Interactions on record — worth a quick check against your medications. Based on 1 of 2 ingredients. Check your meds →
Dietary supplement

Cascara Sagrada Max-V Ingredients & Drug Interactions

by Douglas Laboratories

Cascara Sagrada Max-V label
See full label image
Capsule 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 Max-V 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 Max-V is a dietary supplement by Douglas Laboratories with 2 active ingredients. 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.

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Check Your Meds Against Cascara Sagrada Max-V by Douglas Laboratories

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

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HelloPharmacist Scorecard of Cascara Sagrada Max-V by Douglas Laboratories

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 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 2 active ingredients, both forms of cascara sagrada — an extract and the whole herb. Cascara sagrada is a stimulant laxative derived from the bark of the buckthorn plant.

The inactive ingredients are cellulose, silica, and vegetable stearate, which are standard capsule fillers and binders.

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 health and bowel regularity.
  • We looked for evidence on: Constipation, Bowel preparation, Laxative effect, Bowel cleansing.
  • 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 limited. For bowel preparation, it's rated possibly ineffective.

For constipation itself, there isn't enough reliable evidence to rate whether it works. The data we hold doesn't establish how well this product actually relieves constipation, so talk with your pharmacist about whether it's your best option.

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 abdominal discomfort and cramps.

However, long-term use carries real risks: it's been linked to low potassium, protein in the urine, blood in the urine, and wasting (cachexia). Rarely, it can cause liver damage, and fresh or improperly aged bark can trigger severe vomiting.

Cascara sagrada is not recommended during pregnancy. While nursing, the active compounds may pass into breast milk, so it's best avoided.

If you're pregnant or breastfeeding, talk with your doctor or pharmacist before using this product.

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 Cascara Sagrada Max-V, check if you use corticosteroids, diuretics (water pills), warfarin or other blood thinners, digoxin, other stimulant laxatives, or medications your liver breaks down via the CYP3A4 pathway — cascara can affect how these work or cause dangerous potassium loss. Ask your pharmacist to verify your exact medications.

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 works best as a short-term remedy for occasional constipation. If you take corticosteroids, diuretics, warfarin, digoxin, or other stimulant laxatives, you'll need to check with your pharmacist first — the risks of low potassium and bleeding are real.

Long-term use isn't safe. Pregnant and nursing mothers should avoid it.

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 Feb 23, 2012.

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 Max-V, straight from the product label.

Brand Douglas Laboratories
Barcode (UPC) 310539773123
Net contents 90 Vegetarian Capsules
Market status On market
Date entered into DSLD Feb 23, 2012
DSLD ID 5435
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Children (All), Seniors/Mature (>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 Max-V by Douglas Laboratories, 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 Vegetarian Capsule(s)
Maximum serving Sizes:
1 Vegetarian Capsule(s)
Servings per container
90
UPC/BARCODE
310539773123
IngredientAmount% DV
Cascara sagrada extract50 mg--
Cascara sagrada100 mg--

Other ingredients: Cellulose, Silica, Vegetable Stearate

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.
FDA Statement of Identity

Standardized Herbal Extract Supplement

Suggested/Recommended/Usage/Directions

Suggested Usage: As a dietary supplement, adults take 1 capsule daily between meals. Children and elderly adults: 1/4 to 1/2 capsule.

Precautions

KEEP OUT OF REACH OF CHILDREN.

Do not use if pregnant or nursing.

Laxative effect will be transmitted to nursing infants.

Caution: Use only as recommended.

Do not use if you have ulcers or irritable bowel syndrome. Results take 6 to 8 hours to occur. Very high doses have cathartic effect (violent expulsion).

Stop use and consult your healthcare professional if allergic reactions occur.

Tamper resistant package, do not use if outer seal is missing.

Storage

For optimal storage conditions, store in a cool, dry place. (59°-77°F/15°-25°C) (35-65% relative humidity)

Formula

25% hydroxyanthracine derivatives

The bark of Cascara sagrada (Rhamnus purshiana DC.) was introducted to early explorers by the Native Americans. It contains free antraquinone and hydroxyanthracine derivatives (HAD). This U.S.P. extract is standardized at 25% to 30% HAD, or which 80% is cascaroside.

General

Formula #77312

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

See for yourself

Cascara Sagrada Max-V by Douglas Laboratories label

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

Cascara Sagrada Max-V 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 Max-V by Douglas Laboratories

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

Serving size1 Vegetarian Capsule(s) Dosage formCapsule Servings per container90 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.

Cascara sagrada extract

Interacts with
745 drugs
50 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

Cascara sagrada

Interacts with
745 drugs
100 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 monograph & interactions

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

Interaction report

Cascara Sagrada Max-V by Douglas Laboratories Drug Interactions

Want to check YOUR meds against Cascara Sagrada Max-V?

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 Max-V interact with 745 drugs. Click any drug to see the details.

1 of the 2 ingredients in Cascara Sagrada Max-V 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 Max-V 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 Max-V, from the product label.

Douglas Laboratories

See all Douglas Laboratories products
Name
Douglas Laboratories
Street Address
600 Boyce Road
City
Pittsburgh
State
PA
ZipCode
15205
Web Address
www.douglaslabs.com
Pharmacist Counseling Corner

Cascara Sagrada Max-V by Douglas Laboratories: Common Questions

Does Cascara Sagrada Max-V by Douglas Laboratories interact with any medications?
Yes. Based on its ingredients, Cascara Sagrada Max-V 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 Max-V 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 pregnant or breastfeeding?
No — stimulant laxatives like cascara are not recommended in pregnancy. While breastfeeding, the active compounds may pass into breast milk, so it's best avoided. Talk with your doctor or pharmacist about safer options.
What are the most common side effects?
Mild abdominal discomfort and cramps are the usual effects when used short-term. Long-term use raises the risk of more serious problems, including low potassium, protein or blood in the urine, and wasting.
How long can I safely use this?
Cascara sagrada is meant for short-term use only. Long-term use carries real risks, especially low potassium and liver or kidney problems. If constipation persists, talk with your pharmacist about other approaches.
Does this product actually work for constipation?
There isn't enough reliable evidence in our data to say whether cascara sagrada truly relieves constipation. For bowel preparation, it's rated possibly ineffective. Your pharmacist can help you weigh whether it's your best option.
Why does this product have two forms of cascara sagrada?
Both the extract and the whole herb deliver the same active compound, cascara sagrada. The two forms together make up the 2 active ingredients in this capsule. The effect and interactions are the same from either source.

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

Not sure if Cascara Sagrada Max-V 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 Max-V label
Go deeper

The Full Monographs Behind Cascara Sagrada Max-V’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 Max-V'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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