Drug & supplement interaction

Cascara Sagrada + Magnesium Hydroxide (OTC drug)

Magnesium Hydroxide (OTC drug) brand name: Milk of Magnesia (MOM).

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

Cascara Sagrada has a moderate interaction with Magnesium Hydroxide (OTC drug). Theoretically, cascara sagrada might have additive adverse effects when taken with stimulant laxatives.

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

Cascara Sagrada and Magnesium Hydroxide (OTC drug)

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

Moderate

STIMULANT LAXATIVES

Why this applies to Magnesium Hydroxide (OTC drug)

Magnesium Hydroxide (OTC drug) falls under STIMULANT LAXATIVES — the group Cascara Sagrada interacts with.

Theoretically, cascara sagrada might have additive adverse effects when taken with stimulant laxatives.
Cascara sagrada has stimulant laxative effects and might compound fluid and electrolyte losses when taken with stimulant laxatives.
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 simple version: both cascara sagrada and Milk of Magnesia (magnesium hydroxide) work to get your bowels moving, just through different routes. Cascara stimulates the colon muscles to contract, while Milk of Magnesia pulls water into the gut. Stacking two laxatives together can be like pushing the gas pedal twice. You may end up with more cramping, watery diarrhea, and the loss of too much fluid and important salts like potassium and magnesium.

This is a theoretical concern based on how these products work, not hard study data, so it isn't a reason to panic. Still, doubling up usually isn't necessary. If you're reaching for both, check in with your pharmacist or doctor first, especially if you take heart or blood pressure medicines.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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, 625 minor known drug interactions in our database — the Magnesium Hydroxide (OTC drug) one above is one of them. If you take anything else, check it against the full list below.

Moderate 121 Minor 625 No known interaction 2,084 (incl. Magnesium Hydroxide (OTC drug))
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 Magnesium Hydroxide (OTC drug)

This page covers Cascara Sagrada only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Magnesium Hydroxide (OTC drug) page lists 46 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Jalap (major), Oleander (major), Alder Buckthorn (moderate) and Aloe (moderate).

By severity: 3 major · 34 moderate · 9 minor.

From our pharmacist’s overview on the Magnesium Hydroxide (OTC drug) page

“Milk of magnesia (magnesium hydroxide) is the medicine-cabinet fix for constipation, and most of the 46 supplements known to interact with it come from the same shelf. Twenty-nine are herbal stimulant laxatives, aloe latex and cascara sagrada among them, and doubling up on laxatives can drain fluid and potassium fast.”

Reviewed by 2 · Jul 18, 2026

Open the Magnesium Hydroxide (OTC drug) 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 Magnesium Hydroxide (OTC drug) 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 Magnesium Hydroxide (OTC drug) 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%

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

29 days ago today
Medication Magnesium Hydroxide (OTC drug)
Top 25%

#301 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
625Minor
2,083No known interaction
121 Moderate 625 Minor 2,083 No interaction
Moderate

121 interactions

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

Minor

625 interactions

Showing 60 of 625 minor interactions — see all 625 on the Cascara Sagrada page.

No interaction 2,083 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 2,083 medications checked with no known interaction — see the full Cascara Sagrada list.

See the full Cascara Sagrada interactions page
See every supplement checked against Magnesium Hydroxide (OTC drug), 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 Magnesium Hydroxide (OTC drug) supplement interactions › Every supplement checked against Magnesium Hydroxide (OTC drug), ranked by severity 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 Magnesium Hydroxide (OTC drug) Together: Common Questions

Can you take Cascara Sagrada with Magnesium Hydroxide (OTC drug)?
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 Magnesium Hydroxide (OTC drug) 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 Magnesium Hydroxide (OTC drug) 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.