senna (OTC)

Brand and Other Names:Senokot, ExLax Regular Strength, more...Lax Pills, Little Tummys Stimulant Laxative Drops, Senexon, SennaGen, Senna Smooth, ExLax Maximum Strength, SenokotXTRA

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 8.6mg
  • 15mg
  • 25mg

chewable tablet

  • 10mg
  • 15mg

liquid

  • 8.8mg/5mL

concentrated oral drops

  • 8.8mg/mL

syrup

  • 8.8mg/5mL

senna leaves

  • 454g

Constipation

15 mg PO once daily; not to exceed 70-100 mg/day divided q12hr

Not for use >1 week

Senna Leaf Extract

  • 362-1056 mg PO qDay

Bowel Preparation

Various regimens exist that include senna laxative with additional gastric lavage

Usual dose: 130 mg PO between 2:00 and 4:00 PM in afternoon of day before procedure

Dosage Forms & Strengths

tablet

  • 8.6mg
  • 15mg
  • 25mg

chewable tablet

  • 10mg
  • 15mg

liquid

  • 8.8mg/5mL

concentrated oral drops

  • 8.8mg/mL

syrup

  • 8.8mg/5mL

senna leaves

  • 454g

Constipation

2-6 years: 4.3-17.2 mg/day PO; not to exceed 17.2 mg/day

6-12 years: 6-50 mg/day PO; not to exceed 50 mg/day

>12 years: 12-100 mg/day PO; not to exceed 100 mg/day

Not for use >1 week

Senna Leaf Extract

  • 2-6 years: 166.5-666 mg/day PO
  • 6-12 years: 333-999 mg/day PO
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Interactions

Interaction Checker

and senna

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (3)

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of senna by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol

                senna, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Stimulant laxatives may increase the risk of mucosal ulceration or ischemic colitis when coadministered with bowel preps.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of senna by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of stimulant laxatives and sodium sulfate/magnesium sulfate/potassium chloride may increase the risk of mucosal ulceration or ischemic colitis.

              Monitor Closely (4)

              • deflazacort

                senna and deflazacort both decrease serum potassium. Use Caution/Monitor.

              • dichlorphenamide

                dichlorphenamide and senna both decrease serum potassium. Use Caution/Monitor.

              • digoxin

                senna increases toxicity of digoxin by Other (see comment). Use Caution/Monitor. Comment: Increased risk of cardiac toxicity due to K+ depletion.

              • lily of the valley

                senna increases toxicity of lily of the valley by Other (see comment). Use Caution/Monitor. Comment: Increased risk of cardiac toxicity due to K+ depletion.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Abdominal pain

                Diarrhea

                Electrolyte abnormalities, including hypokalemia

                Excessive bowel activity

                Finger clubbing (long-term use)

                Melanosis coli

                Nausea

                Nephritis

                Yellow-brown urine discoloration

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                Warnings

                Contraindications

                Hypersensitivity

                GI obstruction or perforation

                Ulcerative colitis

                Symptoms of appendicitis or acute surgical abdomen

                Acute intestinal inflammation (Chron's disease)

                Fecal impaction

                GI or rectal bleeding

                Cautions

                Not recommended in patients experiencing sudden change in bowel movements lasting >2 weeks, stomach pain, or nausea or vomiting

                15 mg/kg dose potentially toxic in children <6 years

                Over-the-counter use not recommended in children <2 years

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                Pregnancy & Lactation

                Pregnancy category: C

                Lactation: Not excreted in milk; compatible;

                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.

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                Pharmacology

                Mechanism of Action

                Intestinal irritant and stimulant

                Absorption

                Onset: 6-10 hr

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                Images

                No images available for this drug.
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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.