senna (Senokot, ExLax Regular Strength, Lax Pills, Little Tummys Stimulant Laxative Drops, Senexon, SennaGen, Senna Smooth, ExLax Maximum Strength, SenokotXTRA)
Classes: Laxatives, Stimulant
Dosing and uses of Senokot, ExLax Regular Strength (senna)
Adult dosage forms and 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
Pediatric dosage forms and 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
Senokot, ExLax Regular Strength (senna) adverse (side) 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
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
Pregnancy and 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.
Pharmacology of Senokot, ExLax Regular Strength (senna)
Mechanism of action
Intestinal irritant and stimulant
Absorption
Onset: 6-10 hr
