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Dietary supplement

Cascara Sagrada Ingredients & Drug Interactions

by L.A. Naturals

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

Cascara Sagrada is a dietary supplement by L.A. Naturals 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 wild harvested Cascara Sagrada. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Cascara Sagrada by L.A. Naturals

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: wild harvested Cascara Sagrada, a plant whose bark is used as a stimulant laxative. It also includes Modified Vegetable Cellulose as an inactive ingredient (the capsule material).

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: digestive support and bowel regularity.
  • We looked for evidence on: Bowel preparation, Constipation, hemorrhoid relief, liver support.
  • 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.

The evidence on cascara sagrada is mixed and limited. For bowel preparation before medical procedures, it's rated possibly ineffective.

For everyday constipation, there isn't enough reliable evidence to rate how well it actually works. If you're considering it for constipation, talk with your pharmacist about whether the risks — especially with repeated use — make sense 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.

Short-term use of cascara sagrada is generally well tolerated, though mild belly discomfort and cramps are common. The real concern is long-term use: cascara can cause low potassium (hypokalemia), protein in your urine (albuminuria), blood in your urine (hematuria), and severe weight loss and wasting (cachexia).

Fresh or improperly aged cascara bark can trigger severe vomiting. Cascara sagrada should not be used during pregnancy — stimulant laxatives are generally not recommended.

For nursing, the safety data advises against it because active compounds may pass into breast milk.

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 if you're on blood thinners like warfarin (Moderate risk of increased bleeding), water pills or steroids (Moderate risk of low potassium), digoxin or other heart medications (Moderate risk of toxicity from low potassium), other stimulant laxatives (Moderate risk of compounded fluid and electrolyte losses), or medications broken down by the CYP3A4 liver enzyme (Minor risk of decreased effectiveness). If any of these apply, talk to your pharmacist.

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 may help with short-term constipation, but it's not your first choice and carries real risks, especially if you use it long-term or take certain medications. If you're on a blood thinner, water pill, steroid, or heart medication, you need to check with your pharmacist before starting it.

Talk to your doctor or pharmacist about whether this is the right option 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 Jul 25, 2014.

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, straight from the product label.

Brand L.A. Naturals
Barcode (UPC) 641356154209
Net contents 90 Veggie Cap(s)
Market status On market
Date entered into DSLD Jul 25, 2014
DSLD ID 34927
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Kosher
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 by L.A. Naturals, 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 Veggie Cap(s)
Maximum serving Sizes:
2 Veggie Cap(s)
Servings per container
90
UPC/BARCODE
641356154209
IngredientAmount% DV
wild harvested Cascara Sagrada420 mg--

Other ingredients: Modified Vegetable Cellulose

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.
Precautions

Keep out of the reach of children.

WARNINGS: Do not use this product if you have abdominal pain, nausea, vomiting or diarrhea.

Consult a health care provider prior to use if you are pregnant or nursing.

Discontinue use in the event of diarrhea or watery stools. Do not exceed recommended dosage. Not for long-term use.

General Statements

Rev: 091001

RAW SINGLE HERB MEDICINAL BOTANICALS VEGGIE CAPSULES

K-1604

MADE IN THE USA

Seals/Symbols

L.a.(TM)

K PARVE

Formulation

100% VEGETARIAN

FDA Statement of Identity

DIETARY SUPPLEMENT

Suggested/Recommended/Usage/Directions

SUGGESTED USE: Take 1 or 2 caps, preferably before bedtime for results in the morning. Repeat as needed or as directed by a health care professional.

See for yourself

Cascara Sagrada by L.A. Naturals label

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

What’s inside

The Ingredients in Cascara Sagrada by L.A. Naturals

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

Serving size1 Veggie Cap(s) Dosage formCapsule Servings per container90 Amounts shown are per serving.

Wild harvested Cascara Sagrada

Interacts with
745 drugs
420 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...

Wild harvested Cascara Sagrada monograph & interactions

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

Interaction report

Cascara Sagrada by L.A. Naturals Drug Interactions

Want to check YOUR meds against Cascara Sagrada?

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 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.

wild harvested 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, from the product label.

L.A. Naturals

See all L.A. Naturals products
Name
Palko Services
Street Address
4991 W. US Hwy 20
City
Michigan City
State
IN
ZipCode
46360
Pharmacist Counseling Corner

Cascara Sagrada by L.A. Naturals: Common Questions

Does Cascara Sagrada by L.A. Naturals interact with any medications?
Yes. Based on its ingredients, Cascara Sagrada 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 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.
Will this work for my constipation?
Cascara sagrada may help short-term, but we don't have enough solid evidence to say how reliable it is for everyday constipation. It's rated possibly ineffective for bowel prep before medical procedures. Your pharmacist can suggest other options if this doesn't feel right for you.
Is it safe to use long-term?
No — long-term use of cascara sagrada carries real risks including low potassium, protein and blood in your urine, and severe weight loss. It's meant for short-term use only. If constipation is a chronic problem, talk to your doctor about safer long-term approaches.
Can I take this while pregnant or nursing?
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 avoided. Talk to your doctor or pharmacist about safer constipation options during these times.
What side effects should I expect?
Mild belly discomfort and cramps are the most common. Rarely, fresh or improperly aged cascara bark can cause severe vomiting. Long-term use can lead to low potassium, protein in your urine, blood in your urine, and weight loss — which is why short-term use only is recommended.
What's in this product besides the cascara?
The capsule is made of Modified Vegetable Cellulose, which is just the capsule material. Cascara sagrada is the only active ingredient.

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 label
Sources

Sources & How We Checked

Cascara Sagrada'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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