Senna, Cascara & Psyllium Complex Ingredients & Drug Interactions
by Swanson
What is this page for?
First and foremost: checking Senna, Cascara & Psyllium Complex 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
Senna, Cascara & Psyllium Complex is a dietary supplement by Swanson with 3 active ingredients. Its ingredients are commonly taken for constipation, bowel cleansing before procedures, hemorrhoids.Based on those ingredients, 750 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Cascara Sagrada, Senna. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Senna, Cascara & Psyllium Complex by Swanson
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HelloPharmacist Scorecard of Senna, Cascara & Psyllium Complex by Swanson
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.
What’s inside
Full disclosure
This product contains three active ingredients: psyllium husk, cascara sagrada, and senna. All three are laxatives, but they work in different ways.
Psyllium husk is a bulk-forming fiber that absorbs water and helps stool move through your intestines. Cascara sagrada and senna are both stimulant laxatives — they trigger muscle contractions in your colon to push stool along.
The product also includes inactive ingredients (gelatin, magnesium stearate, and silica) that make up the capsule and help it hold together.
Does it work?
Strong evidence
For constipation, senna is rated Likely Effective — real evidence backs it up. Cascara sagrada for the same purpose has only Insufficient Reliable Evidence To Rate, meaning we don't have strong data yet.
Neither ingredient's evidence supports using this product for bowel preparation before procedures — senna is only Possibly Effective for that, and cascara sagrada is Possibly Ineffective. Neither has established evidence for treating high potassium (hyperkalemia).
The mix of ingredients aims at occasional constipation relief, but effectiveness hinges mainly on the senna component.
How safe is it?
Well-documented data
Senna and cascara sagrada are generally well tolerated when used short-term in normal doses — most people experience only mild stomach cramps, abdominal discomfort, or diarrhea. Long-term daily use, though, carries real risks: both can lead to low potassium, kidney problems (protein and blood in urine), and wasting of muscle and body tissue.
Serious side effects like skin rashes are rare. The safety data advises against stimulant laxatives during pregnancy and while nursing, as active compounds may pass into breast milk.
This product is for short-term occasional use, not long-term daily relief without a doctor's guidance.
Meds to double-check
Moderate interaction found
Double-check before starting if you take blood thinners like warfarin, diuretics (water pills), other laxatives, digoxin (a heart drug), corticosteroids, or estrogen-based birth control or hormone therapy — all have Moderate-severity interactions with one or both active ingredients here. No interactions are documented for psyllium husk in our data.
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.
If you take blood thinners, diuretics, heart or hormone medications, or corticosteroids, you must check your exact drugs before starting this product — the interactions are real and can affect how your medications work or raise your risk of bleeding or low potassium. For occasional short-term constipation in people without those medications, senna has solid evidence; cascara sagrada's benefit is less proven.
Don't use this long-term without talking to your doctor first.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 25, 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
General information
Key facts about Senna, Cascara & Psyllium Complex, straight from the product 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 Senna, Cascara & Psyllium Complex by Swanson, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Psyllium Husk | 100 mg | -- |
| Cascara Sagrada | 100 mg | -- |
| Senna | 350 mg | -- |
Other ingredients: Gelatin, Magnesium Stearate, Silica
Tap any ingredient to jump to its full detail below.
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.
Formulation
Total wellness for mind, body & home Unsurpassed purity & potency 100% Money back guaranteed
Digestive health Triple-action support
Brand IP Statement(s)
Swanson Science-Backed Quality Since 1969
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, take one capsule one to three times per day with a full glass of water.
Precautions
Warning: For adults only. Keep out of reach of children.
This product contains senna and cascara.
Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stools or abdominal pain as this product may worsen these conditions and be harmful to your health. Not recommended for extended use. Do not use if seal is broken.
Consult your healthcare provider if you have frequent diarrhea or if you are pregnant, nursing, taking medication or have a medical condition.
Storage
Store in a cool, dry place.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
FDA Statement of Identity
Herbal Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Senna, Cascara & Psyllium Complex by Swanson label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
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)The Ingredients in Senna, Cascara & Psyllium Complex by Swanson
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 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.
Psyllium Husk
Cascara Sagrada
Interacts with745 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. Becaus...
Cascara Sagrada monograph & interactionsSenna
Interacts with140 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 occasiona...
Senna monograph & interactionsOther (inactive) ingredients: Gelatin, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.
Senna, Cascara & Psyllium Complex by Swanson Drug Interactions
HelloPharmacist Interaction Report
Senna, Cascara & Psyllium Complex by Swanson contains two ingredients with documented interactions: cascara sagrada and senna.
Both are stimulant laxatives, and the most serious concern across both is a Moderate-severity interaction with blood thinners like warfarin (Coumadin) — either ingredient can cause diarrhea, which increases warfarin's effects and bleeding risk.
Read the full breakdown — every affected drug type, severity by severity
Both cascara sagrada and senna interact with diuretics (water pills) and other stimulant laxatives at Moderate severity, raising the risk of low potassium (hypokalemia) and fluid loss. Cascara sagrada also poses a Moderate-severity risk with corticosteroids and heart medications like digoxin (Lanoxin) via the same potassium-loss mechanism.
Senna interacts Moderately with estrogens — birth control and hormone therapy — by speeding up intestinal transit and reducing their absorption. Cascara sagrada may also slightly decrease the effects of certain other medications (CYP3A4 substrates) at Minor severity.
We could not check psyllium husk — no interaction data is on file for it. Altogether, these interactions span 740 individual medications.
Run your exact medications through the checker on this page before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Senna, Cascara & Psyllium Complex?
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 checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Senna, Cascara & Psyllium Complex interact with 750 drugs. Click any drug to see the details.
2 of the 3 ingredients in Senna, Cascara & Psyllium Complex interact with drugs. Each result below shows which ingredient is responsible. Cascara Sagrada Senna
Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
Cascara SagradaCytochrome P450 3a4 (cyp3a4) Substrates, Diuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
Read the full Cascara Sagrada + Acetaminophen, Caffeine, Pyrilamine interactionSennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Acetaminophen, Pamabrom, Pyrilamine interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Acetaminophen, Pamabrom, Pyrilamine interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Acetazolamide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Acetazolamide interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Amiloride, Hydrochlorothiazide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Amiloride, Hydrochlorothiazide interactionAmmonium ChlorideAmmonium Chloride
How Ammonium Chloride interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Ammonium Chloride interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Ammonium Chloride interactionArmodafinilNuvigil
How Armodafinil interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
Cascara SagradaCytochrome P450 3a4 (cyp3a4) Substrates, Stimulant Laxatives Moderate
Interaction Summary
Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
Read the full Cascara Sagrada + Armodafinil interactionSennaStimulant Laxatives Moderate
Interaction Summary
Theoretically, senna might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Read the full Senna + Armodafinil interactionAtenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic
How Atenolol, Chlortalidone interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
Cascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Atenolol, Chlortalidone interactionSennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Atenolol, Chlortalidone interactionAtenolol, ChlorthalidoneTenoretic
How Atenolol, Chlorthalidone interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Atenolol, Chlorthalidone interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Atenolol, Chlorthalidone interactionAzelastine Hydrochloride, Fluticasone PropionateDymista
How Azelastine Hydrochloride, Fluticasone Propionate interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCytochrome P450 3a4 (cyp3a4) Substrates, Corticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
Read the full Cascara Sagrada + Azelastine Hydrochloride, Fluticasone Propionate interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Azilsartan, Chlorthalidone interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Azilsartan, Chlorthalidone interactionBazedoxifene Acetate, Conjugated EstrogensDuavee
How Bazedoxifene Acetate, Conjugated Estrogens interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaEstrogens Moderate
Interaction Summary
Theoretically, taking senna may interfere with the absorption of exogenous estrogens.
Read the full Senna + Bazedoxifene Acetate, Conjugated Estrogens interactionCascara SagradaCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
Read the full Cascara Sagrada + Bazedoxifene Acetate, Conjugated Estrogens interactionBeclometasone DipropionateBecotide
How Beclometasone Dipropionate interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCorticosteroids, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Read the full Cascara Sagrada + Beclometasone Dipropionate interactionBeclomethasoneBeclovent, Vanceril
How Beclomethasone interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCytochrome P450 3a4 (cyp3a4) Substrates, Corticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
Read the full Cascara Sagrada + Beclomethasone interactionBeclomethasone DipropionateQNASL, Qvar
How Beclomethasone Dipropionate interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCorticosteroids, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Read the full Cascara Sagrada + Beclomethasone Dipropionate interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Benazepril, Hydrochlorothiazide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Benazepril, Hydrochlorothiazide interactionBendroflumethiazideAprinox, Naturetin, Neo-NaClex
How Bendroflumethiazide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bendroflumethiazide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bendroflumethiazide interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bendroflumethiazide, Nadolol interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bendroflumethiazide, Nadolol interactionBendroflumethiazide, PotassiumCentyl K, Neo-NaClex-K
How Bendroflumethiazide, Potassium interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bendroflumethiazide, Potassium interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bendroflumethiazide, Potassium interactionBendroflumethiazide, Rauwolfia SerpentinaRauzide
How Bendroflumethiazide, Rauwolfia Serpentina interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bendroflumethiazide, Rauwolfia Serpentina interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bendroflumethiazide, Rauwolfia Serpentina interactionBenzthiazideExna
How Benzthiazide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Benzthiazide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Benzthiazide interactionBetamethasoneCelestone, Diprolene AF, Diprosone
How Betamethasone interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCorticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Read the full Cascara Sagrada + Betamethasone interactionBetamethasone DipropionateSernivo
How Betamethasone Dipropionate interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCorticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Read the full Cascara Sagrada + Betamethasone Dipropionate interactionBetamethasone Dipropionate, CalcipotrieneEnstilar, Wynzora
How Betamethasone Dipropionate, Calcipotriene interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCorticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Read the full Cascara Sagrada + Betamethasone Dipropionate, Calcipotriene interactionBetamethasone ValerateLuxiq
How Betamethasone Valerate interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCorticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with corticosteroids.
Read the full Cascara Sagrada + Betamethasone Valerate interactionBisacodylDulcolax, Gentlax
How Bisacodyl interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
Cascara SagradaStimulant Laxatives Moderate
Interaction Summary
Theoretically, cascara sagrada might have additive adverse effects when taken with stimulant laxatives.
Read the full Cascara Sagrada + Bisacodyl interactionSennaStimulant Laxatives Moderate
Interaction Summary
Theoretically, senna might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Read the full Senna + Bisacodyl interactionBisacodyl, DocusateDulcolax Laxative Tabs
How Bisacodyl, Docusate interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaStimulant Laxatives Moderate
Interaction Summary
Theoretically, senna might increase the risk for fluid and electrolyte loss when taken with other stimulant laxatives.
Read the full Senna + Bisacodyl, Docusate interactionCascara SagradaStimulant Laxatives Moderate
Interaction Summary
Theoretically, cascara sagrada might have additive adverse effects when taken with stimulant laxatives.
Read the full Cascara Sagrada + Bisacodyl, Docusate interactionBisoprolol, HydrochlorothiazideZiac
How Bisoprolol, Hydrochlorothiazide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bisoprolol, Hydrochlorothiazide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bisoprolol, Hydrochlorothiazide interactionBudesonideEntocort EC, Eohilia, Pulmicort, Tarpeyo, Uceris
How Budesonide interacts with Senna, Cascara & Psyllium Complex — through 1 ingredient. Tap an ingredient for the detail:
Cascara SagradaCytochrome P450 3a4 (cyp3a4) Substrates, Corticosteroids Moderate
Interaction Summary
Theoretically, cascara sagrada might decrease the effects of CYP3A4 substrates.
Read the full Cascara Sagrada + Budesonide interactionBumetanideBurinex
How Bumetanide interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bumetanide interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bumetanide interactionBumetanide, PotassiumBurinex K
How Bumetanide, Potassium interacts with Senna, Cascara & Psyllium Complex — through 2 ingredients. Tap an ingredient for the detail:
SennaDiuretic Drugs Moderate
Interaction Summary
Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Senna + Bumetanide, Potassium interactionCascara SagradaDiuretic Drugs Moderate
Interaction Summary
Theoretically, cascara sagrada might increase the risk of hypokalemia when taken with diuretic drugs.
Read the full Cascara Sagrada + Bumetanide, Potassium interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Senna, Cascara & Psyllium Complex 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
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.
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.
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.
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.
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.
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.
Senna
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.
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.
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.
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.
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.
Brand information
Manufacturer and brand details for Senna, Cascara & Psyllium Complex, from the product label.
Swanson
See all Swanson products- Name
- Swanson Health Products
- City
- Fargo
- State
- ND
- ZipCode
- 58104
- Phone Number
- 1-800-437-4148
- Web Address
- swanson.com
Senna, Cascara & Psyllium Complex by Swanson: Common Questions
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What's psyllium husk doing in here if senna and cascara are stimulant laxatives?
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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.
The Full Monographs Behind Senna, Cascara & Psyllium Complex’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Cascara Sagrada
Interacts with 745 drugsCascara 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 monographSenna
Interacts with 140 drugsSenna 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 →Sources & How We Checked
Senna, Cascara & Psyllium Complex'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.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
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 51 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
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- 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
- 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
- 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.
- Cirillo C, Capasso R. Constipation and botanical medicines: an overview. Phytother Res 2015;29(10):1488-93. PubMed
- 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
Senna 42 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89. PubMed
- 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
- Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med 2004;141:650-1. PubMed
- 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
- Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. PubMed
- Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet 1978;2:947. PubMed
- Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease--benefits and dangers. Aliment Pharmacol Ther 2001;15:1239-52. PubMed
- 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
- Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230-6. PubMed
- van Os FH. Anthraquinone derivatives in vegetable laxatives. Pharmacology 1976;14:7-17. PubMed
- 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
- Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin 1977;4:540-3. PubMed
- Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.
- [No authors listed] Senna in the puerperium. Pharmacology 1992;44:23-5. PubMed
- 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
- 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
- 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
- Kittisupamongkol W, Nilaratanakul V, Kulwichit W. Near-fatal bleeding, senna, and the opposite of lettuce. Lancet 2008;371:784. PubMed
- Prather CM. Pregnancy-related constipation. Curr Gastroenterol Rep 2004;6:402-4. PubMed
- Werthmann WM Jr, Krees SV. Quantitative excretion of Senokot in human breast milk. Med Ann Dist Columbia 1973;42:4-5.
- Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact 1998;14:259-62. PubMed
- Faber P, Strenge-Hesse A. Senna-containing laxatives: excretion in the breast milk? Geburtshilfe Frauenheilkd 1989;49:958-62.
- Faber P, Strenge-Hesse A. Relevance of rhein excretion into breast milk. Pharmacology 1988;36 Suppl 1:212-20. PubMed
- Duncan AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J 1957;1:439-41. PubMed
- Stickel, F. and Schuppan, D. Herbal medicine in the treatment of liver diseases. Dig.Liver Dis. 2007;39(4):293-304. PubMed
- 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
- 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.
- Beuers, U., Spengler, U., and Pape, G. R. Hepatitis after chronic abuse of senna. Lancet 2-9-1991;337(8737):372-373. PubMed
- 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
- McLaughlin, A. F. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 9-15-2008;189(6):348. PubMed
- Soyuncu, S., Cete, Y., and Nokay, A. E. Portal vein thrombosis related to Cassia angustifolia. Clin.Toxicol.(Phila) 2008;46(8):774-777.
- 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
- 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
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
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