(SEN na)
Constipation: Relieves occasional constipation (irregularity); generally causes bowel movement in 6 to 12 hours
Constipation: Oral:
Syrup (8.8 mg sennosides/5mL): 10 to 15 mL (17.6 mg to 26.4 mg sennosides) once daily; maximum: 15 mL (26.4 mg sennosides) twice daily.
Tablets:
8.6 mg sennosides/tablet: Two tablets (17.2 mg sennosides) once daily; maximum: 4 tablets (34.4 mg sennosides) twice daily
15 mg sennosides/tablet: Two tablets (30 mg sennosides) once or twice daily
17.2 mg sennosides/tablet: One tablet (17.2 mg sennosides) once daily; maximum: 2 tablets (34.4 mg sennosides) twice daily
25 mg sennosides/tablet: Two tablets (50 mg sennosides) once or twice daily
Refer to adult dosing.
Constipation: Children:
Syrup (8.8 mg sennosides/5mL):
Children 2 to <6 years: 2.5 to 3.75 mL (4.4 to 6.6 mg sennosides) once daily; maximum: 3.75 mL (6.6 mg sennosides) twice daily
Children 6 to <12 years: 5 to 7.5 mL (8.8 to 13.2 mg sennosides) once daily; maximum: 7.5 mL (13.2 mg sennosides) twice daily
Children ≥12 years and Adolescents: Refer to adult dosing.
Tablets:
8.6 mg sennosides/tablet:
Children 2 to <6 years: One-half tablet (4.3 mg sennosides) once daily; maximum: 1 tablet (8.6 mg sennosides) twice daily
Children 6 to <12 years: One tablet (8.6 mg sennosides) once daily; maximum: 2 tablets (17.2 mg sennosides) twice daily
Children ≥12 years and Adolescents: Refer to adult dosing.
15 mg sennosides/tablet:
Children 6 to <12 years: One tablet (15 mg sennosides) once or twice daily
Children ≥12 years and Adolescents: Refer to adult dosing.
17.2 mg sennosides/tablet:
Children 6 to <12 years: One-half tablet (8.6 mg sennosides) once daily; maximum: 1 tablet (17.2 mg sennosides) twice daily
Children ≥12 years and Adolescents: Refer to adult dosing.
25 mg sennosides/tablet:
Children 6 to <12 years: One tablet (25 mg sennosides) once or twice daily
Children ≥12 years and Adolescents: Refer to adult dosing.
Once-daily doses should be preferentially taken at bedtime. Administer 2 hours before or after other medications.
Store at 20 � �C to 25 � �C (77 � �F); excursions are permitted between 15 � �C and 30 � �C (59 � �F to 86 � �F).
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 (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]
There are no known significant interactions.
Frequency not defined: Abdominal cramps, diarrhea, nausea, vomiting
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:
- Appropriate use: Failure to have a bowel movement or occurrence of rectal bleeding after use should be reported to health care provider.
- 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. Do not use for more than 1 week.
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).
The anthraquinone group of stimulant laxatives includes the plant-derived agents such as senna. Stimulant laxatives typically induce defecation by stimulating peristaltic activity on the intestine by direct action on intestinal mucosa or nerve plexus, therefore increasing motility.
Hepatic
Feces (via bile); urine
Oral: Within 6 to 24 hours
- 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 abdominal pain (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 health care 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.