Cascara sagrada

Be careful of

Cautions

• AmountThe EMA says not to use it for more than 1 week, and usually only 2 or 3 times in that week. Long-term use of stimulant laxatives can impair bowel function and lead to dependence; if you need a laxative every day, the cause should be looked into.
• ConditionDo not use it with intestinal blockage or narrowing, appendicitis, inflammatory bowel disease (Crohn's disease, ulcerative colitis), abdominal pain of unknown cause, or severe dehydration. People with kidney disease should watch for electrolyte imbalance.
• InteractionLosing potassium through overuse can strengthen the effect of heart medicines such as digoxin and interact with antiarrhythmics. Diuretics, corticosteroids and licorice root can add to potassium loss. Talk with a doctor first if you take any of these, or medicines that prolong the QT interval.
• PregnancyThe EMA says not to use it in pregnancy (laboratory data suggest a genetic-damage risk from some anthraquinones) or while breastfeeding (active compounds pass into milk in small amounts). LactMed notes it might cause loose stools in breastfed infants.
• ConditionNot for children under 12 (EMA).
• NoteIt can cause cramping, abdominal pain and watery stools, and may turn urine yellow or red-brown, which is harmless. Allergic skin reactions can occur. Long-term use can darken the lining of the colon.
• Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.