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

Cascara Sagrada Extract Ingredients & Drug Interactions

by BulkSupplements.com

Cascara Sagrada Extract label
See full label image
Powder 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 Extract 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 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.

Jump to a section

Check Your Meds Against Cascara Sagrada Extract by BulkSupplements.com

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

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

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

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 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 extract, a plant compound that works as a stimulant laxative. It's meant to help move things along in your bowel.

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 digestive support.
  • We looked for evidence on: Constipation, Bowel preparation, Laxative effect, Bowel regularity.
  • 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.

For bowel preparation before procedures, cascara sagrada is rated possibly ineffective based on available evidence. For regular constipation, the evidence isn't strong enough yet to say whether it works — we simply don't have reliable data on it.

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 cramps and discomfort are common. The real caution is long-term use: cascara can cause potassium loss, protein in the urine, blood in the urine, and serious weight loss over time.

In rare cases, fresh or improperly aged bark can trigger severe vomiting, and liver damage has been reported. Stimulant laxatives like cascara aren't recommended during pregnancy.

If you're nursing, active compounds may pass into breast milk, so it's best avoided while breastfeeding. Talk with your pharmacist or doctor about safer options in both situations.

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 with your pharmacist if you're on water pills (diuretics), steroids (corticosteroids), blood thinners like warfarin, the heart medication digoxin, other stimulant laxatives, or medications that depend on the liver enzyme CYP3A4 to work — all carry Moderate or Minor interaction risks.

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 relief, but it carries real risks — especially if you take water pills, steroids, blood thinners, or heart medications, or if you plan long-term use. Check your medications with us first, and talk to your pharmacist about whether this is right 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 May 23, 2024.

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) X0019Q2RF1
Net contents 250 Gram(s); 8.8 Ounce(s)
Market status On market
Date entered into DSLD May 23, 2024
DSLD ID 311303
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
500
UPC/BARCODE
X0019Q2RF1
IngredientAmount% DV
Cascara Sagrada extract500 mg--

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)

BulkSupplements.com Clean & Pure Bulk Supplements

Formulation

Color may vary

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

Stool softeners Natural laxative

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

Formula

Cascara Bark Herbal Laxatives

General Statements

Use an accurate milligram scale. Contents are sold by weight, not volume. Settling may occur. New

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

See for yourself

Cascara Sagrada Extract by BulkSupplements.com label

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

Cascara Sagrada Extract 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 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 container500 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
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

Cascara Sagrada extract 745

Individual Drug Interactions

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

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

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
Cascara Sagrada extract full monograph & interactions
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.
Is cascara sagrada safe to use long-term?
No — long-term use carries real risks. Cascara can cause potassium loss, protein and blood in your urine, and serious weight loss. Short-term use for constipation is generally okay, but don't rely on it for weeks or months without talking to your pharmacist.
What are the common side effects?
Mild belly cramps and discomfort are the most common when taken short-term. Severe vomiting is rare but can happen with fresh or improperly aged bark. Long-term use brings more serious problems like potassium loss and liver damage.
Can I take cascara while pregnant or breastfeeding?
No to both. Stimulant laxatives like cascara aren't recommended in pregnancy, and the active compounds pass into breast milk. Talk with your doctor or pharmacist about safer ways to manage constipation during these times.
Does cascara sagrada actually work for constipation?
We don't have strong enough evidence to say whether it works for regular constipation. For bowel prep before procedures, it's rated possibly ineffective. If you're considering it, talk with your pharmacist about other options first.
What if I'm on a water pill or steroid?
You need to check with your pharmacist first. Both of these drugs can lower your potassium, and cascara's laxative effect makes that worse — potentially causing a dangerous drop. Don't start cascara without running it by us.

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
Go deeper

The Full Monographs Behind Cascara Sagrada Extract’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 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
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team