Drug & supplement interaction

Manna + Casanthranol

Casanthranol brand name: Doxidan Liquid Gels.

Moderate Interaction
The bottom line Moderate

Manna has a moderate interaction with Casanthranol. Theoretically, manna might increase the risk for fluid and electrolyte loss 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

Manna and Casanthranol

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

Moderate

STIMULANT LAXATIVES

Why this applies to Casanthranol

Casanthranol falls under STIMULANT LAXATIVES — the group Manna interacts with.

Theoretically, manna might increase the risk for fluid and electrolyte loss when taken with stimulant laxatives.
Due to the osmotic laxative effects of manna, concomitant use with stimulant laxatives might compound fluid and electrolyte loss.
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. Casanthranol is a stimulant laxative, meaning it nudges your bowel muscles to squeeze and move things along. Manna works differently, pulling extra water into your gut to soften stool. Neither one changes how the other is broken down in the body, so this isn't an enzyme problem. The concern is that you're using two laxatives at once.

When you combine them, the worry is simply too much of a good thing: more watery stools, and with that, more loss of fluid and important minerals like potassium. That can leave some folks feeling dizzy, weak, or crampy. This is a theoretical caution based on how they work, not a hard danger, but it's a real one. Please check with your pharmacist or doctor before pairing them.

References
  1. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 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

Manna Also Interacts With Other Medications

Manna has 98 moderate known drug interactions in our database — the Casanthranol 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 Manna

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

Everything else you take

See Every Supplement That Interacts With Casanthranol

This page covers Manna only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Casanthranol 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 Casanthranol page

“Casanthranol, the stimulant laxative inside Doxidan Liquid Gels, deserves genuine care around supplements, mostly because so many herbal products are stimulant laxatives themselves. Stack them and the fluid and potassium losses add up, and low potassium is precisely what makes oleander hazardous here, since it raises the risk of toxici…”

Reviewed by 2 · Jul 18, 2026

Open the Casanthranol interaction page

One more smart check

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

We hold 27 real supplement products containing Manna, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Manna. Your product may carry other ingredients that interact with Casanthranol too, on top of Manna — 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 Manna and Casanthranol 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 Manna
Top half

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

29 days ago today
Medication Casanthranol
Steady interest

#1,832 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 Manna

What is Manna?

Manna
  • Gentle constipation relief
  • Mild laxative for children and elderly
  • Natural sweetener
  • Occasional bowel softening

Manna is the dried, sweet sap of the flowering ash tree (Fraxinus ornus) and is best known as a gentle, mild laxative because it contains a sugar alcohol called mannitol. It is generally considered mild and is sometimes used for occasional constipation, but high-quality modern studies are limited, so talk with your pharmacist or doctor before using it.

Read the full Manna monograph & all interactions
Keep checking

Other Drugs & Manna

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

0Major
98Moderate
0Minor
2,731No known interaction
Moderate

98 interactions

Showing 60 of 98 moderate interactions — see all 98 on the Manna page.

No interaction 2,731 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 Manna and Casanthranol Together: Common Questions

Can you take Manna with Casanthranol?
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 Manna and Casanthranol 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 Casanthranol and Manna?

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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.