Skip to main content

Psyllium/senna Side Effects

Applies to psyllium/senna: oral capsule, oral granule for reconstitution.


Gastrointestinal side effects have included several cases of esophageal impaction and duodenal bezoars in patients receiving a bulk laxative product containing 82% psyllium and 18% senna (commercially available as Perdiem Overnight Relief).[Ref]


While hypersensitivity reactions to psyllium may be severe, they are most frequently reported by workers in the pharmaceutical firms that manufacture the drug. This is because when it is mixed or poured, fine dust particles are readily dispersed into the air and can then be inhaled and cause sensitization. Orally ingested psyllium seems less likely to induce sensitization.

A case has been reported of a factory worker who developed IgE-mediated asthma and rhinoconjunctivitis five months after exposure to senna.[Ref]

Hypersensitivity side effects have been reported rarely. They have included sensitization to psyllium resulting from inhalation of fine dust particles dispersed into the air as the product is mixed or poured. Occupational sensitization to senna has been reported rarely.[Ref]


The case report of eosinophilia was believed to be a sole manifestation of an allergic reaction to psyllium.[Ref]

Hematologic side effects have included a case of eosinophilia in a patient receiving psyllium.[Ref]


Musculoskeletal side effects include a case of finger clubbing presumed to be associated with senna use.[Ref]

More about psyllium/senna

Related treatment guides


1. Angueira C, Kadakia S "Esophageal and duodenal bezoars from Perdiem [letter]." Gastrointest Endosc 39 (1993): 110-1

2. Schneider RP "Perdiem causes esophageal impaction and bezoars." South Med J 82 (1989): 1449-50

3. "Product Information. Perdiem (psyllium-senna)." Novartis Pharmaceuticals

4. Gillespie BF, Rathbun FJ "Adverse effects of psyllium." CMAJ 146 (1992): 16-7

5. Helin T, Makinen-Kiljunen S "Occupational asthma and rhinoconjunctivitis caused by senna." Allergy 51 (1996): 181-4

6. Nelson AM, Taubin HL, Frank HD "Eosinophilia associated with psyllium hydrophilic colloid ingestion [letter." JAMA 243 (1980): 329-30

7. Prior J, White I "Tetany and clubbing in patient who ingested large quantities of senna [letter." Lancet 2 (1978): 947

8. Malmquist J, Ericsson B, Hulten-Nosslin MB, Jeppsson JO, Ljungberg O "Finger clubbing and aspartylglucosamine excretion in a laxative- abusing patient." Postgrad Med J 56 (1980): 862-4

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.