Last update Feb. 17, 2026

Cascara Sagrada

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

The bark of this shrub, native to North America, is used. It contains irritant anthraquinones (cascosides), tannins and resins. Attributed properties: laxative. (EMEA 2007, WHO 2002)

According to old and poorly documented reports, it is excreted in breast milk (Knowles 1974) and may cause diarrhoea in infants (Tyson 1937). In other studies, no diarrhoea was observed in infants whose mothers took buckthorn. (Duncan 1957)

Several authors advise against its use during breastfeeding (Amir 2011) and in some countries the sale of the plant as such has been restricted (MSC 2004). Bulk-forming, osmotic, emollient or lubricant laxatives are safer.

A balanced diet rich in fibre and fluids and physical exercise are essential for treating and preventing constipation.

American Academy of Paediatrics: medication usually compatible with breastfeeding. (AAP 2001)

Alternatives

  • Bisacodyl (Safe product and/or breastfeeding is the best option.)
  • Lactulose (Safe product and/or breastfeeding is the best option.)
  • Magnesium Hydroxide (Safe product and/or breastfeeding is the best option.)
  • Senna (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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Other names

Cascara Sagrada is also known as


Cascara Sagrada in other languages or writings:

Groups

Cascara Sagrada belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Cascara Sagrada in its composition:

List of 15 tradenames
  • Doce Alivio™. Contains other elements than Cascara Sagrada in its composition
  • Effectalax™
  • En-Ga-Lax™. Contains other elements than Cascara Sagrada in its composition
  • Fave De Fuca™. Contains other elements than Cascara Sagrada in its composition
  • Femibu™
  • Gameral™. Contains other elements than Cascara Sagrada in its composition
  • Heblax™
  • Laxor™
  • Legapas™
  • Linoforce™. Contains other elements than Cascara Sagrada in its composition
  • Linomed™. Contains other elements than Cascara Sagrada in its composition
  • Natulax Plus™. Contains other elements than Cascara Sagrada in its composition
  • Peritone™. Contains other elements than Cascara Sagrada in its composition
  • Purelax™
  • Zeninas™. Contains other elements than Cascara Sagrada in its composition

References

  1. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract
  2. EMEA. Rhamnus purshianus Community herbal monographs. 2007 Full text (in our servers)
  3. MSC - Ministerio de Sanidad y Consumo de España. ORDEN SCO/190/2004, de 28 de enero, por la que se establece la lista de plantas cuya venta al público queda prohibida o restringida por razón de su toxicidad. BOE 2004; 32:5061-6065 Full text (link to original source) Full text (in our servers)
  4. WHO. World Health Organization. Geneva. WHO monographs on selected medicinal plants. Volume 2. WHO monographs. 2002 Full text (link to original source) Full text (in our servers)
  5. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  6. Knowles JA. Breast milk: a source of more than nutrition for the neonate. Clin Toxicol. 1974 Abstract
  7. Greenleaf JO, Leonard HSD. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner 1973;210:259–63. 1973
  8. DUNCAN AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J. 1957 Abstract Full text (link to original source) Full text (in our servers)
  9. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I. Laxatives. J Pediatr 1937;11:824–32. 1937

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