Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Cascara Sagrada Extract Ingredients & Drug Interactions

by BulkSupplements.com

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

Cascara Sagrada Extract is a dietary supplement by BulkSupplements.com 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 extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Cascara Sagrada Extract by BulkSupplements.com

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 extract, a plant-based stimulant laxative derived from the bark of the cascara buckthorn tree. It's meant to promote bowel movements and relieve constipation by stimulating the muscles in your colon.

There are no other inactive ingredients listed.

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: 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 — like before a procedure — the data we have suggests it's probably ineffective.

For constipation itself, we don't have enough reliable evidence to rate how well it works. The takeaway: short-term use for constipation may help some people, but that benefit has to be weighed against the real risks, especially if you plan to use it beyond a few days.

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.

Cascara sagrada is generally well tolerated for short-term use, though mild belly discomfort and cramping are common. The serious concern is long-term use: it can lead to low potassium, loss of muscle mass (cachexia), protein in the urine (albuminuria), and blood in the urine (hematuria).

Also, fresh or improperly aged cascara bark can cause severe vomiting. The product should be avoided during pregnancy — stimulant laxatives are not recommended.

While nursing, it's best avoided too, since 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 taking this product, double-check if you're on water pills (diuretics), steroids (corticosteroids), the heart medication digoxin, the blood thinner warfarin, other stimulant laxatives, or drugs processed through your liver's CYP3A4 pathway. All of these have documented interactions with cascara sagrada.

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 might help short-term constipation in someone without heart or kidney issues and not taking water pills, steroids, or blood thinners. If you take any of those medications, or if you need relief for more than a few days, talk with us first — the risks climb quickly with longer use.

Even for short-term use, check your medications on this page before you start.

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 Sep 24, 2021.

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 Extract, straight from the product label.

Brand BulkSupplements.com
Barcode (UPC) X0019Q3S9P
Net contents 500 Gram(s); 17.6 Ounce(s)
Market status On market
Date entered into DSLD Sep 24, 2021
DSLD ID 253404
Product type Botanical
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Dairy 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 Extract by BulkSupplements.com, 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:
500 mg
Maximum serving Sizes:
500 mg
Servings per container
1000
UPC/BARCODE
X0019Q3S9P
IngredientAmount% DV
Cascara Sagrada extract500 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.
General Statements

Clean & pure bulk supplements

Bulksupplements CAscara Sagrada Extract Powder (500 Grams) NewItem

Formulation

Color may vary

Free Of: Added sugar, soy, dairy, yeast, additives

FDA Disclaimer Statement

Warning: This product is not intended to diagnose, treat, cure, or prevent any disease.

Precautions

Always consult a physician before taking any dietary supplement.

Keep out of reach of children.

Suggested/Recommended/Usage/Directions

Suggested Use: As a dietary supplement, take 500 mg (about 1/5 tsp) once or twice daily, or as directed by a physician.

Storage

Store in a dry, cool place

See for yourself

Cascara Sagrada Extract by BulkSupplements.com label

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

What’s inside

The Ingredients in Cascara Sagrada Extract by BulkSupplements.com

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

Serving size500 mg Dosage formPowder Servings per container1000 Amounts shown are per serving.

Cascara Sagrada extract

Interacts with
745 drugs
500 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 extract monograph & interactions

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

Interaction report

Cascara Sagrada Extract by BulkSupplements.com Drug Interactions

Want to check YOUR meds against Cascara Sagrada Extract?

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 Extract 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 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
The maker

Brand information

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

BulkSupplements.com

See all BulkSupplements.com products
Name
BulkSupplements.com
Street Address
7511 Eastgate Rd
City
Henderson
State
NV
ZipCode
89011
Web Address
BulkSupplements.com
Pharmacist Counseling Corner

Cascara Sagrada Extract by BulkSupplements.com: Common Questions

Does Cascara Sagrada Extract by BulkSupplements.com interact with any medications?
Yes. Based on its ingredients, Cascara Sagrada Extract 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 Extract 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 cascara sagrada help my constipation?
We don't have enough reliable evidence in our data to say for certain whether it works for constipation. Some people find short-term relief with stimulant laxatives, but the risks — especially electrolyte loss and muscle loss — increase with longer use. If you're constipated for more than a few days, talk with us about safer options.
Is it safe to take cascara long-term?
No. Long-term use carries real risks: low potassium, loss of muscle mass, and protein or blood in your urine. Cascara is meant for short-term use only.
Can I take cascara while pregnant?
No. Stimulant laxatives like cascara are not recommended during pregnancy. Talk with your doctor about safe alternatives for constipation during pregnancy.
Can I take cascara while breastfeeding?
No. The active compounds may pass into your breast milk, so it's best avoided while nursing.
What side effects should I expect?
Mild abdominal discomfort and cramping are common with short-term use. Fresh or improperly aged cascara bark can cause severe vomiting. Long-term use can lead to low potassium, protein in the urine, blood in the urine, and loss of muscle mass.

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

Not sure if Cascara Sagrada Extract is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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 Extract label
Sources

Sources & How We Checked

Cascara Sagrada Extract'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

Keep exploring