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Pronunciation

(SEN na)

Index Terms

  • Sennosides

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Leaves, Oral:

Generic: (454 g)

Liquid, Oral:

Senexon: 8.8 mg/5 mL (237 mL) [contains methylparaben, propylene glycol, propylparaben]

Powder, Oral:

Generic: (1 g [DSC])

Syrup, Oral:

Senna-GRX: 8.8 mg/5 mL (15 mL, 236 mL) [contains parabens]

Generic: 8.8 mg/5 mL (236 mL, 237 mL); 176 mg/5 mL (15 mL, 237 mL)

Tablet, Oral:

Ex-Lax: 15 mg [sodium free]

Ex-Lax Maximum Strength: 25 mg [sodium free]

Geri-kot: 8.6 mg

GoodSense Senna Laxative: 8.6 mg

Perdiem Overnight Relief: 15 mg

Senexon: 8.6 mg

Senna Lax: 8.6 mg

Senna Laxative: 8.6 mg

Senna Maximum Strength: 25 mg

Senna Smooth: 15 mg [contains sodium benzoate]

Senna-Gen: 8.6 mg [DSC]

Senna-Lax: 8.6 mg

Senna-Tabs: 8.6 mg

Senna-Time: 8.6 mg

SennaCon: 8.6 mg

Senno: 8.6 mg

Senokot: 8.6 mg

Senokot To Go: 8.6 mg [DSC]

Senokot XTRA: 17.2 mg

Generic: 8.6 mg, 15 mg

Tablet Chewable, Oral:

Ex-Lax: 15 mg

Ex-Lax: 15 mg [chocolate flavor]

Brand Names: U.S.

  • Ex-Lax Maximum Strength [OTC]
  • Ex-Lax [OTC]
  • Geri-kot [OTC]
  • GoodSense Senna Laxative [OTC]
  • Perdiem Overnight Relief [OTC]
  • Senexon [OTC]
  • Senna Lax [OTC]
  • Senna Laxative [OTC]
  • Senna Maximum Strength [OTC]
  • Senna Smooth [OTC]
  • Senna-Gen [OTC] [DSC]
  • Senna-GRX [OTC]
  • Senna-Lax [OTC]
  • Senna-Tabs [OTC]
  • Senna-Time [OTC]
  • SennaCon [OTC]
  • Senno [OTC]
  • Senokot To Go [OTC] [DSC]
  • Senokot XTRA [OTC]
  • Senokot [OTC]

Pharmacologic Category

  • Laxative, Stimulant

Metabolism

Hepatic

Excretion

Feces (via bile); urine

Onset of Action

Oral: Within 6 to 24 hours; Rectal: Evacuation occurs in 30 minutes to 2 hours

Use: Labeled Indications

Short-term treatment of constipation; evacuate the colon for bowel or rectal examinations

Contraindications

Per Commission E: Intestinal obstruction, acute intestinal inflammation (eg, Crohn disease), colitis ulcerosa, appendicitis, abdominal pain of unknown origin

Dosing: Adult

Bowel evacuation: Oral: OTC labeling: Usual dose: Sennosides 130 mg between 2-4 PM the afternoon of the day prior to procedure

Constipation: Oral: OTC ranges: Sennosides 15 mg once daily (maximum: 70-100 mg/day, divided twice daily)

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Bowel evacuation: OTC labeling: Children ≥12 years: Refer to adult dosing.

Constipation: OTC ranges: Children:

2-6 years:

Sennosides: Initial: 3.75 mg once daily (maximum: 15 mg/day, divided twice daily)

6-12 years:

Sennosides: Initial: 8.6 mg once daily (maximum: 50 mg/day, divided twice daily)

≥12 years: Refer to adult dosing.

Administration

Oral: Once daily doses should be taken at bedtime. Granules may be eaten plain, sprinkled on food, or mixed in liquids

Dietary Considerations

Liquid may be administered with fruit juice or milk to mask taste.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined: Abdominal cramps, diarrhea, nausea, vomiting

Warnings/Precautions

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC, 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors, 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer’s labeling.

Other warnings/precautions:

• Self-medication (OTC use): Not recommended for use in patients experiencing stomach pain, nausea, vomiting, or a sudden change in bowel movements which lasts >2 weeks. Not recommended for OTC use in children <2 years of age.

Pregnancy Considerations

An increased risk of congenital abnormalities was not observed following maternal use of senna during pregnancy (Acs, 2009). Short-term use of senna is generally considered safe during pregnancy (Mahadevan, 2006).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience abdominal cramps. Have patient report immediately to prescriber severe dyspepsia (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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