Indications
Cascara Sagrada is the dried, aged bark of the Rhamnus purshiana tree. It is a herbal stimulant laxative used for short term relief of occasional constipation, and it appears as an ingredient in some herbal and Unani compound laxative preparations.
How It Works
The bark contains anthraquinone glycosides called cascarosides. Bacteria in the large bowel turn them into active substances that stimulate the bowel muscles and draw water into the stool, making it softer and easier to pass. It usually works 6 to 12 hours after a dose, so it is commonly taken at bedtime.
Dosage and Administration
Use as directed on the label or by a registered practitioner, usually once at bedtime with a glass of water. Use the lowest amount that works, and do not use for more than 1 week without medical advice.
Interactions
- Loss of potassium can increase the risk of toxicity with Digoxin and some heart rhythm medicines.
- The risk of low potassium is higher with diuretics (water tablets), corticosteroids and Liquorice root.
- It may reduce the absorption of other medicines taken at the same time because it speeds the gut.
Contraindications
- Intestinal blockage, appendicitis or unexplained stomach pain, nausea or vomiting.
- Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
- Severe dehydration or low potassium.
- Pregnancy, breastfeeding and children under 12 years.
Side Effects
Stomach cramps, diarrhoea and a harmless change in urine colour may occur. Long term use can cause loss of fluid and potassium, muscle weakness, dependence on laxatives and darkening of the bowel lining. Rare cases of liver injury have been reported.
Get urgent medical help if you have severe or bloody diarrhoea, severe stomach pain, signs of dehydration, irregular heartbeat, marked muscle weakness, or yellowing of the skin or eyes.
Pregnancy and Lactation
Do not use during pregnancy or while breastfeeding. Gentler options, such as fibre and fluids, are preferred; ask your doctor.
Precautions and Warnings
- Not for long term or regular use.
- See a doctor if constipation lasts more than a week, or if there is blood in the stool, weight loss or a sudden change in bowel habit.
- Take extra care in elderly people and in heart, kidney or liver disease.
- Increase fibre, fluids and activity as the first step for constipation.
Overdose
Overdose can cause severe diarrhoea, cramps, dehydration and dangerous loss of potassium and other salts. Seek medical help promptly.
Therapeutic Class
Herbal preparation; stimulant laxative.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.