Health Guide


What is it?

Cascara is an herbal medicine used for constipation (not able to have a bowel movement).

Other names for cascara include: Cascara sagrada, buckthorn, chittem bark, Rhamnus, sacred bark.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

  • are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement).
  • are pregnant or plan to become pregnant while using this medicine.
  • are breastfeeding.
  • have abdominal or stomach pain, upset stomach, vomiting, bowel blockage, inflammatory bowel disease, or appendicitis.
  • have any other health problems, such as high blood pressure or heart or blood vessel disease.


Talk with your caregiver about how much cascara you should take. The amount depends on the strength of the medicine and the reason you are taking cascara. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take cascara without talking to your doctor first if you are taking:

  • Heart medication (anti-arrhythmia drugs, example: Lanoxin(R), digoxin)


  • Before taking cascara, tell your doctor if you are pregnant or breastfeeding.
  • Do not use at the same time as another laxative.
  • Do not use for a long period of time or too often (2).
  • Do not take if you have stomach or abdominal pain, nausea, vomiting, bowel obstruction, inflammatory bowel disease, or appendicitis (4,5).
  • Do not take for more than 7 days. If symptoms persist, contact your doctor (2,4).

Side Effects:

Call your doctor right away if you have any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hand, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

  • Dry mouth, increased thirst, muscle cramps, nausea or vomiting (2)
  • Upset stomach, nausea, or vomiting (4)


1. Wren RC: Potter's New Cyclopaedia of Botanical Drugs and Preparations. C.W. Daniel Co. Ltd., Essex, England; 1975.

2. Blumenthal M, Busse WR, Goldberg A et al: The Complete Commission E Monographs; Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin, TX; 1998.

3. Wichtl M & Bisset MG (eds): Herbal Drugs and Phytopharmaceuticals. Medpharm GmbH Scientific Publishers, Stuttgart, Germany; 1994.

4. McGuffin M, Hobbs C, Upton R et al (eds): American Herbal Products Association's Botanical Safety Handbook. CRC Press, Boca Raton, FL; 1997.

5. Hsieh C: Treatment of constipation in older adults. Am Fam Physician 2005; 72(11):2277-2284.

Last Updated: 7/4/2018
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