Senna

Senna is an over-the-counter (OTC) laxative. It is used to treat constipation and also to clear the bowel before diagnostic tests such as colonoscopy.

• Senna is available under the following different brand names: Senokot, ExLax Regular Strength, Lax Pills, Little Tummys Stimulant Laxative Drops, Senexon, SennaGen, Senna Smooth, ExLax Maximum Strength, and SenokotXTRA.

Dosage Forms and Strengths

Tablet, extended-release

• 8.6 mg
• 15 mg
• 25 mg

Chewable tablet

• 10 mg
• 15 mg

Liquid

• 8.8 mg/5mL

Concentrated oral drops

• 8.8 mg/mL

Syrup

• 8.8 mg/5mL

Senna leaves

• 454g

Constipation

• Adult: 15 mg orally once daily; not to exceed 70-100 mg/day divided every 12 hours
  • Not for use more than 1 week
• Senna Leaf Extract
  • 362-1056 mg orally once/day
• Pediatric:
  • Children 2-6 years: 4.3-17.2 mg/day orally; not to exceed 17.2 mg/day
  • Children 6-12 years: 6-50 mg/day orally; not to exceed 50 mg/day
  • Children over 12 years: 12-100 mg/day orally; not to exceed 100 mg/day
  • Not for use more than 1 week
• Senna Leaf Extract
  • 2-6 years: 166.5-666 mg/day orally
  • 6-12 years: 333-999 mg/day orally

Other Indications and Uses

• Alkalinizing agent for maintaining long-term alkaline urine, alkalinizing agent for correcting acidosis of certain renal tubular disorders
• Management of renal tubular acidosis with calcium stones, hypocitraturia calcium oxalate nephrolithiasis, uric acid lithiasis
• Pediatric: Safety and efficacy not established

Bowel Preparation

• Various regimens exist that include senna laxative with additional gastric lavage
• Usual dose: 130 mg orally between 2:00 and 4:00 PM in afternoon of the day before the procedure

Common side effects of senna include:

• Abdominal pain or discomfort
• Cramps
• Diarrhea
• Electrolyte abnormalities, including low potassium (hypokalemia)
• Excessive bowel activity
• Finger clubbing (long-term use)
• Melanosis Coli
• Nausea
• Kidney inflammation
• Yellow-brown urine discoloration

Serious side effects of senna include:

• Changes in blood electrolytes that can cause heart function disorders, muscle weakness, liver damage, and other harmful effects (long-term use)

This is not a complete list of side effects and other serious side effects may occur. Call your doctor for information and medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If your doctor has directed you to use this medication for your condition, your doctor or pharmacist may already be aware of any possible drug interactions or side effects and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider, or pharmacist first.

• Senna has no known severe interactions with other drugs.
• Serious Interactions of potassium citrate include:
  • sodium sulfate/potassium sulfate/magnesium sulfate
  • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
• Moderate Interactions of senna include:
  • deflazacort
  • dichlorphenamide
  • digoxin
  • lily of the valley
• Mild Interactions of senna include:
  • None

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

This medication contains senna. Do not take Senokot, ExLax Regular Strength, Lax Pills, Little Tummys Stimulant Laxative Drops, Senexon, SennaGen, Senna Smooth, ExLax Maximum Strength, or SenokotXTRA if you are allergic to senna or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity
• Gastrointestinal (GI) obstruction or perforation
• Ulcerative colitis
• Symptoms of appendicitis or acute surgical abdomen
• Acute intestinal inflammation (Crohn's disease)
• Fecal impaction
• GI or rectal bleeding

Effects of Drug Abuse

• Longer use can cause the bowels to stop functioning normally and might cause dependence on laxatives.
• Long-term use can cause changes in blood electrolytes that can cause heart function disorders, muscle weakness, liver damage, and other harmful effects.

Short-Term Effects

• See "What Are Side Effects Associated with Using Senna?"

Long-Term Effects

• Longer use can cause the bowels to stop functioning normally and might cause dependence on laxatives.
• Long-term use can cause changes in blood electrolytes that can cause heart function disorders, muscle weakness, liver damage, and other harmful effects.
• See "What Are Side Effects Associated with Using Senna?"

Cautions

• Not recommended in patients experiencing sudden change in bowel movements lasting more than 2 weeks, stomach pain, or nausea or vomiting.
• 15 mg/kg dose potentially toxic in children under 6 years.
• Over-the-counter use not recommended in children under 2 years.

Pregnancy and Lactation

• Use senna with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• Senna is not excreted in milk; it is compatible with breastfeeding.