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Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
CASRN: 8047-27-6
Drug Levels and Effects
Summary of Use during Lactation
Maternal cascara intake might cause loose stools in some breastfed infants and should be avoided.[1] Other cathartics are preferred.
Drug Levels
After administration of 65 mg of cascara sagrada as cascara fluidextract, cascara was qualitatively detected in the breastmilk of 5 of 10 women collected over 20 hours.[2] The sensitivity of the assay was about 1100 mg/L of cascara.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
In 2 uncontrolled studies, a total of 10 of 22 breastfed neonates appeared to have loose stools after administration of 65 mg of cascara as cascara fluidextract to their mothers.[2]
In an observational case series, no cases of diarrhea were observed among the breastfed infants of 142 mothers who received 400 mg of cascara extract on day 3 postpartum.[3] This result might have been because of the small amount of colostrum received by the infants of this age.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
References
- 1.
- Lewis JH, Weingold AB., Committee of FDA-Related Matters American College of Gastroenterology. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol. 1985;80:912–23. [PubMed: 2864852]
- 2.
- Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I: Laxatives. J Pediatr. 1937;11:824–32. [CrossRef]
- 3.
- Duncan AS. Standardized senna as a laxative in the puerperium. A clinical assessment. Br Med J. 1957;1:439–41. [PMC free article: PMC1974525] [PubMed: 13396280]
Substance Identification
Substance Name
Cascara Sagrada
CAS Registry Number
8047-27-6
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- [Toxic hepatitis following consumption of the herbal medicinal product Cascara Sagrada].[Ugeskr Laeger. 2009][Toxic hepatitis following consumption of the herbal medicinal product Cascara Sagrada].Jacobsen C, Semb S, Kromann-Andersen H. Ugeskr Laeger. 2009 Nov 9; 171(46):3367-9.
- A Serendipitous Find: A Case of Cholangiocarcinoma Identified Incidentally After Acute Liver Injury Due to Cascara sagrada Ingestion.[Hawaii J Med Public Health. 2015]A Serendipitous Find: A Case of Cholangiocarcinoma Identified Incidentally After Acute Liver Injury Due to Cascara sagrada Ingestion.Nakasone ES, Tokeshi J. Hawaii J Med Public Health. 2015 Jun; 74(6):200-2.
- The spectrophotometric examination of extracts of cascara sagrada.[Am J Pharm Sci Support Public ...]The spectrophotometric examination of extracts of cascara sagrada.AIKENHEAD J, VAIDYA BR, HUYCK CL. Am J Pharm Sci Support Public Health. 1962 Apr; 134:133-46.
- Review Gastrointestinal medications and breastfeeding.[J Hum Lact. 1998]Review Gastrointestinal medications and breastfeeding.Hagemann TM. J Hum Lact. 1998 Sep; 14(3):259-62.
- Review Initial description of gastric melanosis in a laxative-abusing patient.[Am J Gastroenterol. 1997]Review Initial description of gastric melanosis in a laxative-abusing patient.Mitty RD, Wolfe GR, Cosman M. Am J Gastroenterol. 1997 Apr; 92(4):707-8.
- Cascara Sagrada - Drugs and Lactation Database (LactMed®)Cascara Sagrada - Drugs and Lactation Database (LactMed®)
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