Pronunciation: SEN-ah
Class: Laxative

Trade Names

Agoral
- Liquid 25 mg

Black Draught
- Granules 20 mg/5 mL
- Tablets 6 mg

ex•lax
- Tablets 15 mg

ex•lax chocolate
- Tablets 15 mg

Fletcher Castoria
- Liquid 33.3 mg/mL

Senexon
- Tablets 8.5 mg

Senna-Gen
- Tablets 8.6 mg

Senokot
- Granules 15 mg/5 mL
- Syrup 8.8 mg/5 mL
- Tablets 8.6 mg

SenokotXTRA
- Tablets 17 mg

Senna Laxative Pills Extra Strength Peristaltic Stimulant (Canada)
Senna Laxative Pills Regular Strength Peristaltic Stimulant (Canada)
Senna Tablets Peristaltic Stimulant (Canada)

Pharmacology

Directly acts on intestinal mucosa by altering water and electrolyte secretion, inducing peristalsis and defecation.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Indications and Usage

Short-term treatment of constipation; preoperative and preradiographic bowel evacuation for procedures involving GI tract.

Contraindications

Nausea, vomiting, or other symptoms of appendicitis; acute surgical abdomen; fecal impaction; intestinal obstruction; undiagnosed abdominal pain.

Dosage and Administration

Adults

PO 2 tablets, 5 mL of granules or 10 to 15 mL of syrup, usually at bedtime (max, 15 mL twice daily of syrup).

PR 1 suppository at bedtime; may repeat in 2 h.

Children 6 to 12 y of age

PO 1 tablet or 2.5 mL granules, or 5 to 7.5 mL of syrup once daily, usually at bedtime (max, 7.5 mL twice daily of syrup).

PR ½ suppository at bedtime.

2 to younger than 6 y

PO 2.5 to 3.75 mL of syrup once daily, usually at bedtime (max, 3.75 mL twice daily of syrup).

General Advice

  • Administer at bedtime on empty stomach.
  • Shake liquid solution before administering.
  • Dissolve granules before administering.
  • Give oral dosages with full glass of water or juice.
  • Administer suppository with patient lying on left side.

Storage/Stability

Store between 59° and 86° F.

Drug Interactions

None well documented.

Adverse Reactions

Cardiovascular

Palpitations.

CNS

Dizziness, fainting.

GI

Abdominal cramping, bloating, excessive bowel activity (eg, griping, diarrhea, nausea, vomiting), flatulence, perianal irritation.

Miscellaneous

Sweating, weakness.

Precautions

Monitor

Assess bowel function, including normal frequency, type, last bowel movement, bowel sounds, abdominal distention.


Pregnancy

Category C .

Lactation

Undetermined.

Abuse/dependency

Long-term use may lead to laxative dependency, which may result in fluid and electrolyte imbalances, steatorrhea, osteomalacia, and vitamin and mineral deficiencies. Cathartic colon, a poorly functioning colon, results from long-term abuse. Pathologic presentation may resemble ulcerative colitis.

Discoloration of acidic urine

May result in yellow-brown urine.

Discoloration of alkaline urine

May result in pink to red urine.

Fluid and electrolyte imbalance

Excessive laxative use may lead to significant fluid and electrolyte imbalance.

Melanosis Coli

Darkened pigmentation of colonic mucosa may occur after long-term use, usually resolving within 5 to 11 mo of discontinuation.

Rectal bleeding or failure to respond

May indicate serious condition requiring further attention.

Overdosage

Symptoms

Gripping pain, diarrhea.

Patient Information

  • Explain potential hazards (eg, dependence) associated with long-term laxative use.
  • Advise that senna may result in discolored yellow-brown or reddish urine.
  • Explain that bowel patterns are very individual.
  • Identify measures to improve bowel function (ie, fluids, activity, dietary bulk).
  • Caution against taking laxatives in presence of acute abdominal pain or in presence of nausea or vomiting.

Copyright © 2009 Wolters Kluwer Health.

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