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Dietary supplement

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives Ingredients & Drug Interactions

by Nature's Plus

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives is a dietary supplement by Nature's Plus with 1 active ingredient. Its ingredients are commonly taken for constipation, bowel cleansing before procedures, hemorrhoids.Based on those ingredients, 745 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Cascara Sagrada. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus

Ask about any prescription or over-the-counter medication and we check it for interactions with Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 6, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains one active ingredient: cascara sagrada at 100 mg per capsule, standardized to 25–30% hydroxyanthracene derivatives—the compounds responsible for its laxative effect. The remaining capsule is made up of inactive ingredients (microcrystalline cellulose, vegetable cellulose, silica, magnesium stearate, and purified water) that serve as the capsule shell and binding agent.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Cascara Sagrada's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: nutritional support for natural elimination processes.
  • We looked for evidence on: Constipation, Bowel preparation, Laxation, Digestive regularity.
  • The closest evidence on file: Cascara Sagrada is rated "Possibly Ineffective" for Bowel preparation (Natural Medicines).
  • Also on file: Cascara Sagrada is rated "Insufficient Reliable Evidence To Rate" for Constipation.

Cascara sagrada is rated possibly ineffective for bowel preparation. For constipation, we hold insufficient reliable evidence to rate it—meaning the data we have doesn't establish whether it works for that purpose.

If you're considering it for short-term constipation relief, talk it over with your doctor or pharmacist to see if it's right for your situation.

The evidence, ingredient by ingredient Cascara Sagrada

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

When used short-term and appropriately, cascara sagrada is generally well tolerated. The most common side effect is mild abdominal discomfort and cramps.

Long-term use carries real risks: it can lead to low potassium levels, protein in the urine (albuminuria), blood in the urine (hematuria), and muscle wasting (cachexia). Fresh or improperly aged cascara bark can cause severe vomiting.

The safety data advises against cascara sagrada during pregnancy. While nursing, the active compounds may pass into breast milk, so it's best avoided—talk with your doctor or pharmacist if you're breastfeeding and considering a laxative.

Side effects, ingredient by ingredient Cascara Sagrada

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Cascara Sagrada.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; heart-rhythm medications.
  • For scale: 746 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before you take this product, double-check with your doctor or pharmacist if you're on blood thinners like warfarin, heart medications like digoxin, water pills (diuretics), corticosteroids, or any other stimulant laxatives. All of these carry Moderate-severity interaction risks with cascara sagrada.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Cascara sagrada is a short-term constipation remedy, but it's not a long-term solution and comes with real interaction risks, especially if you take blood thinners, heart medications, water pills, or steroids. If you're pregnant or nursing, this product isn't recommended.

Before you start, check with your doctor or pharmacist—especially if you're on any regular medications.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Aug 25, 2015.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives, straight from the product label.

Brand Nature's Plus
Barcode (UPC) 097467071360
Net contents 60 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Aug 25, 2015
DSLD ID 49349
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), No Allergies, Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
UPC/BARCODE
097467071360
IngredientAmount% DV
Cascara Sagrada100 mg--

Other ingredients: Microcrystalline Cellulose, Vegetable Cellulose, Silica, Magnesium Stearate, purified Water

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Nutritional Support for the Body’s Natural Elimination Processes.* Each Herbal Actives Cascara Sagrada capsule, providing the greatest concentration of active botanical principles, maximizes the synergistic benefits of the whole bark, which has been used by traditional health care practitioners for decades. Guaranteed Maximum Potency: Each Herbal Actives formula is scientifically standardized to the highest level of active principles. HerbaShield: An exclusive purity and safety system including light-resistant bottle, airtight inner seal, moisture-absorbing packet, tamper-evident safety cap and tamper-proof full bottle seal.

THIS IS NOT A PRESCRIPTION PRODUCT. It is a dietary supplement made with the highest possible quality standards.

Prescription Quality

Formula

NOTICE: This product contains cascara.

HYPO-ALLERGENIC.

Precautions

NOTICE: This product contains cascara. Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stools, or abdominal pain because cascara may worsen these conditions and be harmful to your health.

Consult your physician if you have frequent diarrhea or if you are pregnant, nursing, taking medication, or have a medical condition.

Printed HerbaShield inner seal and full bottle seal. Do not use if either seal is missing or broken.

KEEP OUT OF REACH OF CHILDREN.

FDA Disclaimer Statement

*This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Seals/Symbols

HerbaShield(R)

GUARANTEED MAXIMUM POTENCY(R)

GLUTEN Free

General

PRODUCT NO. 7136 LBL. 1132964

Brand IP Statement(s)

The Energy Supplements(R)

Vcaps(R) is a trademark of Capsugel(R)

(C)NATURAL ORGANICS(R)

FDA Statement of Identity

STANDARDIZED BOTANICAL SUPPLEMENT

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement offering the consistent benefits of exact potency, one capsule daily or as recommended by your health care professional.

Formulation

Free from artificial colors and preservatives. Free from the common allergens yeast, wheat, soy and milk.

Storage

KEEP TIGHTLY CLOSED IN A COOL, DRY PLACE.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Amounts shown are per serving.

Cascara Sagrada

Interacts with
745 drugs
100 mg per serving Form: Hydroxyanthracene Derivatives

Cascara sagrada is a stimulant laxative made from the aged bark of a Pacific Northwest tree, used mainly for short-term relief of constipation. Becaus...

Cascara Sagrada monograph & interactions

Other (inactive) ingredients: Microcrystalline Cellulose, Vegetable Cellulose, Silica, Magnesium Stearate, Purified Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus Drug Interactions

Want to check YOUR meds against Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
745Drugs
122 Moderate 623 Minor

Ingredients driving the most interactions

Cascara Sagrada 745

Individual Drug Interactions

The ingredients in Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives interact with 745 drugs. Click any drug to see the details.

1 of the 1 ingredient in Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives interact with drugs. Each result below shows which ingredient is responsible. Cascara Sagrada

Each ingredient & the kinds of drugs it affects

For each ingredient in Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

Cascara Sagrada6 drug types · 745 drugs

Corticosteroids

Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Cascara sagrada has stimulant laxative effects, and long-term use has been associated with hypokalemia.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, cascara sagrada might cause hypokalemia, potentially increasing the risk of digoxin toxicity.
Cascara sagrada has stimulant laxative effects, and long-term use has been associated with hypokalemia.

Likelihood Possible Evidence D
Diuretic Drugs

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.

Likelihood Possible Evidence D
Stimulant Laxatives

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.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, cascara sagrada might increase the risk of bleeding when taken with warfarin.
Cascara sagrada has stimulant laxative effects. In some people, cascara sagrada can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
In vitro research suggests that cascara sagrada can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.

Likelihood Possible Evidence D
Cascara Sagrada full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives, from the product label.

Nature's Plus

See all Nature's Plus products
Name
Natural Organics Laboratories, Inc. makers of Nature's Plus
Street Address
9500 New Horizons Blvd.
City
Amityville
State
New York
ZipCode
11701
Web Address
www.naturesplus.com
Pharmacist Counseling Corner

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus: Common Questions

Does Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives by Nature's Plus interact with any medications?
Yes. Based on its ingredients, Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives has a known interaction with 745 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take cascara sagrada if I'm pregnant?
No. Stimulant laxatives like cascara are not recommended during pregnancy. Talk with your doctor or pharmacist about safer options for constipation relief.
Can I use this while breastfeeding?
The active compounds may pass into breast milk, so it's best avoided while nursing. If you need a laxative and you're breastfeeding, ask your doctor or pharmacist for a safer alternative.
What are the side effects?
Short-term use usually causes mild abdominal discomfort and cramps. Long-term use can lead to more serious effects, including low potassium levels, protein or blood in the urine, and muscle wasting. Fresh or improperly aged cascara can trigger severe vomiting.
How long can I safely take this?
Cascara sagrada is intended for short-term use only. Long-term use carries real health risks. If you need long-term constipation relief, talk with your doctor or pharmacist about safer options.
Does cascara sagrada actually work for constipation?
The evidence we hold on cascara sagrada for constipation is insufficient to rate whether it works. For bowel prep, it's rated possibly ineffective. Your doctor or pharmacist can help you figure out whether it's right for your situation.

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

Not sure if Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives is safe with your meds?

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives label
Go deeper

The Full Monographs Behind Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Cascara Sagrada

Interacts with 745 drugs

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, an...

Read the full Cascara Sagrada monograph →
Sources

Sources & How We Checked

Herbal Actives Cascara Sagrada 100 mg/25-30% Hydroxyanthracene Derivatives's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 9 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Cascara Sagrada 9 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  5. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  6. Nadir A, Reddy D, Van Thiel DH. Cascara-sagrada induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity. Am J Gastroenterol 2000;95:3634-7. PubMed
  7. Nakasone ES, Tokeshi J. A serendipitous find: a case of cholangiocarcinoma identified incidentally after acute liver injury due to cascara sagrada ingestion. Hawaii J Med Public Health 2015;74(6):200-2.
  8. Cirillo C, Capasso R. Constipation and botanical medicines: an overview. Phytother Res 2015;29(10):1488-93. PubMed
  9. Mazzari ALDA, Lacerda MG, Milton FA, et al. In vitro effects of European and Latin-American medicinal plants in CYP3A4 gene expression, glutathione levels, and P-glycoprotein activity. Front Pharmacol 2022;13:826395. PubMed

See these in context on the Cascara Sagrada monograph →

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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