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Dietary supplement

Cascara Sagrada & Buckthorn Ingredients & Drug Interactions

by TerraVita

Cascara Sagrada & Buckthorn label
See full label image
Liquid 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 & Buckthorn 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 & Buckthorn is a dietary supplement by TerraVita with 2 active ingredients. Its ingredients are commonly taken for constipation, bowel cleansing before procedures, hemorrhoids.Based on those ingredients, 904 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Cascara Sagrada Glycerite Liquid Extract, Buckthorn Glycerite Liquid Extract. 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 & Buckthorn by TerraVita

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

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HelloPharmacist Scorecard of Cascara Sagrada & Buckthorn by TerraVita

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

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 0 of its 2 active ingredients.
  • “Proprietary Blend” is a proprietary blend — the label gives one combined amount (0.13 mL) without saying how much of each component you get.

This product contains 2 active ingredients: cascara sagrada glycerite liquid extract and buckthorn (sea buckthorn) glycerite liquid extract, delivered in a proprietary blend. Both are herbal extracts prepared in glycerin, which acts as a preservative and carrier.

Glycerin is the only inactive ingredient listed.

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.

Why this rating?
  • The label markets this product for: Digestive health and constipation relief.
  • We looked for evidence on: Constipation, Bowel preparation, Dyspepsia, Bowel regularity, Gastrointestinal support, Laxative action.
  • The closest evidence on file: Cascara Sagrada is rated "Possibly Ineffective" for Bowel preparation (Natural Medicines).
  • Also on file: Sea Buckthorn is rated "Insufficient Reliable Evidence To Rate" for Dyspepsia.
  • Also on file: Cascara Sagrada is rated "Insufficient Reliable Evidence To Rate" for Constipation.

Cascara sagrada has possibly ineffective evidence for bowel preparation and insufficient evidence for treating constipation — so the data we hold doesn't show it reliably works for either purpose. Sea buckthorn (buckthorn) shows possibly effective results for burns, but possibly ineffective for eczema, and insufficient evidence for aging skin, cholesterol issues, or cancer.

If you're considering this product for short-term constipation relief, the evidence doesn't support a strong case.

The evidence, ingredient by ingredient Cascara Sagrada Sea Buckthorn

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 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Cascara sagrada is generally well tolerated when used short-term and properly, though mild abdominal discomfort and cramps can occur. The real caution is with long-term use — it can lead to serious effects including low potassium, loss of blood in urine, muscle wasting, and in rare cases, liver damage if the bark is fresh or improperly aged.

Sea buckthorn is generally well tolerated as a food, but supplement safety hasn't been fully studied; high doses may cause yellow skin staining, and topical application can cause dryness, irritation, redness, or rash. Cascara sagrada should be avoided during pregnancy and is possibly unsafe while breastfeeding because active compounds may pass into milk.

Sea buckthorn has insufficient safety data for breastfeeding — talk with your pharmacist or doctor about use while nursing.

Side effects, ingredient by ingredient Cascara Sagrada Sea Buckthorn

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?
  • 2 of the 2 matched ingredients can interact with medications — Sea Buckthorn, 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: 905 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 with your pharmacist before taking this if you use water pills (diuretics), corticosteroids, warfarin or other blood thinners, digoxin, antiplatelet drugs like aspirin, blood pressure medications, or other stimulant laxatives. Cascara sagrada's ability to lower potassium and thin your blood, and buckthorn's blood-pressure and bleeding effects, need to be reviewed against your specific medications.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

This product is meant for short-term constipation relief, but the evidence for that isn't strong, and long-term use carries real risks including low potassium and other serious effects. If you take water pills, heart medications, blood thinners, blood pressure drugs, or corticosteroids, you need to check this product with your pharmacist first.

If you're pregnant or nursing, ask your doctor before starting.

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

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 13, 2022.

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 & Buckthorn, straight from the product label.

Brand TerraVita
Barcode (UPC) 064435222178
Net contents 1 Fluid Ounce(s); 30 mL
Market status On market
Date entered into DSLD Dec 13, 2022
DSLD ID 281979
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other
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 & Buckthorn by TerraVita, 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:
25 Drop(s)
Maximum serving Sizes:
40 Drop(s)
Servings per container
227
UPC/BARCODE
064435222178
IngredientAmount% DV
Proprietary Blend0.13 mL--
Cascara Sagrada Glycerite Liquid Extract0 NP--
Buckthorn Glycerite Liquid Extract0 NP--

Other ingredients: Glycerin

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.
Brand IP Statement(s)

Copyright 2018 TerraVita - Distributed by ZooScape LLC, All Rights Reserved.

Formula

Glycerite liquid extract (1:5)

Formulation

Alcohol free No Flavor

Suggested/Recommended/Usage/Directions

Suggested Use: Take 25-40 drops of extract in a small amount of warm water 3-4 times daily. Shake well before using.

Precautions

Keep away from children.

Do not use if safety seal around cap is broken or missing.

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

See for yourself

Cascara Sagrada & Buckthorn by TerraVita label

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

Cascara Sagrada & Buckthorn 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 & Buckthorn by TerraVita

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size25 Drop(s) Dosage formLiquid Servings per container227 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Other (inactive) ingredients: Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cascara Sagrada & Buckthorn by TerraVita Drug Interactions

Want to check YOUR meds against Cascara Sagrada & Buckthorn?

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
904Drugs
341 Moderate 563 Minor

Ingredients driving the most interactions

Cascara Sagrada Glycerite Liquid Extract 745
Buckthorn Glycerite Liquid Extract 289

Individual Drug Interactions

The ingredients in Cascara Sagrada & Buckthorn interact with 904 drugs. Click any drug to see the details.

2 of the 2 ingredients in Cascara Sagrada & Buckthorn interact with drugs. Each result below shows which ingredient is responsible. Cascara Sagrada Glycerite Liquid Extract Buckthorn Glycerite Liquid Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Cascara Sagrada & Buckthorn with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Cascara Sagrada Glycerite Liquid Extract6 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 Glycerite Liquid Extract full monograph & interactions

Buckthorn Glycerite Liquid Extract2 drug types · 289 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, sea buckthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that sea buckthorn fruit extracts can inhibit platelet aggregation and adhesion to collagen and fibrinogen.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, taking sea buckthorn with antihypertensive drugs might increase the risk of hypotension.
Taking sea buckthorn appears to reduce blood pressure in some patients.

Likelihood Possible Evidence D
Buckthorn Glycerite Liquid Extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Cascara Sagrada & Buckthorn, from the product label.

TerraVita

See all TerraVita products
Name
ZooScape LLC
Phone Number
844-449-0444
Web Address
www.ZooScape.com
Pharmacist Counseling Corner

Cascara Sagrada & Buckthorn by TerraVita: Common Questions

Does Cascara Sagrada & Buckthorn by TerraVita interact with any medications?
Yes. Based on its ingredients, Cascara Sagrada & Buckthorn has a known interaction with 904 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Cascara Sagrada & Buckthorn contains 2 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is 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 this if I'm on a water pill or blood pressure medication?
Not without checking with your pharmacist first. Cascara sagrada can lower potassium when combined with water pills or corticosteroids, and buckthorn may lower your blood pressure further. Both carry Moderate severity interactions, so get your specific medications reviewed before starting.
Is this safe to use long-term for constipation?
No — cascara sagrada is meant for short-term use only. Long-term use can lead to low potassium, loss of blood in urine, and muscle wasting. The evidence also doesn't show it reliably works for constipation anyway.
Can I take this while pregnant or breastfeeding?
Cascara sagrada should be avoided during pregnancy, and it's possibly unsafe while breastfeeding because active compounds may pass into milk. Sea buckthorn doesn't have enough safety data for breastfeeding either. Talk with your doctor or pharmacist about your options.
What side effects might I notice?
Short-term and proper use usually causes only mild abdominal discomfort and cramps. Long-term use carries serious risks, and sea buckthorn at high doses can cause yellow staining of the skin or local irritation, redness, and rash if applied topically.
Does this actually work for constipation?
The data we hold shows insufficient evidence to rate cascara sagrada for constipation, and it's rated possibly ineffective for bowel preparation. So no, the evidence doesn't support that this works reliably for what you might be taking it for.

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 & Buckthorn label
Go deeper

The Full Monographs Behind Cascara Sagrada & Buckthorn’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 → Herb & supplement monograph

Sea Buckthorn

Interacts with 289 drugs

Sea buckthorn is a berry-bearing shrub rich in vitamins, carotenoids, and fatty acids that people use for skin, eye, digestive, and heart health. Early research is promising for a few uses l...

Read the full Sea Buckthorn monograph →
Sources

Sources & How We Checked

Cascara Sagrada & Buckthorn'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 16 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 →

Sea Buckthorn 7 references
  1. Johansson AK, Korte H, Yang B, et al. Sea buckthorn berry oil inhibits platelet aggregation. J Nutr Biochem 2000;11:491-5.. PubMed
  2. Grad, S. C., Muresan, I., and Dumitrascu, D. L. Generalized yellow skin caused by high intake of sea buckthorn. Forsch.Komplementmed. 2012;19(3):153-156. PubMed
  3. Vlasov, V. V. [Hippophae oil in the treatment of superficial skin burns]. Vestn.Dermatol Venerol. 1970;44(6):69-72.
  4. Chang BB, Wang F Xu TY Zhang QQ He J Zhang XJ Li J. Total flavones of Hippophae rhamnoides L. for essential hypertension: a systematic review of randomized controlled trials. Chinese Journal of Evidence-Based Medicine. 2009;9(11):1207-1213. DOI
  5. Olas B, Kontek B, Szczesna M, et al. Inhibition of blood platelet adhesion by phenolics rich fraction of Hippophae rhamnoides L. fruits. J Physiol Pharmacol. 2017;68(2):223-9.
  6. Larmo P, Järvinen R, Laihia J, et al. Effects of a sea buckthorn oil spray emulsion on dry eye. Cont Lens Anterior Eye. 2019;42(4):428-433. PubMed
  7. De Seta F, Caruso S, Di Lorenzo G, Romano F, Mirandola M, Nappi RE. Efficacy and safety of a new vaginal gel for the treatment of symptoms associated with vulvovaginal atrophy in postmenopausal women: A double-blind randomized placebo-controlled study. Ma PubMed

See these in context on the Sea Buckthorn 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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