Senna

(sehn-uh)

Trade/other name(s): Black-Draught, Senekot, Senexon, Senokot

Why would this drug be used?

Senna is used to treat constipation. It is sometimes used along with other types of laxatives to prevent constipation in people who are taking opioid pain medicines. You can buy senna over the counter, without a prescription.

How does this drug work?

Senna is a stimulant laxative. It irritates and stimulates the smooth muscle of the intestines. This increases the normal forward movement of the intestines (peristalsis). It also brings more water into the colon, usually resulting in a bowel movement within 6 to 10 hours.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have nausea, vomiting, rectal bleeding, unexplained abdominal pain, blocked intestine, or any disease of the stomach or intestine. Something other than constipation may be causing your problem, and laxatives may worsen it.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Other medicines may not work as well if taken at the same time as laxatives. Do not take this medicine within 2 hours of your other medicines.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

Although senna works faster when taken on an empty stomach, no serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether specific foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Senna is given as a pill, syrup, or rectal suppository. The dose of the pill or liquid form depends on the reason you are taking it and how well it works for you. Take the pill or liquid with a full 8-ounce glass of water.

If you are using the suppository, open the package and dip the tip of the suppository in cold water. If you are right-handed, lie down on your left side, bring your knees up near your chest, and insert the suppository in your rectum about an inch. Stay in this position for about 15 minutes, then get up and wash your hands well.

Take this drug exactly as directed by your doctor, or follow the directions on the label. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

Some laxatives can cause diarrhea, which results in loss of fluids, nutrients, and electrolytes (minerals and salts). It is important to replace the fluid that you lose through diarrhea. Try to drink 2 to 3 quarts of fluid a day. Fluids with electrolytes, such as chicken broth or sports drinks, are helpful in replacing potassium and salt that are lost in diarrhea.

When overused, stimulant laxatives can cause diarrhea and serious loss of electrolytes such as potassium. This can cause confusion, unusual tiredness or weakness, irregular heart beat, and muscle cramps. If you notice these symptoms, call your doctor.

If you are taking opioid pain relievers, you will need to take laxatives regularly to counter their action on the bowel. This helps to prevent severe complications such as impaction. Let your doctor or nurse know if you haven't had a bowel movement for 3 days.

Senna laxatives can color the urine pink, violet, reddish, or brown. This disappears soon after the laxative is stopped.

If you are not taking opioid pain medicine and you use laxatives all the time, your body may forget how to move your bowels normally and you come to depend on laxatives. Talk to your doctor if this is a problem for you.

To help avoid constipation, try to drink 2 to 3 quarts of fluid a day. Increase the amount of fiber you eat in foods by eating fruits, vegetables, beans, peas, and whole-grain breads and cereal. Talk to your doctor about what kind of exercise may help you.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• loss of normal bowel response when used on a long-term basis*
• nausea
• rectal burning as suppository is absorbed

Less common

• vomiting
• abdominal cramping
• diarrhea
• dehydration due to fluid loss in diarrhea*
• loss of electrolytes due to diarrhea, usually with over-use*

Rare

• allergic reactions, rash

*See the "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

This drug appears to pre-date the current FDA approval process, which would mean it was not required to get formal FDA approval.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your me