Adult: For the short-term relief of occasional constipation: Doses are expressed in terms of total sennosides calculated as sennoside B: As 7.5 mg or 15 mg tab; 7.5 mg/5 mL syrup: 7.5-15 mg as single dose at bedtime. Max: 30 mg daily. Reduce dose as bowel habit becomes regular. Alternatively, doses may be expressed in terms of total sennosides: As 8.6 mg tab/cap or 17.2 mg tab: 17.2 mg once daily at bedtime (Max: 34.4 mg bid). As 15 mg tab: 30 mg 1-2 times daily. As 25 mg tab: 50 mg 1-2 times daily. As 8.8 mg/5 mL syrup: 17.6-26.4 mg once daily at bedtime (Max: 26.4 mg bid). Max treatment duration: 1 week. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines). Child: For the short-term relief of occasional constipation: Doses are expressed in terms of total sennosides: 2-<6 years As 8.6 mg tab: 4.3 mg once daily at bedtime (Max: 8.6 mg bid); As 8.8 mg/5 mL syrup: 4.4-6.6 mg once daily at bedtime (Max: 6.6 mg bid). 6-<12 years As 8.6 mg tab/cap: 8.6 mg once daily at bedtime (Max: 17.2 mg bid); As 15 mg tab: 15 mg 1-2 times daily; As 25 mg tab: 25 mg 1-2 times daily; As 8.8 mg/5 mL syrup: 8.8-13.2 mg once daily at bedtime (Max: 13.2 mg bid). ≥12 years Same as adult dose. Max treatment duration: 1 week. Dosage recommendations may vary among countries and individual products (refer to specific product guidelines).
Not recommended for use in patients experiencing a sudden change in bowel movements that lasts for >2 weeks. Avoid prolonged use. Several types of products are available in different countries and multiple formulations exist that are not equivalent; refer to individual product guidelines for detailed information. Children and elderly. Pregnancy and lactation.
Adverse Reactions
Gastrointestinal disorders: Abdominal pain and cramps, nausea, vomiting, diarrhoea, faeces discolouration; pseudomelanosis coli (chronic use). Immune system disorders: Hypersensitivity reaction (e.g. urticaria, pruritus, local or generalised exanthema). Metabolism and nutrition disorders: Hypokalaemia (prolonged excessive use). Renal and urinary disorders: Chromaturia; albuminuria, haematuria (chronic use). Reproductive system and breast disorders: Breast milk discolouration.
Symptoms: Griping pain and severe diarrhoea with consequent fluid and electrolyte losses. Management: Supportive treatment. Give generous amounts of fluid, particularly fruit drinks, in case of severe diarrhoea. Monitor electrolyte levels, especially K.
Drug Interactions
May enhance electrolyte imbalance with drugs that induce hypokalaemia (e.g. diuretics, adrenocorticosteroids).
Action
Description: Mechanism of Action: Senna is an anthraquinone stimulant laxative obtained from Cassia senna (Cassia acutifolia) and Cassia angustifolia. Its primary active cathartic principles are the stereoisomeric glucosides, sennosides A and B. As stimulant laxative, it induces defaecation by directly acting on intestinal mucosa or nerve plexus, thereby stimulating peristaltic activity on the intestine and increasing motility. Onset: Within 6-12 hours (may take up to 24 hours). Pharmacokinetics: Absorption: Minimally absorbed from the small intestine. Distribution: Enters breast milk (small amounts of active metabolites). Metabolism: Unabsorbed senna undergoes bacterial hydrolysis in the colon to release the pharmacologically active free anthraquinones, while absorbed senna undergoes hepatic metabolism. Excretion: Via urine and faeces.
Chemical Structure
Sennosides Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 5199, Sennosides. https://pubchem.ncbi.nlm.nih.gov/compound/Sennosides. Accessed Feb. 28, 2022.
Storage
Store between 15-30°C. Storage recommendations may vary among countries and individual products. Refer to detailed product guidelines.
A06AB06 - senna glycosides ; Belongs to the class of contact laxatives.
References
Anon. Senna. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 27/01/2022.Anon. Senna. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 29/11/2021.Boots Max Strength Senna Adult Laxative 15 mg Tablets (The Boots Company PLC). MHRA. https://products.mhra.gov.uk. Accessed 29/11/2021.Buckingham R (ed). Senna. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/11/2021.Chocolate Flavored Senna (CVS Pharmacy, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Ex-lax Maximum Strength Stimulant Laxative (GlaxoSmithKline Consumer Healthcare Holdings [US] LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Ex-lax Regular Strength Chocolated Stimulant Laxative (GlaxoSmithKline Consumer Healthcare Holdings [US] LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Ex-lax Regular Strength Stimulant Laxative (GlaxoSmithKline Consumer Healthcare Holdings [US] LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Joint Formulary Committee. Senna. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/11/2021.Senna (Reliable 1 Laboratories LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Senna Capsule, Gelatin Coated (Cardinal Health). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Senna Laxative (Care One [Retail Business Services, LLC.]). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Senna Syrup (Method Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/11/2021.Senna. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 27/01/2022.Sennosides 7.5 mg Tablets (Blue Bio Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 29/11/2021.Senokot (Mundipharma Distribution GmbH [Philippine Branch]). MIMS Philippines. http://www.mims.com/philippines. Accessed 29/11/2021.Senokot 7.5 mg/5 mL Syrup 12 Years Plus (Reckitt Benckiser Healthcare [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 29/11/2021.Senokot Tablet, Film-Coated (Avrio Health L.P.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 27/01/2022.
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