Cascara Sagrada

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 laxatives 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.


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:


Bisacodyl,Magnesium Hydroxide,Senna


References:


1. Lewis JH, Weingold AB and the 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. PMID:2864852
2. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. Part I: laxatives. J Pediatr. 1937;11:824-32.
3. Duncan AS. Standardizedsennaas a laxative in the puerperium. A clinical assessment. Br Med J. 1957;1:439-41. PMID:13396280



Substance Identification:




Substance Name:

Cascara Sagrada

CAS Registry Number:

8047-27-6

Drug Class:


  • Cathartics

  • Gastrointestinal Agents


  • Administrative Information:




    LactMed Record Number:


    452


    Last Revision Date:


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