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Dietary supplement

Cascara Sagrada Ingredients & Drug Interactions

by Pure Herbs

Cascara Sagrada 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 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 is a dietary supplement by Pure Herbs 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 Bark 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 by Pure Herbs

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

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HelloPharmacist Scorecard of Cascara Sagrada by Pure Herbs

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 bark extract, a stimulant laxative derived from the bark of the cascara tree. It works by directly stimulating the colon to promote bowel movements.

There are no other active ingredients.

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: occasional constipation relief.
  • 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.

The evidence for cascara sagrada is mixed. For bowel preparation—cleaning the colon before a medical procedure—it's rated possibly ineffective.

For everyday constipation, we don't have enough reliable evidence to rate it one way or the other. So while it may help some people with short-term constipation, the science doesn't firmly back its use.

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. The most common side effect is mild stomach discomfort and cramps.

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

During pregnancy, stimulant laxatives like this one are generally not recommended. While nursing, cascara sagrada is rated possibly unsafe because active compounds may pass into breast milk—it's best to avoid it.

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, check whether you use warfarin (Coumadin) or other blood thinners, water pills (diuretics), steroid medications, digoxin (Lanoxin), other laxatives, or any drug processed through the CYP3A4 pathway. These are Moderate- or Minor-severity interactions you'll want to discuss with your pharmacist first.

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 may help with short-term constipation, but it's not a long-term solution and it has real downsides, especially if you take water pills, steroids, digoxin, or blood thinners. Talk to your pharmacist before starting it, and don't use it if you're pregnant or breastfeeding.

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 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, straight from the product label.

Brand Pure Herbs
Net contents 1 Fluid Ounce(s); 30 mL
Market status On market
Date entered into DSLD Dec 13, 2022
DSLD ID 278759
Product type Botanical
Supplement form Liquid
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 by Pure Herbs, 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 mL
Maximum serving Sizes:
2 mL
Servings per container
15
IngredientAmount% DV
Cascara sagrada Bark Extract1892 mg--

Other ingredients: None

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

Directions: For adults, mix 2 mL (abt. 1/2 tsp) of extract in 2 fl. oz (60 mL) water one time daily preferably with a meal.

Shake well before use

Formulation

Beneficial for occasional constipation.

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.

Precautions

Notice: This product contains Cascara Sagrada. Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stool, or abdominal pain because Cascara Sagrada 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.

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

Keep out of reach of children

Brand IP Statement(s)

Pure Herbs, Ltd. Natural Herbal Extracts

FDA Statement of Identity

Dietary Supplement

General Statements

"No expense has been spared to provide the finest nature has to offer."

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

See for yourself

Cascara Sagrada by Pure Herbs label

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

Cascara Sagrada 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 by Pure Herbs

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

Serving size2 mL Dosage formLiquid Servings per container15 Amounts shown are per serving.

Cascara sagrada Bark Extract

Interacts with
745 drugs
1892 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 Bark Extract monograph & interactions

Other (inactive) ingredients: None. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cascara Sagrada by Pure Herbs 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

Cascara sagrada Bark Extract 745

Individual Drug Interactions

The ingredients in Cascara Sagrada interact with 745 drugs. Click any drug to see the details.

1 of the 1 ingredient in Cascara Sagrada interact with drugs. Each result below shows which ingredient is responsible. Cascara sagrada Bark Extract

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.

Cascara sagrada Bark 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 Bark Extract full monograph & interactions
The maker

Brand information

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

Pure Herbs

See all Pure Herbs products
Name
Pure Herbs, Ltd.
City
Sterling Heights
State
MI
Phone Number
(800) 860-4372
Web Address
www.pureherbs.com
Pharmacist Counseling Corner

Cascara Sagrada by Pure Herbs: Common Questions

Does Cascara Sagrada by Pure Herbs 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.
Is cascara sagrada safe to use long-term?
No. While short-term use is generally well tolerated, long-term use carries real risks including low potassium levels, protein and blood in your urine, and serious weight loss. It's meant for short-term constipation relief only.
What are the common side effects?
Mild stomach discomfort and cramps are the most common. Rare but serious effects include liver toxicity (hepatotoxicity) and, if the bark is fresh or improperly aged, severe vomiting.
Can I use cascara sagrada if I'm pregnant or breastfeeding?
No. Stimulant laxatives like cascara are not recommended during pregnancy. While nursing, active compounds may pass into breast milk, so it's best avoided. Talk to your doctor about safer options.
Does cascara sagrada actually work for constipation?
We don't have enough reliable evidence to say for certain. For bowel preparation before medical procedures, it's rated possibly ineffective. For everyday constipation, the science is unclear.
Why does cascara sagrada interact with so many drugs?
Its main mechanism—stimulating the colon and causing diarrhea—lowers potassium and can change how other drugs work in your body, especially blood thinners and heart medications. That's why checking your specific drugs with your pharmacist matters.

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

Not sure if Cascara Sagrada 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 label
Go deeper

The Full Monographs Behind Cascara Sagrada’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'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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