Rhamnus purshiana

Cascara/Drug Interactions:

  • AnticoagulantsAnticoagulants: Theoretically, cascara may potentiate anticoagulant therapy by reducing absorption of vitamin K from the gut.
  • CorticosteroidsCorticosteroids: Concomitant use of corticosteroids with cascara may increase the risk of potassium depletion.
  • Digitalis glycosides, digoxinDigitalis glycosides, digoxin: Cascara may inhibit the absorption of digitalis glycosides, and decrease their cardiac action. However, cathartic-induced hypokalemia increases the toxicity and potency of absorbed digitalis.
  • DiureticsDiuretics: Theoretically, concomitant use of cascara with diuretics may cause excessive loss of potassium.
  • Isoniazid, sulfisoxazoleIsoniazid, sulfisoxazole: Laxative-induced diarrhea may result in decreased absorption of isoniazid or sulfisoxazole.
  • Oral medicationsOral medications: The cathartic action of cascara may hasten the passage of all oral medications through the gut, thereby inhibiting their action.
  • Potassium depleting drugsPotassium depleting drugs: Theoretically, concomitant use of cascara along potassium depleting drugs can increase the risk of potassium depletion.
  • Stimulant laxativesStimulant laxatives: Concomitant use of cascara with other laxatives may theoretically cause electrolyte and fluid depletion.

    • Cascara/Herb/Supplement Interactions:

  • Anticoagulant herbs and supplementsAnticoagulant herbs and supplements: Theoretically, cascara may potentiate anticoagulant therapy by reducing absorption of vitamin K from the gut.
  • Diuretic herbs and supplementsDiuretic herbs and supplements: Theoretically, concomitant use of cascara with diuretic herbs and supplements may cause excessive loss of potassium.
  • Cardiac glycoside herbs (similar to digoxin or foxglove)Cardiac glycoside herbs (similar to digoxin or foxglove): Cascara may inhibit the absorption of digitalis glycosides, and decrease their cardiac action. However, cathartic-induced hypokalemia increases the toxicity and potency of absorbed digitalis.
  • LicoriceLicorice: Using cascara concomitantly with licorice can increase the risk of potassium depletion.
  • Oral herbs and supplementsOral herbs and supplements: The cathartic action of cascara may hasten the passage of all oral medications through the gut, thereby inhibiting their action.
  • Potassium depleting herbsPotassium depleting herbs: Theoretically, concomitant use of cascara along with potassium depleting herbs such as horsetail can increase the risk of potassium depletion.
  • SquillSquill: Cascara may inhibit the absorption of digitalis glycosides, and decrease their cardiac action. However, cathartic-induced hypokalemia increases the toxicity and potency of absorbed digitalis.
  • Stimulant laxative herbsStimulant laxative herbs: Theoretically, cascara used concomitantly with other herbs that are stimulant laxatives can increase the risk of potassium depletion.
  • Vitamin KVitamin K: Cascara induces increased speed of intestinal emptying, which theoretically may result in decreased absorption of vitamin K.

    • Cascara/Food Interactions:

  • Insufficient available evidence:

    • Cascara/Lab Interactions:

  • Colorimetric testsColorimetric tests: Cascara can discolor urine (pink, red, purple, orange, rust), interfering with diagnostic tests that depend on a color change, due to its anthraquinone content.
  • PotassiumPotassium: Anthraquinones in cascara may discolor the urine and interfere with diagnostic tests.