Frangula Purshiana (Frangula purshiana): Benefits, Dosage, Safety & Evidence

Questions fréquentes

How does cascara sagrada work as a laxative?

Cascara sagrada (Frangula purshiana) contains anthraquinone glycosides called cascarosides A-D, which are metabolized by intestinal bacteria into active compounds. These metabolites stimulate colonic smooth muscle contraction and increase fluid secretion into the intestinal lumen, promoting bowel movement. The laxative effect typically occurs 6-12 hours after ingestion. This mechanism makes it a stimulant laxative, distinct from bulk-forming or osmotic laxatives. Evidence Level: C.

Does cascara sagrada interact with any medications?

Cascara sagrada can interact with several medication classes. Due to potential potassium depletion from chronic use, it may increase toxicity risk from cardiac glycosides like digoxin. It may potentiate potassium-wasting effects of diuretics and corticosteroids, worsening electrolyte imbalances. Concurrent use with other stimulant laxatives increases adverse effect risk. Patients on heart medications, diuretics, or corticosteroids should consult a healthcare provider before use. Evidence Level: C.

What is the recommended dosage for cascara sagrada bark?

The standard adult dosage is 300-500mg of aged bark extract or 1-2 grams of dried aged bark prepared as a tea, taken once daily at bedtime. The bark must be aged at least one year before use, as fresh bark contains emetic compounds that cause severe gastrointestinal irritation. Effects typically occur within 6-12 hours. Use should be limited to short-term duration of 1-2 weeks maximum. Evidence Level: C/Traditional.

Is cascara sagrada safe during pregnancy and breastfeeding?

No, cascara sagrada is contraindicated during pregnancy and breastfeeding. The anthraquinone compounds can stimulate uterine contractions, potentially causing miscarriage or premature labor. Active metabolites may pass into breast milk, causing diarrhea and electrolyte disturbances in nursing infants. Pregnant and breastfeeding individuals should avoid all stimulant laxatives containing anthraquinones. Safer alternatives include dietary fiber, adequate hydration, and osmotic laxatives under healthcare provider guidance. Evidence Level: C/D.

What are the side effects of long-term cascara sagrada use?

Long-term cascara sagrada use can cause electrolyte imbalances, particularly hypokalemia, which may affect heart rhythm and muscle function. Melanosis coli, a benign dark pigmentation of the colon lining, may develop after extended use and typically resolves after discontinuation. Chronic use can lead to laxative dependency and cathartic colon, where the colon becomes unresponsive to normal stimuli. Use should not exceed 1-2 weeks without medical supervision. Evidence Level: C.

Fiche d'information compilée à partir de PubMed

Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.

Compilé à partir de 28 articles PubMed · modèle : gemma4:31b

Résumé

Frangula purshiana, also known as California buckthorn or Cascara Sagrada, is a plant whose bark contains anthraquinones used for their potent cathartic properties [PMID:30000918].

Contexte

Frangula purshiana (DC.) J. G. Cooper (also referred to as Rhamnus purshiana), belonging to the Rhamnaceae family, is a species whose dried bark is widely used as an official laxative herbal medicine in western Pharmacopoeias [PMID:26350278, PMID:30000918].

Usages traditionnels

The herb is widely used for the treatment of constipation [PMID:39964315, PMID:23605186].

Composés actifs

The bark contains anthraquinones [PMID:30000918], specifically six anthraquinone diglucosides known as cascarosides A-F [PMID:32876395].

Mécanisme d'action

The plant contains anthranoid compounds that act as stimulant laxatives [PMID:12001972, PMID:30000918].

Preuves cliniques

Preuve DConstipation

Used as a laxative to treat constipation [PMID:39964315, PMID:23605186].

Preuve DColon Cleansing

Administration of Cascara sagrada in combination with a salt solution was used to cleanse the large bowel prior to roentgen examination and rectoscopy [PMID:1215526].

Sécurité et effets indésirables

Long-term use of aggressive laxative herbs like Cascara sagrada may cause potential toxicity and mucosal damage [PMID:37101734]. Reported severe adverse effects include toxic hepatitis and liver failure [PMID:19925744], cholestatic hepatitis complicated by portal hypertension [PMID:11151906], and acute liver injury [PMID:26114074]. Additionally, it has been identified as a causal agent for IgE-mediated occupational asthma and rhinitis in pharmacy workers [PMID:9396980]. The FDA has ruled that cascara sagrada ingredients in OTC drug products are not generally recognized as safe and effective or are misbranded [PMID:12001972].

Grossesse et allaitement

Maternal intake of cathartic buckthorn products should be avoided as it might cause loose stools in breastfed infants [PMID:30000918].

Synthèse des preuves

The evidence consists primarily of case reports, historical journal articles, and reviews. There is significant documentation of hepatotoxicity and a lack of FDA recognition for safety and effectiveness in OTC products.

Sources PubMed

1.PMID: 30000918 (2006) — Cascara Sagrada. · The Southern medical record
2.PMID: 32876395 (2020) — Isolation of six anthraquinone diglucosides from cascara sagrada bark by high-performance countercurrent chromatography. · Journal of separation science
3.PMID: 37619095 (1888) — Cascara Sagrada in Rheumatism. · The Chicago medical journal and examiner
4.PMID: 20750684 (1883) — Cascara Sagrada in Constipation. · British medical journal
5.PMID: 36393475 (1898) — Wine of Cascara Sagrada. · The Journal of comparative medicine and veterinary archives
6.PMID: 35828636

Frangula Purshiana

Sources et citations

Calculer une dose sûre de Frangula Purshiana