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Cascara Sagrada

Posting Date: 06/30/2002

Pregnant women and nursing mothers should avoid cascara sagrada.

People with intestinal blockage, undiagnosed stomach pain, or symptoms that might indicate appendicitis must avoid laxatives such as cascara sagrada.

People with diarrhea, inflammatory bowel disease, or intestinal ulcers must not use cascara sagrada.

Children younger than twelve with constipation should not be treated with cascara sagrada.

Adverse Effects

Abdominal cramps or diarrhea have been reported.

Chronic use of laxatives may lead to excessive loss of potassium or other electrolytes, which may be dangerous. In addition, anthraquinones can cause pigmentation of the large bowel.

A serious problem associated with chronic use, however, is that a person may become dependent on such a stimulant laxative and become unable to evacuate without it. This leads to problems that resemble ulcerative colitis.

Possible Interactions

If cascara sagrada results in excessive potassium loss, heart rhythm irregularities may occur. This problem could be especially severe for people taking the heart drug Lanoxin.

It would be unwise to use cascara sagrada together with other herbal medicines that can cause potassium loss, such as aloe or licorice.

Medications such as hydrochlorothiazide, Lasix, Hygroton, Lozol, Bumex, and other potassium-wasting diuretics are probably incompatible with cascara sagrada, at least if it were used more than very occasionally.

Cascara sagrada, like other strong laxatives, may reduce the absorption of other medicines taken orally.