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Dietary supplement

Cascara Sagrada 425 mg Ingredients & Drug Interactions

by Dr. Clark Store

Capsule Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Cascara Sagrada 425 mg is a dietary supplement by Dr. Clark Store 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.

HelloPharmacist Scorecard of Cascara Sagrada 425 mg by Dr. Clark Store

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

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, 425 mg per capsule. Cascara sagrada is the dried bark of a tree, traditionally used as a stimulant laxative to move your bowels.

The capsule itself is made of gelatin.

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: herbal laxative.
  • We looked for evidence on: Constipation, Bowel preparation.
  • 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.

Here's what the evidence shows: cascara sagrada is rated possibly ineffective for bowel prep before medical procedures. For regular constipation, we don't have reliable evidence either way — the data just isn't solid enough to say whether it works.

It may help short-term, but the risks with long-term use are real.

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 cramping.

Long-term use, though, carries serious risks: it can lead to protein in your urine (albuminuria), blood in your urine (hematuria), and muscle wasting (cachexia). Rare but serious, fresh or improperly aged cascara bark can cause severe vomiting and liver damage.

The safety data advises against stimulant laxatives like cascara during pregnancy. Active compounds may pass into breast milk, so it's best avoided while nursing.

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 taking cascara sagrada, check whether you take corticosteroids, diuretics (water pills), digoxin, or warfarin — all have Moderate-severity interactions. Also check if you're on any other stimulant laxatives, and ask about drugs your liver breaks down through the CYP3A4 pathway, which cascara may weaken slightly.

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 might work for occasional constipation, but it's not your first choice — especially if you take diuretics, corticosteroids, digoxin, or warfarin. Long-term use comes with real risks to your electrolytes and organs.

Talk with your pharmacist before you start, and definitely check your medications against the tool on this page.

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 May 22, 2020.

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 Cascara Sagrada 425 mg, straight from the product label.

Brand Dr. Clark Store
Barcode (UPC) 652384105644
Net contents 100 Capsule(s)
Market status On market
Date entered into DSLD May 22, 2020
DSLD ID 219878
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
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 Cascara Sagrada 425 mg by Dr. Clark Store, 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)
Servings per container
100
UPC/BARCODE
652384105644
IngredientAmount% DV
Cascara Sagrada425 mg--

Other ingredients: Gelatin Capsules

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.
Suggested/Recommended/Usage/Directions

Suggested Use: For adults 18 years of age and over, take 1 capsule once a day at bedtime with a full glass of water. Take more if needed, in accordance with your own research and advice from a healthcare professional. Consult a physician before giving to children.

Precautions

Note: Laxatives should not be taken for more than 1 week. Frequent or prolonged use may cause dependency.

Keep away from children.

Warning: Do not use if you have abdominal pain or diarrhea.

If you are pregnant, nursing or taking any medications, consult your doctor before use.

Discontinue use if you get diarrhea or watery stools. If any adverse reactions occur, immediately stop using this product and consult your doctor. If seal under cap is damaged or missing, do not use.

General Statements

Self Health Resource Center (866) DR-CLARK (372-5275) www.DrClarkStore.com

Leader in purity Established by Dr. Clark’s Family in 1993

Company does not adopt any Dr. Clark claims.

Seals/Symbols

Made in USA

Formulation

Herbal laxative

FDA Statement of Identity

Dietary Supplement

Storage

Store at room temperature.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

See for yourself

Cascara Sagrada 425 mg by Dr. Clark Store label

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

What’s inside

The Ingredients in Cascara Sagrada 425 mg by Dr. Clark Store

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

Serving size1 Capsule(s) Dosage formCapsule Servings per container100 Amounts shown are per serving.

Cascara Sagrada

Interacts with
745 drugs
425 mg per serving

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: Gelatin Capsules. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cascara Sagrada 425 mg by Dr. Clark Store Drug Interactions

Want to check YOUR meds against Cascara Sagrada 425 mg?

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

Each ingredient & the kinds of drugs it affects

For each ingredient in Cascara Sagrada 425 mg 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
The maker

Brand information

Manufacturer and brand details for Cascara Sagrada 425 mg, from the product label.

Dr. Clark Store

See all Dr. Clark Store products
Name
Dr. Clark Store
Phone Number
(866) 372-5275
Web Address
www.DrClarkStore.com
Pharmacist Counseling Corner

Cascara Sagrada 425 mg by Dr. Clark Store: Common Questions

Does Cascara Sagrada 425 mg by Dr. Clark Store interact with any medications?
Yes. Based on its ingredients, Cascara Sagrada 425 mg 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?
Cascara Sagrada 425 mg 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 use cascara sagrada while pregnant?
The safety data advises against stimulant laxatives like cascara during pregnancy. Talk with your doctor or pharmacist about what's safe for you.
Can I take cascara sagrada if I'm breastfeeding?
Active compounds may pass into breast milk, so it's best avoided while nursing. Ask your pharmacist about alternatives if you need a laxative.
What are the most common side effects?
Mild abdominal discomfort and cramping are the usual ones when you use it short-term. Long-term use carries more serious risks, including protein or blood in your urine and muscle wasting.
Does cascara sagrada actually work for constipation?
The evidence isn't established in our data — we don't have reliable evidence either way. It may help short-term, but it's not a long-term solution because of the risks that come with regular use.
Why can't I take cascara with my water pill or heart medicine?
Cascara sagrada depletes potassium with long-term use. If you're already on a diuretic or corticosteroid (which also lower potassium), the risk climbs. Low potassium can make heart drugs like digoxin dangerous.

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

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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.

Cascara Sagrada 425 mg label
Sources

Sources & How We Checked

Cascara Sagrada 425 mg'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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