Nature's Sunshine Products NSP Forum Index Nature's Sunshine Products NSP
For customer and distributor discussions of Nature's Sunshine Products. Not an official site of NSP.
 
 FAQFAQ   SearchSearch   MemberlistMemberlist   UsergroupsUsergroups   RegisterRegister 
 ProfileProfile   Log in to check your private messagesLog in to check your private messages   Log inLog in 

Cascara Sagrada

 
This forum is locked: you cannot post, reply to, or edit topics.   This topic is locked: you cannot edit posts or make replies.    Nature's Sunshine Products NSP Forum Index -> Forum Archive
View previous topic :: View next topic  
Author Message
CombinedNSP
Site Admin


Joined: 13 Dec 2006
Posts: 1406
Location: Cleveland, OH

PostPosted: Dec Sat 16, 2006 5:21 pm    Post subject: Cascara Sagrada Reply with quote

Cascara Sagrada

This seems quite scientifically thorough and reiterates that the color resulting from Cascara Sagrada use is not, in itself harmful, and is temporary. It also says that abusive use can result in electrolyte loss, etc. Use any purgative herbs with care. Fiber is necessary for bowel health . . . this must be stressed.

This is a site showing a limited number of herbs - I have posted the writeup on Cascara Sagrada. Quite lengthily, mostly scientific information. . . . . . toward the end is the "what for" type information. Might be good for a customer who wants this kind of documented information. -Georgiana
--------------------------
http://onhealth.com/alternative/resource/herbs/index.asp
"Here is one of the best guides you can find to the uses of more than 100 different plants used by herbalists. Our source: "Herbal Medicine," a new authoritative and comprehensive guide based on the famous German Commission E monographs. Each report includes usage, chemistry, interactions and dosage -- and a thorough list of references."
--------------------------
Cascara Sagrada Bark

Latin Name Rhamnus purshiana
Pharmacopeial Name Rhamni purshianae cortex
Other Names cascara, chittem bark, sacred bark

Overview
Cascara sagrada is a deciduous tree native to forests of the North American Pacific Coast, ranging from northern California to British Columbia and almost to the Alaska panhandle, in moist areas below 1,500 m elevation. It is also found in the Rockies of Idaho and in Montana (HPUS, 1992; Leung and Foster, 1996; Moore, 1993). The material of commerce comes mainly from Oregon, Washington, and British Columbia in the form of dried quills, flattened and/or curved pieces of dried bark. It is harvested from trees with a trunk diameter of at least 10 cm and it is cured for at least one year before use (BHP, 1996; HPUS, 1992; Leung and Foster, 1996; Wichtl and Bisset, 1994). Because the anthraquinones in freshly dried cascara bark can cause extreme gastrointestinal irritation, including severe intestinal spasms or vomiting, it is either aged for a year to allow oxidation of the anthrones (Samuelsson, 1992), or it is heated and dried to induce artificial aging. Either process makes the laxative effects mild enough so that the relief of constipation is gentle, even when constipation occurs in patients with hemorrhoids, anal fissures, or pain following anorectal surgery (Schulz et al., 1998).

The modern clinical applications for cascara originate from its traditional use in North American aboriginal medicine. Numerous tribes throughout the Northwest have traditionally used cascara bark as a laxative drug in various dosage forms, including aqueous decoction and/or infusion, cold macerate as well as chewing the bark directly. For example, the Flathead, a Salish people of northwest Montana, and the Kutenai people of Montana, Idaho and British Columbia both prepare a cathartic infusion of the bark as a purgative. The Sanpoil, Shuswap, Skagit, and Yurok peoples prepare the bark as a decoction for laxative action (Moerman, 1998). Cascara was not mentioned in the literature until 1805 and it was not brought into western medical use until 1877 (Der Marderosian, 1999; Trease and Evans, 1989), when its traditional use was reported by Eclectic physician Dr. J.H. Bundy in his "New Preparations." Parke-Davis & Co. then introduced it as a laxative drug in an alcoholic fluidextract form. Eli Lilly & Co. also introduced their laxative product "Elixir Purgans," a compound elixir containing cascara (Rhamnus purshiana DC), wahoo (Euonymus atropurpureus Jacq.), senna (Cassia acutifolia Delile), blue flag (Iris versicolor L.), and hyoscyamus leaves (Hyoscyamus niger L.) combined with aromatics (Felter and Lloyd, 1983).

Many Rhamnus species share anthraquinone derivative constituents and provide similar laxative actions. These constituents were isolated by botanists early in the study of plant chemistry. They are chemically classified as anthraquinone derivatives. The cascarosides in cascara sagrada provide up to two thirds of the plant's anthraquinone content. They induce peristalsis in the large intestine, with few side effects (Harborne and Baxter, 1993).

Very few modern human studies have been done. Some studies have investigated its use as a colon cleansing method for colonoscopy (Hangartner et al., 1989; Phillip et al., 1990) and its effectiveness as a laxative to treat elderly people suffering from chronic functional constipation (Petticrew et al., 1997).

In Germany, cascara is official in the German Pharmacopoeia, approved in the Commission E monographs, and the tea form is official in the German Standard License monographs. It is typically combined with other laxatives in various dosage forms including dry extract, fluidextract, and infusion (Bradley, 1992; Braun et al., 1997; DAB 10, 1994; Wichtl and Bisset, 1994). In the United States, cascara was official in the United States Pharmacopoeia from 1890 up through the 22nd revision in 1990, and recognized in the National Formulary 14th edition (Boyle, 1991; CFR 21, 1985; Leung and Foster, 1996; NF XIV, 1975; USP XXII, 1990). It is a component of numerous over-the-counter laxative preparations (e.g., Cas-Evac, Parke-Davis; Concentrated Milk of Magnesia-Cascara) (Budavari, 1996; Der Marderosian, 1999; Reynolds, 1989; Tyler, 1994). Aromatic Cascara Fluidextract (USP) is a 1:1 (w/v) aqueous extract of cascara with licorice root, preserved in alcohol 20% (v/v). Cascara Sagrada Extract (USP) is a dry extract containing 11% hydroxyanthracene derivatives (Reynolds, 1989). Cascara sagrada is also classified in the Homeopathic Pharmacopoeia of the United States as an OTC Class C drug prepared as a 1:10 (w/v) alcoholic tincture of the bark, in 65% v/v alcohol (HPUS, 1992).

Pharmacopeial grade cascara sagrada bark consists of the dried whole or cut bark of R. purshiana D.C. It must contain not less than 8.0% hydroxyanthracene glycosides of which 60% must be cascarosides, both calculated as cascaroside A with reference to the dried drug. Botanical identity must be confirmed by thin-layer chromatography (TLC), macroscopic and microscopic examinations, and organoleptic evaluation. Tests for adulteration with fresh uncured bark and/or other species of Rhamnus are carried out (BP, 1980; DAB 10, 1994; Ph.Eur.3, 1997; Wichtl and Bisset, 1994). It should contain not less than 15% water-soluble extractive (Karnick, 1994). The ESCOP monograph requires that the material comply with the European Pharmacopoeia (ESCOP, 1997).

Description
Cascara sagrada bark is the dried bark of R. purshiana D.C. (syn. Frangula purshiana (D.C.) A. Gray ex J.C. Cooper) [Fam. Rhamnaceae], as well as its preparations in effective dosage. The bark contains anthranoids, mainly of the aloe-emodin type, in addition to those of the chrysophanol and physcion type.The commercial product must conform to the currently valid pharmacopeia.

Chemistry and Pharmacology
Cascara contains 8–10% of a complex mixture of hydroxyanthracene derivatives, of which 60–70% are cascarosides A, B, C, D, E, and F, 10–30% are aloins A and B with chrysaloins A and B, and 10–20% are a mixture of anthraquinone O-glycosides and free anthraquinones (e.g., aloe-emodin, frangula-emodin, iso-emodin, chrysophanol, and physcion); resins; tannins; lipids (Bradley, 1992; Budavari, 1996; ESCOP, 1997; Leung and Foster, 1996; Meyer-Buchtela, 1999; Wichtl and Bisset, 1994).

The Commission E reported that 1,8-dihydroxy-anthracene derivatives have a laxative effect, due to the influence of the herb on the motility of the colon, inhibiting stationary and stimulating propulsive contractions. This results in an accelerated intestinal passage and, because of the shortened contact time, a reduction in liquid absorption. In addition, stimulation of chloride secretion increases water and electrolyte content. Systematic studies pertaining to the kinetics of cascara sagrada bark preparations are not available. However, it must be concluded that the aglycones contained in the preparation are already absorbed in the upper small intestine. The b-glycosides are prodrugs that are neither absorbed nor cleaved in the upper gastrointestinal tract. They are degraded in the colon by bacterial enzymes to anthrones, laxative metabolites. Active metabolites of other anthronoids, such as rhein, infiltrate in small amounts into the milk ducts. A laxative effect on nursing infants has not been observed. The placental permeability for rhein is very small.

Commercial preparations (i.e., herbal stimulant laxatives) have a higher general toxicity than the pure glycosides, presumably due to the content of aglycones. Experiments pertaining to the genotoxicity of cascara sagrada and its preparations are not available. Some positive data were obtained for aloe-emodin, emodin, physcion, and chrysophanol. No data are available for carcinogenicity.

The fresh bark contains free anthrone and must be stored for one year or artificially aged by heat and aeration. The use of illegally processed cascara sagrada bark, e.g., fresh bark, will cause severe vomiting, possibly spasms.

The British Herbal Pharmacopoeia and the British Pharmacopoeia both reported laxative action (BP, 1980; Bradley, 1992). The Canadian Health Protection Branch Status Manual reported cascara to be an anthraquinone purgative drug with a mild action (HPB, 1992). The Merck Index reported its therapeutic category as cathartic (Budavari, 1996).

Uses:
The Commission E approved the use of cascara sagrada bark for constipation.

ESCOP reported its therapeutic indications for short term use in cases of occasional constipation based on the U.S. FDA monograph (CFR 21, 1985; ESCOP, 1997). The German Standard License for cascara bark tea indicates its use for constipation; all disorders in which easy bowel evacuation with soft stools is desired, e.g., in cases of anal fissures, hemorrhoids, and after recto-anal operations (Bradley, 1992; Braun et al., 1997; Wichtl and Bisset, 1994). The British Herbal Pharmacopoeia indicates its use for occasional constipation; conditions in which a soft stool is desirable, such as anal fissure or hemorrhoids (Bradley, 1992).

Contraindications:
Intestinal obstruction, acute intestinal inflammation, e.g., Crohn's disease, colitis ulcerosa, appendicitis, abdominal pain of unknown origin. Children under 12 years of age.

Side Effects:
In single incidents, cramp-like discomforts of the gastrointestinal tract. These cases require a dosage reduction.

Long-time use/abuse: Disturbances of electrolyte balance, especially potassium deficiency, albuminuria, and hematuria. Pigment implantation into the intestinal mucosa (pseudomelanosis coli) is harmless and usually reverses upon discontinuation of the preparation. Potassium deficiency can lead to disorders of heart function and muscular weakness, especially with concurrent use of heart glycosides, diuretics, or corticosteroids.

Use During Pregnancy and Lactation:
Because of insufficient toxicological investigation, this drug should not be used during pregnancy and lactation.

Interactions with Other Drugs:
With chronic use/abuse, potassium loss may cause an increase in the effectiveness of cardiac glycosides. An effect on antiarrhythmics is possible. Potassium deficiency increases with simultaneous application of thiazide diuretics, corticosteroids, or licorice root.

Dosage and Administration:
Unless otherwise prescribed: 1–2 g per day cut or powdered aged bark yielding 20–30 mg hydroxyanthracene derivatives (calculated as cascaroside A) in tea, decoction, cold maceration, elixir, or dry extract. Liquid or solid forms of medication exclusively for oral use. The individually correct dosage is the smallest dosage necessary to maintain a soft stool.

Note: The form of administration should be smaller than the normal daily dosage.
Bark: 0.3–1 g in a single daily dose (Bradley, 1992; CFR 21, 1985; ESCOP, 1997).
Infusion: Steep 1–2 g in 150 ml boiled water for 10 to 15 minutes (Braun et al., 1997; ESCOP, 1997; Meyer-Buchtela, 1999; Wichtl and Bisset, 1994).

[Note: Extraction with boiling water prevents some of the losses and chemical changes that occur during cold water extraction (Fairbairn and Simic, 1970; Der Marderosian, 1999).]
Cold macerate: 1–2 g in 150 ml cold water for several hours, then boil and strain.
[Note: 90% of the available hydroxyanthracene derivatives are released into cold water after six hours of maceration (Meyer-Buchtela, 1999).]
Elixir: 1–2 ml flavored and sweetened alcoholic fluidextract.
[Note: Cascara Elixir of the British Pharmacopoeia contains cascara in combination with licorice, light magnesium oxide, coriander oil, anise oil, ethanol, saccharin sodium, glycerol, and water (BP, 1980).]
Fluidextract 1:1 (g/ml): 1–2 ml.
[Note: Cascara Liquid Extract dosage range in the British Pharmacopoeia is 2–5 ml (BP, 1980).]
Tincture 1:5 (g/ml): 2–4 ml.
Dry extract 4.0–5.5:1 (w/w) containing approximately 13% (130 mg/g) hydroxyanthracene derivatives: 0.15–0.23 g (BP, 1980; Bradley, 1992; Braun et al., 1997; CFR 21, 1985; ESCOP, 1997; Meyer-Buchtela, 1999; Wichtl and Bisset, 1994).

Special caution for use: Stimulating laxatives must not be used over an extended period of time (1–2 weeks) without medical advice.

Over dosage: Electrolyte and fluid imbalance.

Special warnings: Use of a stimulating laxative longer than recommended can cause intestinal sluggishness. The preparation should be used only if no effects can be obtained through change of diet or use of bulk-forming products.

References:
Boyle, W. 1991. Official Herbs: Botanical Substances in the U.S. Pharmacopoeias 1820–1990. East Palestine, OH: Buckeye Naturopathic Press.

Bradley, P.R. (ed.). 1992. British Herbal Compendium, Vol. 1. Bournemouth: British Herbal Medicine Association.

Braun, R. et al. 1997. Standardzulassungen für Fertigarzneimittel--Text and Kommentar. Stuttgart: Deutscher Apotheker Verlag.

British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association. 53.

British Pharmacopoeia (BP). 1980. London: Her Majesty's Stationery Office. Vol. I: 83–84; Vol. II: 551, 561–562.

Budavari, S. (ed.). 1996. The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 12th ed. Whitehouse Station, N.J.: Merck & Co, Inc.

CFR 21. See U.S.A. Dept. of Health and Human Services: Food and Drug Administration.

Der Marderosian, A. (ed.). 1999. The Review of Natural Products. St. Louis: Facts and Comparisons.

Deutsches Arzneibuch, 10th ed., 3rd suppl. (DAB 10). 1994. Stuttgart: Deutscher Apotheker Verlag.

ESCOP. 1997. "Rhamni purshianae cortex." Monographs on the Medicinal Uses of Plant Drugs. Exeter, U.K.: European Scientific Cooperative on Phytotherapy.

Europäisches Arzneibuch, 3rd ed., 1st suppl. (Ph.Eur.3). 1998. Stuttgart: Deutscher Apotheker Verlag.

Fairbairn, J.W. and S. Simic. 1970. A new dry extract of cascara (Rhamnus purshiana D.C. bark). J Pharm Pharmacol 22(10):778–780.

Felter, H.W. and J.U. Lloyd. 1983. King's American Dispensatory, 18th ed., 3rd rev. Portland, OR: Eclectic Medical Publications [reprint of 1898 original]. 1654-1657.

Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.

Hangartner, P.J., R. Munch, J. Meier, R. Ammann, H. Buhler. 1989. Comparison of three colon cleansing methods: evaluation of a randomized clinical trial with 300 ambulatory patients. Endoscopy 21(6):272–275.

Harborne, J. and H. Baxter. 1993. Phytochemical Dictionary: A Handbook of Bioactive Compounds from Plants. Washington, D.C.: Taylor & Francis.

Health Protection Branch (HPB) Status Manual. 1992. Ottawa: Health Protection Branch.

The Homeopathic Pharmacopoeia of the United States (HPUS). 1992. Revision Service Official Compendium. Fairfax, VA: Pharmacopoeia Convention of the American Institute of Homeopathy.

Karnick, C.R. 1994. Pharmacopoeial Standards of Herbal Plants. Vol. 1:315–316.

Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.

Meyer-Buchtela, E. 1999. Tee-Rezepturen--Ein Handbuch für Apotheker und Ärzte. Stuttgart: Deutscher Apotheker Verlag.

Moerman, D.E. 1998. Native American Ethnobotany. Portland, OR: Timber Press. 237.

Moore, M. 1993. Medicinal Plants of the Pacific West. Santa Fe, NM: Red Crane Books. 304.

National Formulary, 14th ed. (NF XIV).1975. Washington, D.C.: American Pharmaceutical Association.

Petticrew, M., I. Watt, T. Sheldon. 1997. Systematic review of the effectiveness of laxatives in the elderly. Health Technol Assess 1(13):i–iv, 1–52.

Ph.Eur.3. See Europäisches Arzneibuch.

Phillip J., G.E. Schubert, A. Thiel, U. Wolters. 1990. Vorbereitung zur Koloskopie mit "Golytely" eine sichere Methode? Vergleichende histologische und klinische Untersuchung zwischen Lavage und salinischem Laxans [Preparation for colonoscopy using Golytely--a sure method? Comparative histological and clinical study between lavage and saline laxatives]. Med Klin 85(7):415–420.

Reynolds, J.E.F. (ed.). 1989. Martindale: The Extra Pharmacopoeia, 29th ed. London: The Pharmaceutical Press.

Samuelsson, G. 1992. Drugs of Natural Origin: A Textbook of Pharmacognosy. Stockholm: Sweden Pharmaceutical Press.

Schulz, V., R. Hänsel, V.E. Tyler. 1998. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. New York: Springer.

Trease, G.E. and W.C. Evans. 1989. Trease and Evans' Pharmacognosy, 13th ed. London; Philadelphia: Baillière Tindall.

Tyler, V.E. 1994. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Pharmaceutical Products Press.

The United States Pharmacopeia, 22nd rev. (USP XXII). 1990. Rockville, MD: U.S. Pharmacopoeial Convention.

U.S.A. Dept. of Health and Human Services: Food and Drug Administration. 1985. Code of Federal Regulations 21 (CFR 21). Part 334. Tentative final monograph. Washington, D.C.: Office of the Federal Register National Archives and Records Administration. 50(10):2124–2156.

Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers.

Additional Resources

Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.

Giavina-Bianchi, P.F. Jr., F.F. Castro, M.L. Machado, A.J. Duarte. 1997. Occupational respiratory allergic disease induced by Passiflora alata and Rhamnus purshiana. Ann Allergy Asthma Immunol 79(5):449–454.

Hutchens, A.R. 1991. Indian Herbology of North America. Boston: Shambala.

Kinget, R. 1967. [Studies of the drugs of anthraquinone principles. XVI. Determination of the structure of anthracene derivatives reduced from the bark of Rhamnus purshiana DC] [In French]. Planta Med 15(3):233–239.

Muller-Lissner, S. 1993. Adverse effects of laxatives: fact and fiction. Pharmacology 47(suppl. 1):138–145.

Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press.

Reynolds, J.E.F. (ed.). 1996. Martindale: The Extra Pharmacopoeia, 31st ed. London: The Pharmaceutical Press.

Steinegger, E. and R. Hänsel. 1992. Pharmakognosie, 5th ed. Berlin-Heidelberg: Springer Verlag.

Note:
This material was adapted from The Complete German Commission E Monographs-Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.
2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.
3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:
Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
Infusion: 2 g in 150 ml of water
Fluidextract 1:1 (g/ml): 2 ml
Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright © 2000 American Botanical Council
Published by Integrative Medicine Communications

This material is not intended as a guide to self medication by consumers. The lay reader is advised to discuss the information contained herein with a doctor, pharmacist, nurse or other authorized health care practitioner. Neither the editors nor the publisher accepts any responsibility for the accuracy of the information itself or the consequences from the use or misuse of the Information contained herein
Back to top
View user's profile Send private message
Display posts from previous:   
This forum is locked: you cannot post, reply to, or edit topics.   This topic is locked: you cannot edit posts or make replies.    Nature's Sunshine Products NSP Forum Index -> Forum Archive All times are GMT - 6 Hours
Page 1 of 1

 
Jump to:  
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot vote in polls in this forum


Powered by phpBB © 2001, 2005 phpBB Group