II. Indications
III. Mechanism
- Simulant Laxative (Anthraquinone)
- Cascara is derived from the dried aged bark (Cascara Sagrada) of buckthorn (Frangula purshiana or Rhamnus purshiana)
- Cascara extracts include the anthranol glycosides, emodin (anthraquinone) and Casanthranol (cascarosides)
- Casanthranol directly stimulates intestinal wall Muscle Contractions
IV. Precautions
- Avoid chronic use of Stimulant Laxatives (see adverse effects below)
- Cascara is listed for historical purposes and has been replaced by other Laxatives in the U.S.
V. Medications
- Cascara Sagrada aromatic fluid extract
- Cascara Sagrada fluid extract
- Caution! Five times the potency of aromatic fluid extract
VI. Dosing: Constipation
- Dosing is for Cascara aromatic fluid extract (not the much more potent fluid extract)
- Adult
- Take 5 ml aromatic fluid extract at bedtime as needed for Constipation
- Child (2 to 12 years)
- Give 2.5 ml orally at bedtime as needed for Constipation
VII. Pharmacokinetics
- Onset of activity within 6-12 hours
VIII. Adverse Effects: Long-Term (Laxative abuse)
- See Stimulant Laxative
- Avoid prolonged use (habit forming)!
- Colonic denervation and atony (Cathartic colon)
- Decreased motility of right colon with secondary worsening Constipation
- Associated with Anthraquinone Laxatives
- Results from myenteric plexus injury
-
Electrolyte and nutritional disturbance
- Hypokalemia
- Sodium overload
- Protein-losing Enteropathy
-
Melanosis coli
- Benign darkening of colonic mucosa
- Macrophage deposition in lamina propria
IX. Safety
- Pregnancy Category C
- Safe in Lactation
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Definition (MSH) | Dried aged bark of a buckthorn, Frangula purshiana (FRANGULA), that contains the anthraquinone EMODIN and cascarosides. It is used as a laxative (CATHARTICS). |
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
MSH | D002362 |
SnomedCT | 23888001, 387128007 |
English | Cascara, Cascara sagrada, Sacred Bark, cascara sagrada, laxatives cascara sagrada, cascara sagrada (medication), Cascara Sagrada Fluid Extract, cascara sagrada fluid extract, Cascara Sagrada, CASCARA SAGRADA FLUID EXTRACT, CASCARA SAGRADA @ @ FLUID EXTRACT, Cascara [Chemical/Ingredient], cascara sagrada extract, cascara, Cascara (product), Cascara (substance), CASCARA SAGRADA ORAL FLUID EXTRACT, CASCARA SAGRADA@@ORAL@FLUID EXTRACT, CASCARA SAGRADA, CASCARA SAGRADA EXTRACT |
Portuguese | Cáscara |
Swedish | Sagrada |
Czech | kaskara |
Finnish | Sagradankuori |
Italian | Cascara sagrada, Cascara |
Russian | KAZANTRANOL, KASKARA, CASANTHRANOL, КАЗАНТРАНОЛ, КАСКАРА |
Japanese | カスカラ, カスカラサグラダ, カサントラノール |
French | Écorce sacrée, Cascara |
Polish | Kaskara |
Spanish | cáscara (producto), cáscara (sustancia), cáscara sagrada, cáscara, Cáscara |
German | Cascara |
Ontology: Casanthranol (C0205705)
Definition (NCI) | A concentrated mixture of anthranol glycosides from cascara sagrada (dried bark of Rhamnus p.) and used as a laxative in constipation and various medical conditions, stimulant laxative Casanthranol encourages bowel movements by acting on the intestinal wall to increase muscle contractions. (NCI04) |
Definition (MSH) | A concentrated mixture of anthranol glycosides derived from cascara sagrada. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D002362 |
SnomedCT | 116530002, 400300006 |
LNC | LP171651-5 |
English | casanthranol, casanthranol (medication), laxatives casanthranol, Casanthranol [Chemical/Ingredient], Casanthranol (product), Casanthranol (substance), Casanthranol, CASANTHRANOL |
Portuguese | Casantranol |
Spanish | Casantranol, casantranol (producto), casantranol (sustancia), casantranol |
German | Casanthranol |
French | Casanthranol |
Italian | Casanthranol |