Image for Cascara sagrada ()
Cascara sagrada (Rhamnus purshiana)

Synonyms/Common Names/Related Substances:

  • 1,8-dihydroxyanthraquinone, aloe, aloe-emodin, amerikanische faulbaumrinde, amerikanische faulbaum, anthracene glycosides, anthranoid (active constituents and metabolites are 1,8-dihydroxyanthraquinone glycosides), anthraquinone, anthroid, anthrone C-glycosides, Artemisia scoparia, ayapin, bearberry bark, bearwood, bitter bark, California buckthorn, carminic acid, casanthranol, cascara buckthorn, cascara fluid extract aromatic, cascara liquid extract, cascararinde, cascara sagrada, cascara sagrada (dried bark), cascara sagrada extract, cascara sagrada fluid extract (bitter cascara), cascarosides, cassia, cassia senna, chittem bark, coffee tree, dihydroxy-anthraquinones, dihydroxy-anthrones, dihydroxy-dianthrones, dogwood bark, emodin, fimbriatone, Frangula purshiana, nepodin, parietin, Persian bark, phytoestrogens, Polygonaceae, purshiana bark, pursh's buckthorn, Rhamnaceae (family), Rhamni purshianae cortex, Rhamnus purshiana, rhein, rheum, sacred bark, sagrada bark, Sagradafaulbaum (German), vegetable laxatives, wahoo plant, xanthoria elegans, yellow bark.
  • Selected combination products: Bassoran® with cascara (sweet cascara and magnesium oxide), Bicholax® cascara elixir (cascara, licorice, light magnesium oxide, coriander oil, anise oil, ethanol, saccharin sodium, glycerol, water), Cascara Sagrada Whole Herb Active (cascara sagrada bark, cascaroside A), Cascara-SalaxFM, Cas-Evac®, Casylium, Concentrated Milk of Magnesia (Cascara equivalent to 1mL of aromatic fluid extract per teaspoon of milk of magnesia), Elixir Purgans® (cascara, wahoo, senna, blue flag, hyoscyamus leaves aromatics), Kondremul® with Cascara (220mg per teaspoon of mineral oil), Nature's Remedy® Natural Vegetable Laxative Tablets (150mg cascara sagrada and 100mg aloe in tablet), Parke-Davis® Zand® cleansing laxative with cascara sagrada.

Clinical Bottom Line/Effectiveness

Brief Background:

  • Cascara is obtained from the dried bark of Rhamnus purshianus (Rhamnaceae), both a medicinal and poisonous plant. It is found in Europe and western Asia, and in North America, from northern Idaho to the Pacific coast in mountainous areas.
  • In foods and beverages, a bitterless extract of cascara is sometimes used as a flavoring agent. In manufacturing, cascara is used in the processing of some sunscreens.
  • Cascara possesses purgative, toxic, therapeutic, and tonic activity. It is most commonly used as an anthraquinone stimulant laxative for bowel evacuation or preparation for colonoscopy, however well-designed trials are lacking. Stimulant and cathartic laxatives are the most commonly abused laxatives and have the potential for causing long-term damage (1).

Dosing/Toxicology

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Precautions/Contraindications

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Mechanism of Action

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History

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Evidence Table

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Evidence Discussion

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Products Studied

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.