviewed by 2 · Jul 18, 2026

Open the Ethacrynic Acid 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 Ethacrynic Acid 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 Ethacrynic Acid 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%

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

29 days ago today
Medication Ethacrynic Acid
Top half

#1,040 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
Medication

About Ethacrynic Acid

What Is Ethacrynic Acid Used For?

Brand name: Edecrin

Ethacrynic acid tablets (sold as Edecrin and Ethacrynic Acid) are used to treat edema — excess fluid that builds up in the body — when other, milder diuretics aren't strong enough. It treats edema related to congestive heart failure, cirrhosis of the liver, and kidney disease, including nephrotic syndrome (a kidney condition that causes protein loss and swelling).

It is also used for short-term management of fluid buildup from malignancy (cancer-related ascites), idiopathic edema (swelling with no clear cause), and lymphedema (swelling from a blocked lymph system). In hospitalized children (not infants), it may be used short-term for edema related to congenital heart disease or nephrotic syndrome.

See full Ethacrynic Acid drug information
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
121 Moderate 623 Minor 2,085 No 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

We also checked Cascara Sagrada against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,085 medications checked with no known interaction — see the full Cascara Sagrada list.

See the full Cascara Sagrada interactions page
See every supplement checked against Ethacrynic Acid, ranked by severity
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

Keep exploring
Cascara Sagrada monograph › Uses, safety, and every drug interaction in one place Ethacrynic Acid supplement interactions › Every supplement checked against Ethacrynic Acid, ranked by severity Ethacrynic Acid drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Cascara Sagrada and Ethacrynic Acid Together: Common Questions

Can you take Cascara Sagrada with Ethacrynic Acid?
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 Ethacrynic Acid 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

Still Have a Question About Ethacrynic Acid and Cascara Sagrada?

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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.