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Dietary supplement

Cascara Sagrada Bark Ingredients & Drug Interactions

by Herbal Select

Cascara Sagrada Bark 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 Cascara Sagrada Bark 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

Cascara Sagrada Bark is a dietary supplement by Herbal Select 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 Cascara Sagrada Bark by Herbal Select

Ask about any prescription or over-the-counter medication and we check it for interactions with Cascara Sagrada Bark by Herbal Select — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Cascara Sagrada Bark by Herbal Select

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 Jul 12, 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, a plant-based stimulant laxative that works by triggering bowel muscle contractions. The capsules also contain gelatin and water as inactive ingredients.

Does it work?

Leans against
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
Leans against

The strongest graded evidence we hold for the stated purpose leans against a benefit.

Why this rating?
  • The label markets this product for: bowel health and regularity support.
  • We looked for evidence on: Bowel preparation, Constipation, digestive regularity, natural laxative effect.
  • 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 itself, we don't have enough reliable evidence in our data to rate it one way or the other.

If you're considering it for short-term constipation relief, talk with your pharmacist about whether 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 as directed, cascara sagrada is generally well tolerated — most people experience only mild stomach discomfort or cramps. However, long-term use carries real risks: it can cause liver damage, and chronic use has been linked to protein in the urine, blood in the urine, and severe weight loss and wasting.

Stimulant laxatives like cascara are not recommended during pregnancy. If you're nursing, the active compounds may pass into breast milk, so it's best to avoid it while breastfeeding.

If you're pregnant or nursing and considering this product, talk with your doctor or pharmacist.

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.

Check before taking this product if you use warfarin or other blood thinners, water pills (diuretics), corticosteroids, digoxin, or any other stimulant laxatives — these carry Moderate-severity interactions. Also double-check if you take medications processed by your liver's CYP3A4 enzyme, which may be affected at Minor severity.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with graded evidence leaning against its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Cascara sagrada is a short-term constipation option only — it's not meant for long-term use. If you take warfarin, any water pill, a corticosteroid, digoxin, or other stimulant laxatives, you'll need to check with us first.

Pregnant and nursing people should avoid it. Ask your pharmacist whether this is the right choice for you.

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 Feb 25, 2013.

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 Bark, straight from the product label.

Brand Herbal Select
Barcode (UPC) 065279030073
Net contents 60 Capsule(s); 450 mg
Market status On market
Date entered into DSLD Feb 25, 2013
DSLD ID 17663
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Dairy Free, Sugar 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 Cascara Sagrada Bark by Herbal Select, 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:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
UPC/BARCODE
065279030073
IngredientAmount% DV
Cascara Sagrada450 mg--

Other ingredients: Gelatin, 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

Potent-Max Traditional herb Herbal Select Potent-max traditional herbs potent ingredients in effective proportions, so you get consistent results - every time.

ZIN: 100665

Suggested/Recommended/Usage/Directions

Directions: Take 2 capsules at bedtime with water.

Precautions

Do not use if seal is broken.

FDA Statement of Identity

A Dietary Supplement

FDA Disclaimer Statement

Statements not evaluated by FDA. Product not intended to diagnose, treat, cure, or prevent any disease.

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

See for yourself

Cascara Sagrada Bark by Herbal Select label

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

Cascara Sagrada Bark 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 Cascara Sagrada Bark by Herbal Select

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

Serving size2 Capsule(s) Dosage formCapsule Amounts shown are per serving.

Cascara Sagrada

Interacts with
745 drugs
450 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, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cascara Sagrada Bark by Herbal Select Drug Interactions

Want to check YOUR meds against Cascara Sagrada Bark?

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 Cascara Sagrada Bark interact with 745 drugs. Click any drug to see the details.

1 of the 1 ingredient in Cascara Sagrada Bark 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 Cascara Sagrada Bark 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 Cascara Sagrada Bark, from the product label.

Herbal Select

See all Herbal Select products
Name
Herbal Select
Street Address
Unit 2 - 355 Michener Road
City
Guelph
State
Ont.
ZipCode
N1K 1E8
Phone Number
1-888-313-3369
Web Address
www.herbalselect.com
Pharmacist Counseling Corner

Cascara Sagrada Bark by Herbal Select: Common Questions

Does Cascara Sagrada Bark by Herbal Select interact with any medications?
Yes. Based on its ingredients, Cascara Sagrada Bark 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 Bark 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 long-term?
No — it's meant for short-term use only. Long-term use can damage your liver and cause protein or blood in the urine, and severe weight loss. If you're dealing with ongoing constipation, talk with your pharmacist about safer options.
What side effects should I watch for?
Mild stomach cramps and discomfort are common and normal. If you experience severe vomiting, signs of liver damage, or blood in your urine, stop and contact your doctor right away.
Is cascara sagrada safe if I'm pregnant or breastfeeding?
Not recommended. Stimulant laxatives like cascara aren't advised in pregnancy, and the active compounds pass into breast milk. Talk with your doctor or pharmacist about safer alternatives.
Does cascara sagrada actually work for constipation?
We don't have enough reliable evidence to rate it one way or the other for general constipation — the data on that is limited. For bowel preparation before procedures, it's rated possibly ineffective.
What's in this capsule besides the active ingredient?
Just gelatin and water — no other fillers or binders.

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

Not sure if Cascara Sagrada Bark 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.

Cascara Sagrada Bark label
Go deeper

The Full Monographs Behind Cascara Sagrada Bark’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

Cascara Sagrada Bark'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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