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Derived from the bark of the plant, cascara is mainly used to relieve constipation. The major constituents are cascarosides that stimulate the large intestine and produce a laxative effect. Cascara is one of the herbs incorporated in the Hoxey herbal therapy.
In vitro studies indicate that emodin, one of the constituents of cascara, has hepatoprotective, neuroprotective, and chemopreventive effects. Emodin also enhances the cytotoxic effects of some chemotherapeutic agents. Human studies have not been conducted to confirm these effects.

Cascara is not indicated for long term use.
Prolonged use or overdose may cause diarrhea, electrolyte imbalance and hepatitis ⁽⁷⁾.