Cassia fistula (Cassia fistula): Benefits, Dosage, Safety & Evidence

Frequently asked questions

How does Cassia fistula work as a laxative?

Cassia fistula contains sennosides and anthraquinones, which act as stimulant laxatives. These compounds work by irritating the intestinal mucosa and stimulating colonic peristalsis, promoting bowel movements. The anthraquinones also increase fluid and electrolyte secretion into the intestinal lumen, softening stools. This mechanism is similar to senna. Effects typically occur 6-12 hours after ingestion. Evidence level: C (based on traditional use and pharmacological studies).

Is Cassia fistula safe during pregnancy?

Cassia fistula is considered unsafe during pregnancy and should be avoided. The anthraquinone compounds can stimulate uterine contractions and may cause electrolyte imbalances harmful to both mother and fetus. Large amounts pose particular risk. Pregnant women experiencing constipation should consult a healthcare provider for safer alternatives such as dietary fiber supplements or osmotic laxatives. Evidence level: C.

What is the recommended dosage of Cassia fistula for constipation?

The typical adult dosage for Cassia fistula as a mild laxative is the pulp from 1-2 pods, taken once daily. The pulp should be extracted from ripe pods and can be consumed directly or mixed with water. Do not exceed this dosage or use for extended periods (more than 7-10 days) without medical supervision. Evidence level: C (traditional use).

Does Cassia fistula interact with any medications?

Cassia fistula may interact with several medications. Its laxative effects can reduce absorption of orally administered drugs by decreasing intestinal transit time. Chronic use may cause potassium depletion, potentially increasing toxicity of cardiac glycosides like digoxin and affecting antiarrhythmic medications. It may also potentiate effects of diuretics, worsening electrolyte imbalances. Avoid combining with other stimulant laxatives. Evidence level: C.

What are the side effects of Cassia fistula?

Common side effects of Cassia fistula include mild gastrointestinal cramping, abdominal discomfort, and loose stools. These effects are dose-dependent and typically resolve after discontinuation. Chronic or excessive use may lead to electrolyte imbalances (particularly hypokalemia), dehydration, and dependency. Individuals with inflammatory bowel disease should avoid use due to potential irritation of the intestinal lining. Evidence level: C.

PubMed-compiled information sheet

This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.

Compiled from 30 PubMed articles · model: gemma4:31b

Summary

Cassia fistula, also known as 'Yellow Shower' or Indian laburnum, is a medicinal plant used in traditional systems such as Ayurveda, Chinese Traditional Medicine, and Traditional Persian Medicine [PMID:34601194, 24163950, 28348966].

Background

It is a deciduous medium-sized tree characterized by bright yellow flowers and elongated, rod-shaped fruits containing pulp [PMID:34601194]. It is indigenous to the Indian subcontinent, with significant biodiversity in north India [PMID:24163950].

Traditional uses

Traditionally used as a purgative, laxative, carminative, antipyretic, expectorant, analgesic, antiseptic, and as an antidote against snake poison [PMID:36051494]. It is also used in traditional medicine to treat urinary stones [PMID:3841887] and various infections and diseases in Taunggyi [PMID:33659733].

Active compounds

Active constituents include flavonoids [PMID:27538998, 34601372], anthraquinones such as rhein [PMID:28348966, 39830422], lupeol [PMID:28348966], saponins [PMID:34601372], tannins [PMID:34601372], and triterpenoids [PMID:38046519]. The fruit is a source of potassium (K), calcium (Ca), iron (Fe), manganese (Mn), and amino acids including aspartic acid, glutamic acid, and lysine [PMID:7784398].

Mechanism of action

The herb exhibits antioxidant, antimicrobial, anti-inflammatory, and antiproliferative activities [PMID:34601194, 3691956 la]. It may act as a disease modifier in autoimmune bullous diseases [PMID:39599747] and has been studied for its potential to inhibit viral binding and DNA integration in HIV [PMID:38047360].

Clinical evidence

Evidence AChildhood functional constipation

Cassia fistula emulsion was identified in a meta-analysis of nonpharmacologic treatments for treatment success and/or defecation frequency [PMID:34536492]; it is partially effective in reducing pain and stool consistency in children [PMID:39238530].

Evidence CPemphigus vulgaris

A traditional formulary of C. fistula fruit extract in almond oil is reviewed as a topical medication to reduce the duration of treatment for erosions [PMID:28348966].

Evidence DWound healing

Methanol extract of C. fistula flowers showed antibacterial activity against Staphylococcus aureus and antifungal activity against Aspergillus niger [PMID:34601372]; a carboxymethylated gum-based hydrogel film showed 99% wound healing in rats [PMID:39153677].

Evidence DNephrolithiasis

Aqueous and ethanolic fruit extracts were evaluated for antilithiatic potential against calcium oxalate kidney stones in rats [PMID:38415887].

Safety & adverse effects

Animal models have confirmed pharmacological safety and efficacy [PMID:26130932].

Evidence summary

Evidence ranges from high-level systematic reviews for pediatric constipation to low-level in vitro and animal studies for wound healing, oncology, and nephrolithiasis.

PubMed sources

1.PMID: 34536492 (2022) — Nonpharmacologic Treatment for Children with Functional Constipation: A Systematic Review and Meta-analysis. · The Journal of pediatrics
2.PMID: 39599747 (2024) — The Role of Nutrition in the Pathogenesis and Treatment of Autoimmune Bullous Diseases-A Narrative Review. · Nutrients
3.PMID: 34601194 (2021) — The medicinal properties of Cassia fistula L: A review. · Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie
4.PMID: 24163950 (2012) — Pharmacological potentials of Cassia auriculata and Cassia fistula plants: A review. · Pakistan journal of biological sciences : PJBS
5.PMID: 24760067 (2014) — Anti-ulcer activity of leguminosae plants. · Arquivos de gastroenterologia

Cassia fistula

Sources & Citations

Calculate a safe dose of Cassia fistula