Cascara

Purported Benefits, Side Effects & More
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This information describes the common uses of Cascara, how it works, and its possible side effects.
Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

What is it?

Cascara is a strong laxative. It has not been shown to treat or prevent cancer.

Cascara is made out of the bark of the Cascara sagrada plant. It is known to stimulate the large intestine and produces a well-documented laxative effect. Cascara also causes water and electrolytes such as sodium and potassium to be expelled with the feces. This eases bowel passage but can also lead to dangerously low potassium and sodium levels if cascara is used for prolonged periods of time.

Scientists have isolated a compound called aloe-emodin from cascara. In laboratory studies, this compound inhibited the growth of tumor cells, but it is unknown if this effect would take place in the human body. Scientists have also studied whether cascara might be a carcinogen, with inconsistent results.

Cascara is one of the ingredients in the Hoxsey herbal therapy, which is promoted to treat cancer. However, there is no evidence that Hoxsey herbal therapy is effective in treating cancer.

What are the potential uses and benefits?

  • To relieve constipation
    Scientific evidence supports this use, but prolonged use is not recommended because it can lead to dangerous blood electrolyte imbalances and potential liver toxicity.
  • To treat cancer
    Lab studies show that aloe-emodin from cascara has anticancer activity. However, lab results often do not translate to effectiveness in humans, and clinical trials have not yet been conducted.

What are the side effects?

Abdominal cramps, electrolyte imbalance, diarrhea and weight loss with excess use.

Case Reports
Liver disease such as severe or acute hepatitis have been reported.

What else do I need to know?

Patient Warnings:

  • Long-term use or overdose of cascara can cause electrolyte imbalances like very low blood levels of potassium, sodium, and chloride. It may also lead to liver injury.
  • Whether cascara may be a cancer-causing substance is uncertain, as studies have produced conflicting results.

Do Not Take if:

  • You are taking drugs that are substrates of P-Glycoprotein (P-Gp): Emodin, a compound present in cascara inhibits P-Gp, and may affect how these drugs are absorbed or metabolized. Clinical relevance has yet to be determined.