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Cascara sagrada is the dried, aged bark of a North American buckthorn tree (Rhamnus purshiana) that has been used as a laxative for centuries. Like senna, it is a stimulant laxative: its anthraquinone compounds act directly on the colon, speeding bowel movements and reducing how much water and salt the colon reabsorbs. The two differ in regulation. In 2002 the FDA ruled that cascara sagrada is not generally recognized as safe and effective in over-the-counter laxative drugs, after manufacturers failed to submit requested safety data, while senna is still sold in laxatives with Drug Facts labels. Cascara remains available as a dietary supplement ingredient. Both are meant for short-term use only.
Peptide Labs sells cleanse supplements that contain cascara sagrada and senna, and we describe three of them below by their labels. This article is general information, not medical advice.
Key Takeaways
- Cascara sagrada and senna are anthraquinone stimulant laxatives that act directly on the colon.
- Since November 2002, cascara cannot be an active ingredient in OTC laxative drugs; senna still can.
- Senna Drug Facts limit use to 1 week unless a doctor directs otherwise.
- Longer use can cause low potassium and dehydration; rare liver injury has been reported with cascara.
- Avoid stimulant laxatives with abdominal pain, diarrhea or a bowel blockage, and ask first if pregnant.
What is cascara sagrada?
The NIH LiverTox database describes cascara as an extract of the dried, aged bark of the tree. Its active compounds, called cascarosides, irritate the colon to promote bowel movements and block the reabsorption of water and electrolytes. Other plants with similar anthraquinones include senna leaf, aloe latex, frangula bark and rhubarb root, and many cleanse formulas combine several of them. LiverTox says cascara is recommended only for short-term use of less than a week.
How a stimulant laxative works
FDA’s laxative monograph defines a stimulant laxative as an agent that promotes bowel movement by direct action on the intestine. Senna labels say to expect a bowel movement in 6 to 12 hours. That is a different mechanism from fiber or minerals:
| Laxative type | Examples | How it works | Label notes |
|---|---|---|---|
| Stimulant | Senna, cascara, aloe, frangula, bisacodyl | Acts directly on the intestine | Short-term only; senna Drug Facts say 1 week |
| Bulk-forming | Psyllium | Absorbs water and adds bulk | Take with a full glass of liquid |
| Saline | Magnesium salts | Increases water in the intestine | Ask first with kidney disease |
| Stool softener | Docusate | Softens the stool | Often paired with senna |
Our guides to magnesium supplements and fiber side effects cover the other types.
Cascara sagrada, senna and the FDA
In 1998 the FDA proposed moving four stimulant laxative ingredients, aloe, bisacodyl, cascara sagrada and senna, into a category that required more safety data. It asked manufacturers for studies on genetic damage and cancer risk. Nobody submitted data for aloe or cascara, so a final rule published on May 9, 2002 and effective November 5, 2002 declared both not generally recognized as safe and effective for OTC laxative use, and gave makers 180 days to stop selling such products. Senna and bisacodyl stayed under review and are still sold over the counter. Senokot, for example, lists sennosides as its active ingredient on a Drug Facts label.
The 2002 rule covered OTC drugs, not dietary supplements, which is why cascara still appears on Supplement Facts panels. Supplements do not need FDA review before sale.
Senna tea and other senna products
Senna comes from the leaves of Senna alexandrina, and its active compounds are sennosides. Some senna teas are sold as OTC laxatives with Drug Facts; Smooth Move, for example, lists senna leaf as its active ingredient and warns against use with diarrhea, loose stools or abdominal pain. So-called dieter’s teas are a concern: an FDA advisory committee recommended warnings that steeping them longer raises the risk of cramps and diarrhea, and that chronic diarrhea can lead to serious illness or death, and California required warning labels on senna teas and supplements. Senna tea is labeled for occasional constipation, not weight loss.
Is senna safe?
For short-term use as labeled, senna is considered likely safe for adults and children over 2, according to the Natural Medicines monograph. The limits matter. Senokot’s Drug Facts say not to use laxatives for longer than 1 week unless a doctor directs it, to ask a doctor first if you have stomach pain, nausea, vomiting or a change in bowel habits lasting more than 2 weeks, and to stop and ask a doctor if you have rectal bleeding or no bowel movement. Children under 2 need a doctor’s advice. Long-term or high use is rated possibly unsafe and has been linked to electrolyte problems, heart rhythm effects, muscle weakness and liver damage. During breastfeeding, the NIH LactMed database considers usual amounts acceptable because sennosides were not detected in breast milk; pregnant people should ask a health professional first, as the label says.
Cascara sagrada side effects
Natural Medicines rates cascara possibly safe for adults when used for less than a week and possibly unsafe long-term. Short-term side effects include stomach discomfort and cramps. Longer use can cause dehydration and low potassium, sodium and chloride, which may lead to heart problems and muscle weakness. Liver injury is rare but documented: LiverTox notes clinically apparent liver injury with high amounts used longer than recommended, a 2000 case report described cholestatic hepatitis with portal hypertension, and a 2009 Danish report described severe hepatitis after four weeks of a cascara product.
Safety references advise avoiding cascara in pregnancy because not enough is known, it can pass into breast milk and may cause diarrhea in a nursing infant, and it is rated possibly unsafe for children, who dehydrate more easily. It should not be used with a bowel blockage, Crohn’s disease, ulcerative colitis, appendicitis, stomach ulcers or unexplained abdominal pain.
Drug interactions for cascara and senna
- Digoxin: low potassium raises the risk of digoxin side effects.
- Diuretics (water pills) and corticosteroids: potassium may drop too far.
- Warfarin: diarrhea can increase its effect and bleeding risk.
- Other stimulant laxatives: combining them can cause dehydration and mineral loss.
Melanosis coli and the dependence question
Using anthraquinone laxatives for a long time can darken the lining of the colon, a condition called melanosis coli. Cleveland Clinic says it is not harmful and fades 6 to 12 months after stopping. Dependence is debated. A 2005 review in the American Journal of Gastroenterology concluded that stimulant laxatives at recommended amounts are unlikely to harm the colon, that tolerance is uncommon and rebound constipation has not been shown, and that the idea of disease from “autointoxication” by stool has no evidence behind it. Labels still set short limits, and constipation that keeps returning deserves a doctor’s evaluation.
Cleanse supplements that contain cascara or senna
InnoSupps Inno Cleanse 2X lists an 824 mg complex of cascara sagrada, cape aloe, senna and frangula per serving, and its label directs use for up to 14 days at a time, once a month, for adults only. Dr. Tobias Colon 14 Day Cleanse combines cascara, senna and psyllium; its label limits continuous use to 7 days, says not to repeat for 6 to 8 weeks, and requires a full glass of liquid. Health Plus Super Colon Cleanse relies on senna and psyllium and warns not to use it with diarrhea, loose stools or abdominal pain.
Supplement labels allow different lengths of use, some longer than the 1-week limit on senna drug labels, and several combine more than one anthraquinone herb. Do not stack them with other laxatives, and check with a doctor before a second round. Compare labels in our detox and cleanse category, and see our review of colon cleansing supplements.
Who should avoid stimulant laxatives
- People with abdominal pain, nausea, vomiting, diarrhea or loose stools.
- People with a bowel blockage, Crohn’s disease, ulcerative colitis or appendicitis.
- Pregnant or breastfeeding people, unless a clinician approves.
- Children, unless a pediatrician directs it.
- People taking digoxin, diuretics, corticosteroids or warfarin.
- Anyone with a history of an eating disorder or laxative misuse.
Frequently Asked Questions
What is cascara sagrada used for?
It has long been used as a laxative. Since 2002 it cannot be an active ingredient in OTC laxative drugs in the U.S., but it is still sold in dietary supplements.
Is cascara sagrada the same as senna?
No. They come from different plants, but both contain anthraquinones and work as stimulant laxatives. Senna is still an OTC drug ingredient; cascara is not.
Is senna safe to take every day?
Not long term without a doctor. Senna Drug Facts say not to use laxatives for more than 1 week unless a doctor directs it.
Does senna tea help you lose weight?
It is not labeled for weight loss; senna Drug Facts cover occasional constipation. Long use can cause dehydration and low potassium.
How long does a stimulant laxative take to work?
Senna labels say it generally produces a bowel movement in 6 to 12 hours.
Can I take cascara sagrada while pregnant or breastfeeding?
Safety references advise avoiding it in pregnancy, and it can pass into breast milk. Ask your clinician about options.
Questions about a label? Contact us or read our Buyer’s Guide. Follow the label and ask a healthcare provider before starting any supplement, especially if you take medicines. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Last reviewed September 2026.
Related guides: Colon Cleanse & Detox Supplements: What’s on the Label, Magnesium Oxide: Elemental Magnesium, Absorption, Laxative Effect and Safety, Fiber Supplement Side Effects: Gas, Choking Risk, Allergies and Medicine Timing, Metamucil vs MiraLAX: Fiber Laxative vs Osmotic Laxative, and Where Stool Softeners Fit, Fiber for Constipation: What the Evidence Says, How Long It Takes and Natural Laxative Foods, Aloe Vera Juice Benefits: What Studies Show and Safety Facts.