Yes

Laxative, Stimulant

Temporary relief of constipation; sometimes used with milk of magnesia ("black and white" mixture)

C

Nausea, vomiting, abdominal pain, fecal impaction, intestinal obstruction, GI bleeding, appendicitis, congestive heart failure

Excessive use can lead to electrolyte imbalance, fluid imbalance, vitamin deficiency, steatorrhea, osteomalacia, cathartic colon, and dependence; should be avoided during nursing because it may have a laxative effect on the infant

1% to 10%:

Endocrine & metabolic: Electrolyte and fluid imbalance

Gastrointestinal: Abdominal cramps, nausea, diarrhea

Genitourinary: Discoloration of urine (reddish pink or brown)

Decreased effect of oral anticoagulants

Protect from light and heat

Direct chemical irritation of the intestinal mucosa resulting in an increased rate of colonic motility and change in fluid and electrolyte secretion

Onset of action: 6-10 hours

Absorption: Oral: Small amount absorbed from small intestine

Metabolism: In the liver

Note: Cascara sagrada fluid extract is 5 times more potent than cascara sagrada aromatic fluid extract

Infants: 1.25 mL/day (range: 0.5-1.5 mL) as needed

Children 2-11 years: 2.5 mL/day (range: 1-3 mL) as needed

Children greater than or equal to 12 years and Adults: 5 mL/day (range: 2-6 mL) as needed at bedtime (1 tablet as needed at bedtime)

Administer on empty stomach for rapid effect

calcium (S), potassium (S)

No information available to require special precautions

No effects or complications reported

Take with water on an empty stomach for better absorption. Do not take within 1 hour of antacids, milk, or cimetidine. Evacuation will usually occur 6-12 hours after taking. Cascara should not be used regularly for more than 1 week. A regular toileting routine, adequate fluids, regular exercise, and a diet that includes roughage and bulk will help to prevent constipation. May discolor urine (black/brown). Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Cascara sagrada fluid extract is 5 times more potent than cascara sagrada aromatic fluid extract

Aromatic fluid extract: 120 mL, 473 mL

Tablet: 325 mg