Interactions on record — worth a quick check against your medications. Based on 4 of 5 ingredients. Check your meds →
Dietary supplement

Royal Flush Ingredients & Drug Interactions

by Rise-N-Shine

Royal Flush label
See full label image
Capsule Category: Other Combinations
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 Royal Flush 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

Royal Flush is a dietary supplement by Rise-N-Shine with 5 active ingredients. Its ingredients are commonly taken for constipation, bowel cleansing before procedures, hemorrhoids.Based on those ingredients, 830 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Cascara Sagrada bark extract, Senna Leaf Extract, Acai fruit 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 Royal Flush by Rise-N-Shine

Ask about any prescription or over-the-counter medication and we check it for interactions with Royal Flush by Rise-N-Shine — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Royal Flush by Rise-N-Shine

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 Sep 10, 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 5 of its 5 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Royal Flush contains five ingredients: cascara sagrada bark extract and senna leaf extract, both stimulant laxatives meant to promote bowel movement; acai fruit extract, added for antioxidant content; black walnut powder; and bentonite clay. The product also contains inactive ingredients — rice flour, gelatin, magnesium stearate, and silicon dioxide — which are fillers and capsule materials.

Does it work?

Strong evidence
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
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: short-term bowel cleansing and occasional constipation relief.
  • We looked for evidence on: Bowel preparation, Constipation, Occasional irregularity, Digestive regularity.
  • The strongest evidence on file: Senna is rated "Likely Effective" for Constipation (Natural Medicines).
  • Also on file: Senna is rated "Possibly Effective" for Bowel preparation.
  • Also on file: Cascara Sagrada is rated "Possibly Ineffective" for Bowel preparation.

Cascara sagrada has insufficient evidence to rate it for constipation and is rated possibly ineffective for bowel preparation. Senna is rated likely effective for constipation and possibly effective for bowel preparation — it's the ingredient with the strongest evidence here.

Acai is added for potential skin, heart health, and metabolic benefits, but evidence is insufficient to rate it for any of those uses. Black walnut's effectiveness for heart disease or wound healing is also not well established in the data we hold.

The evidence, ingredient by ingredient Cascara Sagrada Senna Acai Black Walnut

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 3 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Short-term use of cascara sagrada and senna in appropriate doses is generally well tolerated, with mild cramping and abdominal discomfort being the most common side effects. Long-term use of either carries real risks, including electrolyte imbalance, kidney effects (albuminuria and blood in urine), and wasting (cachexia).

Cascara sagrada is not recommended during pregnancy and should be avoided while breastfeeding because active compounds may pass into breast milk. Senna is rated possibly safe in pregnancy and lactation, though your own doctor or pharmacist should advise if you're pregnant or nursing.

Acai and black walnut have insufficient safety data in pregnancy and lactation — talk with your doctor or pharmacist if you're expecting or breastfeeding. Black walnut may cause gastrointestinal upset and carries a risk of allergic reaction in people sensitive to tree nuts.

Side effects, ingredient by ingredient Cascara Sagrada Senna Acai Black Walnut

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?
  • 3 of the 4 matched ingredients can interact with medications — Senna, Cascara Sagrada, Acai.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications.
  • For scale: 831 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 Royal Flush, double-check it with your doctor or pharmacist if you're on warfarin (a blood thinner) — moderate risk of increased bleeding. Also confirm if you take digoxin (a heart rhythm drug), diuretics (water pills), corticosteroids (steroid medications), estrogen-based birth control or hormone therapy, or any antidiabetes medications.

These carry documented moderate-severity interactions with the laxative or acai ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

Royal Flush is designed for short-term bowel support, with senna being the ingredient with established effectiveness for constipation. However, the product's laxative ingredients interact with several important medications — especially blood thinners, heart drugs, and medications that affect potassium levels — and are not meant for long-term daily use.

If you take any prescription medications, especially warfarin, digoxin, diuretics, corticosteroids, estrogen, or diabetes drugs, talk with your doctor or pharmacist before starting this product.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 4 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2023.

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 Royal Flush, straight from the product label.

Brand Rise-N-Shine
Barcode (UPC) 899130001052
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD Sep 25, 2023
DSLD ID 297093
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating)
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 Royal Flush by Rise-N-Shine, 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 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
899130001052
IngredientAmount% DV
Cascara Sagrada bark extract100 mg--
Senna Leaf Extract37.5 mg--
Bentonite Clay50 mg--
Acai fruit extract250 mg--
Black Walnut, Powder100 mg--

Other ingredients: Rice Flour, Gelatin, Magnesium Stearate, Silicon Dioxide

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

Suggested use: For occasional use only: 1 to 2 capsules taken at bedtime with 8 ounces of water or as directed by a healthcare professional. Short-Term Cleansing Program: 1 to 2 capsules taken at bedtime with 8 ounces of water for up to 15 days or as directed by a healthcare professional. Do not repeat cleansing program for at least 6 to 8 weeks.

Precautions

Do not repeat cleansing program for at least 6 to 8 weeks. Caution: This product contains Cascara sagrada and Senna leaf.

This product is intended for pregnant or nursing mothers or children under the age of 18.

This product is intended for pregnant or nursing mothers or children under the age of 18.

Do not use this product if you have abdominal pain, diarrhea or loose stools. Rectal bleeding and/or failure to have a bowel movement after the use of a laxative formula may be an indication of a more serious condition.

Should this occur, or if you have a known medical condition and are taking medication, consult your physician prior to taking this or any dietary supplement.

This product is manufactured and packaged in a facility which may also process milk, soy, wheat, egg, peanuts, tree nuts, fish and crustacean shellfish.

Keep out of reach of children.

Do not use if safety seal is damaged or missing.

Allergen Warning: Contains tree nuts (black walnut) Contains natural and synthetic/artificial ingredients.

Storage

Store in a cool, dry place.

FDA Disclaimer Statement

These statements have not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Seals/Symbols

Formulated in the USA

GMP Quality Good Manufacturing Practice Certification

Brand IP Statement(s)

Everyday Desires Met ... Naturally Rise-N-Shine

Formulation

Brazilian cleanse formula

FDA Statement of Identity

Dietary Supplement

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

See for yourself

Royal Flush by Rise-N-Shine label

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

Royal Flush 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 Royal Flush by Rise-N-Shine

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container30 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 bark extract

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 bark extract monograph & interactions

Senna Leaf Extract

Interacts with
140 drugs
37.5 mg per serving

Senna is a plant-based stimulant laxative that is widely used and generally effective for short-term relief of constipation. It is best used occasiona...

Senna Leaf Extract monograph & interactions

Bentonite Clay

50 mg per serving

Acai fruit extract

Interacts with
86 drugs
250 mg per serving

Acai is a nutritious Amazonian berry rich in antioxidants and healthy fats, and it is fine to enjoy as a food. However, strong human evidence is lacki...

Acai fruit extract monograph & interactions

Black Walnut, Powder

No known
interactions
100 mg per serving

Black walnut is a tree whose green hulls are traditionally used as a natural antiparasitic and digestive remedy, but solid human evidence for these us...

Black Walnut, Powder monograph & interactions

Other (inactive) ingredients: Rice Flour, Gelatin, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Royal Flush by Rise-N-Shine Drug Interactions

Want to check YOUR meds against Royal Flush?

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
830Drugs
249 Moderate 581 Minor

Ingredients driving the most interactions

Cascara Sagrada bark extract 745
Senna Leaf Extract 140
Acai fruit extract 86

Individual Drug Interactions

The ingredients in Royal Flush interact with 830 drugs. Click any drug to see the details.

3 of the 5 ingredients in Royal Flush interact with drugs. Each result below shows which ingredient is responsible. Cascara Sagrada bark extract Senna Leaf Extract Acai fruit extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Royal Flush with known interactions, here are the types of medications they 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

Senna Leaf Extract5 drug types · 140 drugs

Digoxin (Lanoxin)

Theoretically, senna might increase the risk of adverse effects when taken with digoxin.
Overuse/abuse of senna increases the risk of adverse effects from cardiac glycosides, such as digoxin, due to potassium depletion.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Overuse of senna might compound diuretic-induced potassium loss and increase the risk for hypokalemia.

Likelihood Possible Evidence D
Estrogens

Theoretically, taking senna may interfere with the absorption of exogenous estrogens.
Some preliminary clinical evidence suggests that senna reduces the absorption of estradiol and decreases serum concentrations of estrone and estrone sulfate by decreasing intestinal transit time.

Likelihood Possible Evidence B
Stimulant Laxatives

Theoretically, senna might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Senna is a stimulant laxative; concomitant use with other stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, excessive use of senna might increase the effects of warfarin.
Senna has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. In one case report, excessive use of senna for 3 weeks resulted in diarrhea, bloody stools, and an elevated INR of 11.9.

Likelihood Possible Evidence D
Senna Leaf Extract full monograph & interactions

Acai fruit extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking acai with antidiabetes drugs might interfere with glycemic control.
Preliminary clinical research in healthy adults has shown that taking acai may increase or decrease levels of fasting blood glucose.

Likelihood Possible Evidence D
Acai fruit extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Royal Flush, from the product label.

Rise-N-Shine

See all Rise-N-Shine products
Name
Rise-N-Shine, LLC
Street Address
17 Woodport Road
City
Sparta
State
NJ
ZipCode
07871
Phone Number
973-729-4141
Web Address
www.rise-n-shine.com
Pharmacist Counseling Corner

Royal Flush by Rise-N-Shine: Common Questions

Does Royal Flush by Rise-N-Shine interact with any medications?
Yes. Based on its ingredients, Royal Flush has a known interaction with 830 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Royal Flush contains 5 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.
Is Royal Flush safe to use every day?
No. The safety data show these laxative ingredients are meant for short-term occasional use only. Long-term daily use carries real risks, including potassium depletion and kidney effects. Check with your doctor or pharmacist about how often and for how long it's safe for you.
Can I take Royal Flush while pregnant?
Cascara sagrada is not recommended during pregnancy. Senna is rated possibly safe, but you should talk with your doctor or pharmacist first — they know your individual situation best. Acai and black walnut have not been well studied in pregnancy, so caution is advised.
Can I take Royal Flush while breastfeeding?
Cascara sagrada should be avoided while nursing because its active compounds may pass into breast milk. Senna is rated possibly safe, but confirm with your doctor or pharmacist. Acai and black walnut have insufficient safety data, so ask your doctor or pharmacist before using.
What are the most common side effects?
Mild abdominal discomfort, cramps, diarrhea, flatulence, and nausea are typical with stimulant laxatives like those in this product. These usually occur with short-term use and are generally well tolerated in appropriate doses.
Will Royal Flush actually help my constipation?
Senna, the main active laxative here, is rated likely effective for constipation. Cascara sagrada has insufficient evidence to rate it for this use. Results vary by person, and these are meant for occasional short-term relief, not ongoing use.
Is there a tree nut allergy risk?
Yes. Black walnut is a tree nut and can trigger allergic reactions in sensitive people. Tree nuts are a major food allergen in the US. If you have a tree nut allergy, talk with your doctor or pharmacist before using this product.

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

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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.

Royal Flush label
Go deeper

The Full Monographs Behind Royal Flush’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 → Herb & supplement monograph

Senna

Interacts with 140 drugs

Senna is a plant-based stimulant laxative that is widely used and generally effective for short-term relief of constipation. It is best used occasionally and for only a few days at a time, s...

Read the full Senna monograph → Herb & supplement monograph

Acai

Interacts with 86 drugs

Acai is a nutritious Amazonian berry rich in antioxidants and healthy fats, and it is fine to enjoy as a food. However, strong human evidence is lacking for the bold health claims often atta...

Read the full Acai monograph → Herb & supplement monograph

Black Walnut

Black walnut is a tree whose green hulls are traditionally used as a natural antiparasitic and digestive remedy, but solid human evidence for these uses is lacking. It contains a compound ca...

Read the full Black Walnut monograph →
Sources

Sources & How We Checked

Royal Flush'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 56 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 →

Senna 42 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89. PubMed
  4. 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
  5. Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med 2004;141:650-1. PubMed
  6. Vanderperren B, Rizzo M, Angenot L, et al. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Ann Pharmacother 2005;39:1353-7. PubMed
  7. Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. PubMed
  8. Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet 1978;2:947. PubMed
  9. Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease--benefits and dangers. Aliment Pharmacol Ther 2001;15:1239-52. PubMed
  10. Joo JS, Ehrenpreis ED, Gonzalez L, et al. Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited. J Clin Gastroenterol 1998;26:283-6. PubMed
  11. Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230-6. PubMed
  12. van Os FH. Anthraquinone derivatives in vegetable laxatives. Pharmacology 1976;14:7-17. PubMed
  13. Sondheimer JM, Gervaise EP. Lubricant versus laxative in the treatment of chronic functional constipation of children: a comparative study. J Pediatr Gastroenterol Nutr 1982;1:223-6. DOI
  14. Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin 1977;4:540-3. PubMed
  15. Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.
  16. [No authors listed] Senna in the puerperium. Pharmacology 1992;44:23-5. PubMed
  17. Passmore AP, Davies KW, Flanagan PG, et al. A comparison of Agiolax and lactulose in elderly patients with chronic constipation. Pharmacology 1993;47:249-52. PubMed
  18. Passmore AP, Wilson-Davies K, Stoker C, Scott ME. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. BMJ 1993;307:769-71. PubMed
  19. MacLennan WJ, Pooler AFWM. A comparison of sodium picosulphate ("Laxoberal") with standardised senna ("Senokot") in geriatric patients. Curr Med Res Opin. 1974;2:641-7. PubMed
  20. Kittisupamongkol W, Nilaratanakul V, Kulwichit W. Near-fatal bleeding, senna, and the opposite of lettuce. Lancet 2008;371:784. PubMed
  21. Prather CM. Pregnancy-related constipation. Curr Gastroenterol Rep 2004;6:402-4. PubMed
  22. Werthmann WM Jr, Krees SV. Quantitative excretion of Senokot in human breast milk. Med Ann Dist Columbia 1973;42:4-5.
  23. Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact 1998;14:259-62. PubMed
  24. Faber P, Strenge-Hesse A. Senna-containing laxatives: excretion in the breast milk? Geburtshilfe Frauenheilkd 1989;49:958-62.
  25. Faber P, Strenge-Hesse A. Relevance of rhein excretion into breast milk. Pharmacology 1988;36 Suppl 1:212-20. PubMed
  26. Duncan AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J 1957;1:439-41. PubMed
  27. Stickel, F. and Schuppan, D. Herbal medicine in the treatment of liver diseases. Dig.Liver Dis. 2007;39(4):293-304. PubMed
  28. BALDWIN, W. F. CLINICAL STUDY OF SENNA ADMINISTRATION TO NURSING MOTHERS: ASSESSMENT OF EFFECTS ON INFANT BOWEL HABITS. Can.Med Assoc.J 9-14-1963;89:566-568. DOI
  29. Sonmez, A., Yilmaz, M. I., Mas, R., Ozcan, A., Celasun, B., Dogru, T., Taslipinar, A., and Kocar, I. H. Subacute cholestatic hepatitis likely related to the use of senna for chronic constipation. Acta Gastroenterol.Belg. 2005;68(3):385-387.
  30. Beuers, U., Spengler, U., and Pape, G. R. Hepatitis after chronic abuse of senna. Lancet 2-9-1991;337(8737):372-373. PubMed
  31. Lim, A. K., Hooke, D. H., and Kerr, P. G. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 1-21-2008;188(2):121-122. PubMed
  32. McLaughlin, A. F. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 9-15-2008;189(6):348. PubMed
  33. Soyuncu, S., Cete, Y., and Nokay, A. E. Portal vein thrombosis related to Cassia angustifolia. Clin.Toxicol.(Phila) 2008;46(8):774-777.
  34. Levine, D., Goode, A. W., and Wingate, D. L. Purgative abuse associated with reversible cachexia, hypogammaglobulinaemia, and finger clubbing. Lancet 4-25-1981;1(8226):919-920. PubMed
  35. Malmquist, J., Ericsson, B., Hulten-Nosslin, M. B., Jeppsson, J. O., and Ljungberg, O. Finger clubbing and aspartylglucosamine excretion in a laxative-abusing patient. Postgrad.Med J 1980;56(662):862-864. PubMed
  36. Lewis, S. J., Heaton, K. W., Oakey, R. E., and McGarrigle, H. H. Lower serum oestrogen concentrations associated with faster intestinal transit. Br.J Cancer 1997;76(3):395-400. PubMed
  37. Lewis, S. J., Oakey, R. E., and Heaton, K. W. Intestinal absorption of oestrogen: the effect of altering transit-time. Eur.J Gastroenterol.Hepatol. 1998;10(1):33-39. PubMed
  38. Vilanova-Sanchez A, Gasior AC, Toocheck N, et al. Are Senna based laxatives safe when used as long term treatment for constipation in children? J Pediatr Surg 2018;53(4):722-7. PubMed
  39. Cogley K, Echevarria A, Correa C, De la Torre-Mondragón L. Contact Burn with Blister Formation in Children Treated with Sennosides. Pediatr Dermatol 2017;34(2):e85-e88. PubMed
  40. Coskun Y, Yuksel I. Polyethylene glycol versus split high-dose senna for bowel preparation: A comparative prospective randomized study. J Gastroenterol Hepatol 2020;35(11):1923-1929.
  41. Haoudar A, Chekhlabi N, El Kettani C, Dini N. Acute Hepatitis and Pancytopenia in a Child With Chronic Abuse of Senna. Cureus 2021;13(1):e12436. PubMed
  42. Irazábal B, Sánchez de Vicente J, Galán C, et al. Anaphylaxis Due to Senna (Cassia angustifolia). J Investig Allergol Clin Immunol 2021;31(1):71-73. PubMed

See these in context on the Senna monograph →

Acai 2 references
  1. Udani JK, Singh BB, Singh VJ, Barrett ML. Effects of acai (Euterpe oleracea Mart.) berry preparation on metabolic parameters in a healthy overweight population: a pilot study. Nutr J 2011;10:45.
  2. de Liz S, Cardoso AL, Copetti CLK, et al. Açaí (Euterpe oleracea Mart.) and juçara (Euterpe edulis Mart.) juices improved HDL-c levels and antioxidant defense of healthy adults in a 4-week randomized cross-over study. Clin Nutr. 2020;39(12):3629-3636. PubMed

See these in context on the Acai monograph →

Black Walnut 3 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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  3. Food and Drug Administration. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA); Public Law 108-282, Title II. Accessed on May 19, 2021. Available at: https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-infor

See these in context on the Black Walnut 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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