Senna 8.6mg Tablets
It is used to treat constipation.
Drug Class
Laxative
Pharmacologic Class
Stimulant laxative (Anthraquinone derivative)
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Senna is a natural laxative that works by stimulating your bowels to move stool through your system. It's used to relieve occasional constipation. It usually takes 6 to 12 hours to work, so it's often taken at bedtime.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most benefit from your medication, follow these steps:
Take your medication exactly as directed by your doctor.
Read all the information provided with your medication and follow the instructions carefully.
Avoid taking other medications within 2 hours of taking this drug.
If you take this medication once a day, take it at bedtime.
Swallow the tablet whole - do not chew, break, or crush it.
Take your medication with a full glass of water.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature in a dry place, away from the bathroom.
Protect it from heat.
Keep all medications in a safe and secure location.
Ensure that all medications are out of the reach of children and pets.
What to Do If You Miss a Dose
If you miss a dose, follow these steps:
Take the missed dose as soon as you remember.
However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
* Do not take two doses at the same time or take extra doses to make up for a missed dose.
To ensure you get the most benefit from your medication, follow these steps:
Take your medication exactly as directed by your doctor.
Read all the information provided with your medication and follow the instructions carefully.
Avoid taking other medications within 2 hours of taking this drug.
If you take this medication once a day, take it at bedtime.
Swallow the tablet whole - do not chew, break, or crush it.
Take your medication with a full glass of water.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication:
Store it at room temperature in a dry place, away from the bathroom.
Protect it from heat.
Keep all medications in a safe and secure location.
Ensure that all medications are out of the reach of children and pets.
What to Do If You Miss a Dose
If you miss a dose, follow these steps:
Take the missed dose as soon as you remember.
However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule.
* Do not take two doses at the same time or take extra doses to make up for a missed dose.
Lifestyle & Tips
- Increase fluid intake (especially water) to help soften stools.
- Increase dietary fiber (fruits, vegetables, whole grains) to promote regular bowel movements.
- Engage in regular physical activity to stimulate bowel function.
- Do not use for more than 7 days unless directed by a doctor, as prolonged use can lead to dependence and electrolyte imbalances.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
17.2 mg (2 tablets of 8.6 mg) orally once daily at bedtime
Dose Range:
8.6 - 50 mg
Condition-Specific Dosing:
constipation:
Initial dose 17.2 mg (2 tablets) orally once daily at bedtime; may increase up to 50 mg daily in divided doses if needed. Do not exceed 50 mg daily.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
2-6 years: 4.3 mg (1/2 tablet of 8.6 mg) orally once daily at bedtime; Max 8.6 mg/day. 6-12 years: 8.6 mg (1 tablet of 8.6 mg) orally once daily at bedtime; Max 17.2 mg/day.
Adolescent:
âĨ12 years: 17.2 mg (2 tablets of 8.6 mg) orally once daily at bedtime; Max 50 mg/day.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended for short-term use.
Moderate:
No specific adjustment recommended for short-term use.
Severe:
Use with caution; potential for electrolyte imbalance. Consult physician.
Dialysis:
Use with caution; potential for electrolyte imbalance. Consult physician.
Hepatic Impairment:
Mild:
No specific adjustment recommended.
Moderate:
No specific adjustment recommended.
Severe:
No specific adjustment recommended.
Pharmacology
Mechanism of Action
Sennosides are prodrugs that are metabolized by colonic bacteria into active anthrones (e.g., rheinanthrone). These active metabolites stimulate the colon's motility by direct irritation of the smooth muscle, increasing peristalsis. They also increase the secretion of water and electrolytes into the intestinal lumen, leading to a softer stool consistency and increased stool volume.
Pharmacokinetics
Absorption:
Bioavailability:
Poor (as sennosides); active metabolites are absorbed to a limited extent.
Tmax:
Not applicable for parent drug; active metabolites reach systemic circulation after bacterial conversion.
FoodEffect:
May delay onset of action slightly, but not clinically significant.
Distribution:
Vd:
Not available
ProteinBinding:
Not available
CnssPenetration:
Limited
Elimination:
HalfLife:
Not precisely defined for active metabolites; effects persist for 6-12 hours.
Clearance:
Not available
ExcretionRoute:
Primarily fecal (unabsorbed sennosides and metabolites); small amount of active metabolites excreted renally.
Unchanged:
Not available
Pharmacodynamics
OnsetOfAction:
6-12 hours (due to time required for bacterial conversion in the colon)
PeakEffect:
Not precisely defined; effect is gradual over 6-12 hours.
DurationOfAction:
Effects typically resolve within 24 hours after a single dose.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention, as they may be signs of a severe and potentially life-threatening reaction:
- 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, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to monitor your response to the medication. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
- Stomach pain or cramps.
Note: This list does not include all possible side effects. If you have concerns about side effects or experience any symptoms not listed here, consult your doctor for advice. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention, as they may be signs of a severe and potentially life-threatening reaction:
- 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, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to monitor your response to the medication. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
- Stomach pain or cramps.
Note: This list does not include all possible side effects. If you have concerns about side effects or experience any symptoms not listed here, consult your doctor for advice. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe abdominal pain, cramping, or nausea/vomiting (stop use and consult doctor).
- Rectal bleeding or failure to have a bowel movement after using a laxative (may indicate a serious condition).
- Signs of dehydration (excessive thirst, dry mouth, decreased urination, dizziness).
- Signs of electrolyte imbalance (muscle weakness, fatigue, irregular heartbeat).
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 conditions, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.
To ensure safe treatment, tell your doctor and pharmacist about:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
* Your complete medical history
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe for you to do so.
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 conditions, including:
+ Bowel blockage
+ Abdominal pain
+ Upset stomach
+ Rectal bleeding
+ Vomiting
+ Changes in bowel habits that last longer than 2 weeks
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.
To ensure safe treatment, tell your doctor and pharmacist about:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
* Your complete medical history
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe for you to do so.
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 use this medication for a period exceeding 1 week unless specifically instructed to do so by your doctor.
Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless your doctor advises you to do so.
If you experience rectal bleeding or fail to have a bowel movement after using this medication, it is crucial that you consult with your doctor.
If you are pregnant, planning to become pregnant, or are currently breast-feeding, you must discuss this with your doctor. This discussion will enable you to understand the benefits and risks associated with using this medication during these conditions, allowing you to make an informed decision regarding you and your baby's health.
Do not use this medication for a period exceeding 1 week unless specifically instructed to do so by your doctor.
Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless your doctor advises you to do so.
If you experience rectal bleeding or fail to have a bowel movement after using this medication, it is crucial that you consult with your doctor.
If you are pregnant, planning to become pregnant, or are currently breast-feeding, you must discuss this with your doctor. This discussion will enable you to understand the benefits and risks associated with using this medication during these conditions, allowing you to make an informed decision regarding you and your baby's health.
Overdose Information
Overdose Symptoms:
- Severe diarrhea
- Abdominal cramps
- Dehydration
- Electrolyte imbalance (especially hypokalemia)
- Nausea
- Vomiting
What to Do:
Discontinue use. Rehydrate with fluids and electrolytes. Seek medical attention if symptoms are severe or persistent. Call 1-800-222-1222 (Poison Control Center).
Drug Interactions
Moderate Interactions
- Digoxin (risk of increased digoxin toxicity due to hypokalemia)
- Diuretics (thiazide, loop) (increased risk of hypokalemia)
- Corticosteroids (increased risk of hypokalemia)
- Licorice (increased risk of hypokalemia)
Minor Interactions
- Antacids (may reduce absorption if taken concurrently, separate by 2 hours)
- H2-receptor antagonists (may reduce absorption if taken concurrently, separate by 2 hours)
Monitoring
Routine Monitoring
Bowel movements
Frequency: Daily, during use
Target: Regular, soft stools
Action Threshold: No bowel movement after 3 days of use, or persistent diarrhea/abdominal pain.
Electrolyte levels (Potassium)
Frequency: Not routinely for short-term use; consider for prolonged use or in at-risk patients (e.g., on diuretics, cardiac conditions)
Target: 3.5-5.0 mEq/L
Action Threshold: Potassium < 3.5 mEq/L or symptoms of hypokalemia (muscle weakness, cramps, arrhythmias).
Symptom Monitoring
- Relief of constipation
- Abdominal pain or cramping
- Diarrhea
- Nausea
- Vomiting
- Rectal bleeding
- Signs of dehydration (dry mouth, decreased urination, dizziness)
- Signs of electrolyte imbalance (muscle weakness, fatigue, irregular heartbeat)
Special Patient Groups
Pregnancy
Generally considered low risk for short-term, occasional use during pregnancy, but consult a healthcare provider before use. Category C due to limited controlled human studies.
Trimester-Specific Risks:
First Trimester:
Low risk for occasional use, but non-pharmacological methods (diet, fiber, fluids) are preferred.
Second Trimester:
Low risk for occasional use.
Third Trimester:
Low risk for occasional use.
Lactation
Considered compatible with breastfeeding for short-term use. Small amounts of active metabolites may pass into breast milk, but are generally not expected to cause adverse effects in the infant. Monitor infant for diarrhea.
Infant Risk:
Low (L3 - Moderately safe)
Pediatric Use
Use with caution and only under medical supervision for children under 2 years. Dosing for children 2-12 years is lower than adults and should be carefully followed. Prolonged use is not recommended.
Geriatric Use
Elderly patients may be more susceptible to fluid and electrolyte imbalances, especially with prolonged use. Start with the lowest effective dose and monitor for dehydration and electrolyte disturbances. Non-pharmacological methods should be tried first.
Clinical Information
Clinical Pearls
- Senna is a stimulant laxative and should only be used for short-term relief of occasional constipation. Prolonged use can lead to laxative dependence, electrolyte imbalances (especially hypokalemia), and damage to the colonic nerves (cathartic colon).
- Advise patients to take Senna at bedtime, as its onset of action is typically 6-12 hours.
- Encourage patients to increase fluid intake and dietary fiber while using Senna to support bowel regularity and prevent dehydration.
- Warn patients about potential abdominal cramping and discolored urine (yellow-brown or reddish-brown) which is a harmless effect of senna metabolites.
- If constipation persists after 7 days of use, or if severe abdominal pain, rectal bleeding, or no bowel movement occurs, advise the patient to seek medical attention.
Alternative Therapies
- Bulk-forming laxatives (e.g., psyllium, methylcellulose)
- Osmotic laxatives (e.g., polyethylene glycol, magnesium hydroxide, lactulose)
- Stool softeners (e.g., docusate sodium)
- Lubricant laxatives (e.g., mineral oil - generally not recommended due to aspiration risk and malabsorption)
- Peripherally acting mu-opioid receptor antagonists (PAMORAs) for opioid-induced constipation (e.g., methylnaltrexone, naloxegol)
Cost & Coverage
Average Cost:
$5 - $20 per 100 tablets
Generic Available:
Yes
Insurance Coverage:
OTC (Over-the-Counter) - generally not covered by prescription plans, but may be eligible for FSA/HSA.
General Drug Facts
If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist. 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 emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.