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Dietary supplement

Cascara Sugar Free Ingredients & Drug Interactions

by Herbal Terra

Cascara Sugar Free 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 Sugar Free 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 Sugar Free is a dietary supplement by Herbal Terra 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 Bark Extract, Dry. 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 Sugar Free by Herbal Terra

Ask about any prescription or over-the-counter medication and we check it for interactions with Cascara Sugar Free by Herbal Terra — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Cascara Sugar Free by Herbal Terra

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.

Cascara Sugar Free is a single-ingredient liquid containing cascara bark extract. Cascara is a plant-based stimulant laxative — it works by directly stimulating your colon muscles to promote bowel movements.

The product also contains alcohol, water, and glycerin as inactive ingredients.

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 regularity.
  • We looked for evidence on: Bowel preparation, Constipation, Laxation, Digestive transit.
  • 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 data shows cascara is possibly ineffective for bowel preparation. For constipation itself, there isn't enough reliable evidence in our data to say whether it works or doesn't.

If you're considering it for short-term constipation relief, talk with us about whether it's the right choice for you.

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 as directed, cascara is generally well tolerated, though mild stomach cramps and discomfort are the most common side effects. The real caution comes with long-term use — cascara can cause serious problems including liver damage, protein in your urine, blood in your urine, and severe weight loss and wasting.

Fresh or improperly aged cascara bark can also trigger severe vomiting. Stimulant laxatives like cascara are not recommended during pregnancy.

Because active compounds can pass into breast milk, it's best avoided while nursing. There isn't enough data on file to advise on safety in these situations, so talk with your pharmacist or doctor for personalized guidance.

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, check with us if you're on blood thinners like warfarin, water pills (diuretics), steroid medications (corticosteroids), the heart drug digoxin, or any other stimulant laxatives. These interactions are all Moderate in severity and could affect how your medications work or raise your potassium risk.

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 may help short-term constipation in people not taking blood thinners, water pills, steroid medications, or heart medications — but it's not for everyday use. Anyone on prescription medications should check their drug list before starting.

Long-term use carries real risks, so talk with us if you're thinking about this beyond a few days.

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 25, 2025.

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 Sugar Free, straight from the product label.

Brand Herbal Terra
Barcode (UPC) 7386004913922
Net contents 2 Fluid Ounce(s); 60 mL
Market status On market
Date entered into DSLD Sep 25, 2025
DSLD ID 324891
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Sugar 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 Sugar Free by Herbal Terra, 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 mL
Maximum serving Sizes:
1 mL
Servings per container
60
UPC/BARCODE
7386004913922
IngredientAmount% DV
Cascara Bark Extract, Dry983 mg--

Other ingredients: Alcohol, Water, Glycerin

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

Shake well before use. Adults take up to 30 drops (1 mL, one full squeeze of the dropper bulb) in 3-4 fl. oz. of juice or water up to 4 times a day.

Precautions

We recommend to seek expert medical advice before taking. May have contraindications and cause adverse reaction.

Consult a physician before giving to children under 18, before using during pregnancy, if nursing, or if you are on any medications.

Consult a physician before giving to children under 18, before using during pregnancy, if nursing, or if you are on any medications. Keep out of the reach of children!

Do not use if you are allergic to any ingredients.

Storage

Store in a cool, dry, dark place.

FDA Disclaimer Statement

This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.

Formulation

cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.

Sugar free

Expertly extracted 100% natural Premium product

Organic alcohol

No artificial ingredients, color additives, fillers or binders.

Natural Gluten free

Formula

Frangula purshiana

Organic alcohol

FDA Statement of Identity

Herbal Supplement

General Statements

Organic raw material.

Organic raw material.

Seals/Symbols

Made in USA

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

See for yourself

Cascara Sugar Free by Herbal Terra label

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

Cascara Sugar Free 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 Sugar Free by Herbal Terra

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

Serving size1 mL Dosage formLiquid Servings per container60 Amounts shown are per serving.

Cascara Bark Extract, Dry

Interacts with
745 drugs
983 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 Bark Extract, Dry monograph & interactions

Other (inactive) ingredients: Alcohol, Water, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Cascara Sugar Free by Herbal Terra Drug Interactions

Want to check YOUR meds against Cascara Sugar Free?

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 Bark Extract, Dry 745

Individual Drug Interactions

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

1 of the 1 ingredient in Cascara Sugar Free interact with drugs. Each result below shows which ingredient is responsible. Cascara Bark Extract, Dry

Each ingredient & the kinds of drugs it affects

For each ingredient in Cascara Sugar Free 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 Bark Extract, Dry6 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 Bark Extract, Dry full monograph & interactions
The maker

Brand information

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

Herbal Terra

See all Herbal Terra products
Name
Herbal Terra LLC
Phone Number
+18083857868
Web Address
herbalterra.com
Pharmacist Counseling Corner

Cascara Sugar Free by Herbal Terra: Common Questions

Does Cascara Sugar Free by Herbal Terra interact with any medications?
Yes. Based on its ingredients, Cascara Sugar Free 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 Sugar Free 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 safe to use long-term?
No. Long-term use of cascara carries serious risks — it can damage your liver, cause protein and blood to appear in your urine, and lead to severe weight loss. It's meant for short-term constipation relief only. If you need ongoing bowel support, talk with your pharmacist about safer options.
What are the most common side effects?
Mild stomach cramps and discomfort are the most common when cascara is used appropriately, short-term. In rare cases, fresh or improperly aged cascara can cause severe vomiting.
Can I take this while pregnant or breastfeeding?
Stimulant laxatives like cascara are not recommended during pregnancy. Because active compounds pass into breast milk, it's best avoided while nursing. Talk with your doctor or pharmacist about what's safe for your situation.
Is this product sweetened with sugar?
No — it's labeled sugar-free. The product contains alcohol, water, and glycerin as its inactive ingredients.
Does cascara actually work for constipation?
For constipation itself, there isn't enough reliable evidence in our data to say whether it works. For bowel preparation, it's rated possibly ineffective. Chat with us about whether it's the right option for your situation.

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

Not sure if Cascara Sugar Free 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 Sugar Free label
Go deeper

The Full Monographs Behind Cascara Sugar Free’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 Sugar Free'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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