Cascara Sagrada


Cascara sagrada is a shrub that grows in North America. The dried bark has been used as a laxative. It can be taken as a pill, liquid, or powder.


There are not any advised doses for cascara sagrada.

What Research Shows

May Not Be Effective

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

Cascara sagrada may be safe for most adults to take for a short period of time. Cascara sagrada should not be taken for a long period Cascara sagrada may damage the liver and should not be taken at all by children, during pregnancy or while breastfeeding, or by people with gastrointestinal conditions.B1


Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:

  • Cascara sagrada is a laxative. It may make the medicines you take less effective.
  • Taking cascara sagrada and licorice may lower blood potassium levels.
  • Taking cascara sagrada and other laxatives can cause stomach ulcers.
  • Taking cascara sagrada and opioids or antidopaminergic drugs can cause irregular heart rhythms.
  • People taking blood pressure medication should talk to their doctors before taking cascara sagrada. It can lower blood potassium levels.


A. Constipation

A1. Constipation Mueller-Lissner SA, Wald A. Constipation in adults. BMJ Clin Evid. 2010 Jul 5;2010.

B. Safety

B1. 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 Jun;74(6):200-202

Last reviewed May 2020 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated:6/2/2020

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