senna/psyllium (OTC)

Frequency Not Defined

Electrolyte imbalance

Potassium loss

Abdominal cramping

Excessive bowel activity

Flatulence

Yellow-brown urine discoloration

Melanosis coli

Contraindications

Hypersensitivity

GI obstruction or perforation

Ulcerative colitis

Symptoms of appendicitis or acute surgical abdomen

Fecal impaction

GI bleeding

Rectal bleeding

Cautions

Use caution in patients with esophageal strictures, stenosis, ulcers, difficulty swallowing, or intestinal adhesions

May predispose the elderly to fecal impaction and bowel obstruction if fluid intake is low

Product must be taken with at least 8 ounces of fluid to prevent choking

Not recommended in patients experiencing stomach pain

Pregnancy category: C (senna); B psyllium

Lactation: Use caution

Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Senna: Intestinal irritant/stimulant

Psyllium: Bulk-producing laxative