Senexon-S 8.6-50mg Tablets
It is used to treat constipation.
Drug Class
Laxative, Stool Softener
Pharmacologic Class
Anionic Surfactant (Docusate), Anthraquinone Derivative (Senna)
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Senexon-S is a combination medicine used to treat occasional constipation. It contains two ingredients: Docusate, which is a stool softener that helps make your stool easier to pass, and Senna, which is a laxative that helps stimulate your bowels to move.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take your medication as directed, and follow these guidelines:
If you take this medication once a day, take it at bedtime.
Take your medication with a full glass of water.
Do not take any other medications within 2 hours of taking this medication.
Storing and Disposing of Your Medication
To store your medication properly:
Keep it at room temperature in a dry place.
Avoid storing it in a bathroom.
Keep all medications in a safe location, out of the reach of children and pets.
When disposing of your medication:
Throw away any unused or expired medication.
Do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of your medication, and ask about potential drug take-back programs in your area.
Missing a Dose
If you take this medication regularly and miss a dose:
Take the missed dose as soon as you remember.
If it's close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not take two doses at the same time or take extra doses.
If you take this medication as needed, do not take it more frequently than directed by your doctor.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take your medication as directed, and follow these guidelines:
If you take this medication once a day, take it at bedtime.
Take your medication with a full glass of water.
Do not take any other medications within 2 hours of taking this medication.
Storing and Disposing of Your Medication
To store your medication properly:
Keep it at room temperature in a dry place.
Avoid storing it in a bathroom.
Keep all medications in a safe location, out of the reach of children and pets.
When disposing of your medication:
Throw away any unused or expired medication.
Do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of your medication, and ask about potential drug take-back programs in your area.
Missing a Dose
If you take this medication regularly and miss a dose:
Take the missed dose as soon as you remember.
If it's close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not take two doses at the same time or take extra doses.
If you take this medication as needed, do not take it more frequently than directed by your doctor.
Lifestyle & Tips
- Drink plenty of fluids (at least 6-8 glasses of water daily) while taking this medication.
- Increase dietary fiber intake (fruits, vegetables, whole grains) if not contraindicated.
- Engage in regular physical activity to promote bowel regularity.
- Do not use for more than 7 days unless directed by a doctor.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
2 tablets (17.2 mg Senna, 100 mg Docusate) once daily at bedtime
Dose Range:
1 - 4 mg
Condition-Specific Dosing:
generalConstipation:
1-2 tablets once daily, preferably at bedtime. May increase to 2 tablets twice daily if needed, not exceeding 4 tablets in 24 hours.
opioidInducedConstipation:
2 tablets once daily, may be increased based on clinical response and tolerability.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not recommended for children under 2 years. For children 2-12 years, consult a physician. Dosing typically lower and based on weight/age for specific products.
Adolescent:
For adolescents 12 years and older, adult dosing may apply, but start with the lowest effective dose (e.g., 1 tablet once daily).
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment generally needed, but use with caution.
Moderate:
Use with caution; monitor for electrolyte imbalances with prolonged use.
Severe:
Avoid prolonged use. Consult physician due to potential for electrolyte disturbances and fluid overload.
Dialysis:
Not well studied. Avoid prolonged use. Consult physician.
Hepatic Impairment:
Mild:
No specific adjustment generally needed.
Moderate:
Use with caution; monitor for adverse effects.
Severe:
Use with caution. Consult physician.
Pharmacology
Mechanism of Action
Docusate sodium is an anionic surfactant that lowers the surface tension of the stool, allowing water and fats to penetrate and soften the fecal mass. Senna (sennosides) is a stimulant laxative. It is a prodrug metabolized by colonic bacteria into active anthrones, which stimulate colonic motility (peristalsis) and inhibit water and electrolyte absorption from the colon, leading to increased fluid content in the stool.
Pharmacokinetics
Absorption:
Bioavailability:
Docusate: Minimal systemic absorption; Senna: Poorly absorbed from the small intestine, active metabolites absorbed from the colon.
Tmax:
Docusate: Not clinically relevant due to local action; Senna: Active metabolites (rhein) Tmax is approximately 6-16 hours after oral administration.
FoodEffect:
Food does not significantly alter the efficacy or absorption of Senna or Docusate.
Distribution:
Vd:
Not available (Docusate: minimal systemic; Senna: active metabolites distribute to tissues)
ProteinBinding:
Not available (Docusate: minimal systemic; Senna: active metabolites bind to plasma proteins)
CnssPenetration:
Limited
Elimination:
HalfLife:
Docusate: Not clinically relevant; Senna (active metabolites): Approximately 6-16 hours.
Clearance:
Not available
ExcretionRoute:
Docusate: Primarily fecal; Senna: Active metabolites primarily excreted in feces (unabsorbed) and urine (absorbed).
Unchanged:
Not available
Pharmacodynamics
OnsetOfAction:
6-12 hours (Senna component)
PeakEffect:
Not well defined, typically within 12-24 hours.
DurationOfAction:
Effects may persist for up to 24 hours after a single dose.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
* Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice about side effects.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
* Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice about side effects.
Seek Immediate Medical Attention If You Experience:
- Severe abdominal pain, nausea, or vomiting (stop use and consult doctor)
- Rectal bleeding or failure to have a bowel movement after using the laxative (may indicate a serious condition)
- Signs of dehydration (excessive thirst, dry mouth, decreased urination, dizziness)
- Muscle weakness or cramps (may indicate electrolyte imbalance)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health issues, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
* If you are currently taking mineral oil
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
Certain health issues, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
* If you are currently taking mineral oil
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Do not exceed a treatment duration of 1 week unless explicitly advised to do so by your doctor. Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless your doctor has instructed you to do so. If you experience rectal bleeding or fail to have a bowel movement after using this medication, consult your doctor promptly. If you are pregnant, planning to become pregnant, or are currently breast-feeding, notify your doctor, as you will need to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Abdominal cramping
- Dehydration
- Electrolyte imbalances (especially hypokalemia)
- Muscle weakness
What to Do:
Discontinue use immediately. Seek emergency medical attention or call Poison Control at 1-800-222-1222. Treatment is supportive, focusing on fluid and electrolyte replacement.
Drug Interactions
Major Interactions
- Mineral oil (Docusate can increase absorption of mineral oil, leading to lipid pneumonia if aspirated or systemic granulomas)
- Digoxin (Prolonged use of senna can cause hypokalemia, potentiating digoxin toxicity)
- Antiarrhythmics (Risk of hypokalemia-induced arrhythmias with prolonged senna use)
Moderate Interactions
- Diuretics (Thiazide, loop diuretics: Increased risk of hypokalemia with prolonged senna use)
- Corticosteroids (Increased risk of hypokalemia with prolonged senna use)
- Other laxatives (Increased risk of severe diarrhea and electrolyte imbalance)
Monitoring
Baseline Monitoring
Assessment of constipation cause
Rationale: To rule out underlying medical conditions requiring different treatment.
Timing: Prior to initiation of therapy
Fluid and electrolyte status
Rationale: To identify baseline imbalances, especially in vulnerable populations (elderly, renal impairment).
Timing: Prior to initiation, especially if prolonged use is anticipated
Routine Monitoring
Bowel movement frequency and consistency
Frequency: Daily
Target: Regular, soft, formed stools
Action Threshold: No bowel movement after 3 days, severe abdominal pain, or diarrhea
Fluid intake
Frequency: Daily
Target: Adequate hydration (e.g., 6-8 glasses of water)
Action Threshold: Signs of dehydration (dry mouth, decreased urination)
Electrolyte levels (Potassium, Sodium)
Frequency: If prolonged use (>1 week) or in at-risk patients
Target: Within normal limits
Action Threshold: Abnormal levels, especially hypokalemia
Symptom Monitoring
- Severe abdominal pain
- Cramping
- Nausea
- Vomiting
- Rectal bleeding
- Signs of dehydration (excessive thirst, dry mouth, decreased urination, dizziness)
- No bowel movement after 7 days of use
Special Patient Groups
Pregnancy
Generally considered for short-term use if lifestyle modifications are insufficient, but always consult a healthcare provider. Docusate and Senna are often considered among the safer laxatives during pregnancy due to limited systemic absorption and historical use, but Category C indicates animal studies show adverse effects or no adequate human studies.
Trimester-Specific Risks:
First Trimester:
Generally avoided unless medically necessary; consult physician.
Second Trimester:
May be used cautiously if benefits outweigh risks; consult physician.
Third Trimester:
May be used cautiously if benefits outweigh risks; consult physician.
Lactation
Both docusate and senna (active metabolites) are excreted in breast milk in small amounts. Generally considered compatible with breastfeeding for short-term use, but monitor the infant for diarrhea. Consult a healthcare provider.
Infant Risk:
Low risk for short-term use; monitor for loose stools or diarrhea in the infant.
Pediatric Use
Not recommended for routine use in children under 12 years without physician consultation. Prolonged use can lead to laxative dependence and electrolyte imbalances. Specific pediatric formulations and dosing are available for younger children.
Geriatric Use
Elderly patients may be more susceptible to fluid and electrolyte imbalances (e.g., dehydration, hypokalemia) with prolonged or excessive use. Start with the lowest effective dose and ensure adequate fluid intake. Monitor for signs of dehydration and electrolyte disturbances.
Clinical Information
Clinical Pearls
- This combination is particularly useful for constipation where both stool softening and bowel stimulation are needed, such as opioid-induced constipation.
- Advise patients that a bowel movement may not occur for 6-12 hours after taking the medication, especially if taken at bedtime.
- Emphasize the importance of adequate fluid intake (at least 6-8 glasses of water daily) to maximize the effectiveness of the stool softener and prevent dehydration.
- Caution against prolonged use (more than 7 days) without medical supervision to prevent laxative dependence and electrolyte disturbances.
- Educate patients on lifestyle modifications (dietary fiber, exercise) as primary strategies for constipation management.
Alternative Therapies
- Bulk-forming laxatives (e.g., psyllium, methylcellulose)
- Osmotic laxatives (e.g., polyethylene glycol, lactulose, magnesium hydroxide)
- Other stimulant laxatives (e.g., bisacodyl)
- Other stool softeners (e.g., docusate sodium alone)
- Lubricant laxatives (e.g., mineral oil - use with caution due to interactions)
- Chloride channel activators (e.g., lubiprostone)
- Guanylate cyclase-C agonists (e.g., linaclotide, plecanatide)
Cost & Coverage
Average Cost:
$5 - $20 per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Often not covered by prescription plans as it is an OTC product, but may be covered by FSA/HSA. Some plans may cover with a prescription.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.