Senna 8.8mg/5ml Liquid
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 plant-based laxative used to treat occasional constipation. It works by stimulating your bowels to move stool through your system, usually producing a bowel movement within 6 to 12 hours after taking it.
How to Use This Medicine
Taking Your Medication Correctly
To ensure you get the most benefit from your medication, follow these guidelines:
Take your medication exactly as directed by your doctor. Read all the information provided with your prescription and follow the instructions carefully.
Do not take any other medications within 2 hours of taking this drug.
If you are taking this medication once a day, take it at bedtime.
Some medications require shaking before use. Make sure you know if your specific product needs to be shaken before using it.
When taking a liquid dose, measure it carefully using the measuring device provided with the medication. If no device is included, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication:
Store it at room temperature in a dry place, avoiding bathrooms and areas with high heat.
Keep all medications in a safe location, 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.
If it is 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 guidelines:
Take your medication exactly as directed by your doctor. Read all the information provided with your prescription and follow the instructions carefully.
Do not take any other medications within 2 hours of taking this drug.
If you are taking this medication once a day, take it at bedtime.
Some medications require shaking before use. Make sure you know if your specific product needs to be shaken before using it.
When taking a liquid dose, measure it carefully using the measuring device provided with the medication. If no device is included, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication:
Store it at room temperature in a dry place, avoiding bathrooms and areas with high heat.
Keep all medications in a safe location, 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.
If it is 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
- Drink plenty of fluids (water, juices) throughout the day to help soften stools and prevent dehydration.
- Increase dietary fiber intake (fruits, vegetables, whole grains) to promote regular bowel movements.
- Engage in regular physical activity to help stimulate bowel function.
- Do not use for more than 7 days unless directed by a doctor, as prolonged use can lead to dependence or electrolyte imbalances.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
10-15 mL (17.6-26.4 mg sennosides) orally once daily at bedtime
Dose Range:
10 - 30 mg
Condition-Specific Dosing:
constipation:
Initial dose 10-15 mL (17.6-26.4 mg sennosides) at bedtime; may increase up to 30 mL (52.8 mg sennosides) daily if needed. Do not exceed recommended dose.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (consult pediatrician)
Child:
2-6 years: 2.5-5 mL (4.4-8.8 mg sennosides) orally once daily at bedtime. 6-12 years: 5-10 mL (8.8-17.6 mg sennosides) orally once daily at bedtime.
Adolescent:
12 years and older: Same as adult dosing, 10-15 mL (17.6-26.4 mg sennosides) orally once daily at bedtime.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended for short-term use.
Moderate:
Use with caution; risk of electrolyte imbalance may be increased. Monitor electrolytes if used chronically.
Severe:
Use with caution; risk of electrolyte imbalance may be increased. Avoid chronic use. Monitor electrolytes.
Dialysis:
Considerations: Not dialyzable. Use with caution due to potential for electrolyte disturbances.
Hepatic Impairment:
Mild:
No specific adjustment recommended.
Moderate:
No specific adjustment recommended, but use with caution in severe liver disease due to potential for electrolyte disturbances.
Severe:
No specific adjustment recommended, but use with caution in severe liver disease due to potential for electrolyte disturbances.
Pharmacology
Mechanism of Action
Sennosides are prodrugs that are metabolized by colonic bacteria into active anthrones (e.g., rhein anthrone). These active metabolites stimulate colonic motility (peristalsis) and increase water and electrolyte secretion into the bowel lumen, leading to a laxative effect.
Pharmacokinetics
Absorption:
Bioavailability:
Limited systemic absorption of active metabolites (rhein anthrone). Prodrugs are absorbed minimally.
Tmax:
Active metabolites (rhein anthrone) reach peak concentrations in the colon, not systemically. Laxative effect typically occurs within 6-12 hours.
FoodEffect:
Minimal impact on efficacy or absorption.
Distribution:
Vd:
Not well quantified due to limited systemic absorption.
ProteinBinding:
Not well quantified.
CnssPenetration:
Limited
Elimination:
HalfLife:
Not well quantified for active metabolites; laxative effect duration is more relevant.
Clearance:
Not well quantified.
ExcretionRoute:
Primarily fecal (as active metabolites and unabsorbed drug); small amounts of metabolites may be excreted renally.
Unchanged:
Not well quantified (prodrug)
Pharmacodynamics
OnsetOfAction:
6-12 hours
PeakEffect:
8-12 hours
DurationOfAction:
Effect typically resolves within 24 hours after a single dose.
Safety & Warnings
Side Effects
Important Side Effects to Report to Your Doctor Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, seek medical attention right away:
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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor for advice:
Stomach pain or cramps
Note: This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, seek medical attention right away:
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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor for advice:
Stomach pain or cramps
Note: This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. 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
- Rectal bleeding or no bowel movement after using the laxative
- Signs of dehydration (e.g., extreme thirst, decreased urination, dizziness)
- Muscle weakness or irregular heartbeat (signs of 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
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 (OTC) 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 issues, 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 (OTC) 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 your doctor has explicitly instructed you to do so.
Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless your doctor has advised 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 conversation will enable you to understand the benefits and risks associated with this medication for both you and your baby, allowing for an informed decision.
Do not use this medication for a period exceeding 1 week unless your doctor has explicitly instructed you to do so.
Additionally, refrain from using other laxatives or stool softeners concurrently with this drug, unless your doctor has advised 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 conversation will enable you to understand the benefits and risks associated with this medication for both you and your baby, allowing for an informed decision.
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 immediate medical attention. Call 1-800-222-1222 (Poison Control).
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)
- Antiarrhythmics (e.g., quinidine, amiodarone) (increased risk of arrhythmias due to hypokalemia)
Monitoring
Routine Monitoring
Bowel movement frequency and consistency
Frequency: Daily during use
Target: Regular, soft stool
Action Threshold: No bowel movement after 3 days of use, or persistent diarrhea/abdominal pain
Electrolytes (Potassium)
Frequency: Only if chronic use (more than 1 week) or in patients at risk for electrolyte imbalance (e.g., on diuretics, digoxin)
Target: 3.5-5.0 mEq/L
Action Threshold: Potassium < 3.5 mEq/L or symptoms of hypokalemia (muscle weakness, cramps, fatigue)
Symptom Monitoring
- Abdominal pain or cramping
- Nausea
- Diarrhea
- Rectal bleeding
- Dizziness or lightheadedness (signs of dehydration/electrolyte imbalance)
- Muscle weakness or cramps (signs of hypokalemia)
Special Patient Groups
Pregnancy
Generally considered safe for short-term use during pregnancy when other measures (diet, fiber, fluids) are insufficient. Consult a healthcare provider before use.
Trimester-Specific Risks:
First Trimester:
Low risk for short-term use.
Second Trimester:
Low risk for short-term use.
Third Trimester:
Low risk for short-term 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.
Infant Risk:
Low risk. Monitor infant for diarrhea, but this is rare.
Pediatric Use
Use with caution and only under medical supervision for children under 2 years. Dosing for older children should be age-appropriate and for short-term use only. Prolonged use can lead to laxative dependence and electrolyte imbalances.
Geriatric Use
Use with caution in elderly patients due to increased susceptibility to dehydration and electrolyte imbalances. Start with the lowest effective dose and monitor hydration status and electrolytes, especially if co-morbidities or other medications are present.
Clinical Information
Clinical Pearls
- Senna is a stimulant laxative, best used for short-term relief of occasional constipation. It is not intended for chronic use.
- Advise patients to take senna at bedtime, as its effects typically occur 6-12 hours later.
- Emphasize the importance of adequate fluid intake and dietary fiber alongside laxative use.
- Warn patients about potential for abdominal cramping and discolored urine (yellow-brown or reddish-brown, harmless) with senna use.
- Educate patients on the risks of laxative abuse, including electrolyte disturbances, dehydration, and laxative dependence.
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)
- Peripherally acting mu-opioid receptor antagonists (PAMORAs) for opioid-induced constipation (prescription only)
Cost & Coverage
Average Cost:
Varies widely ($5 - $20) per 237 mL bottle
Generic Available:
Yes
Insurance Coverage:
Typically not covered by prescription plans as it is an OTC product; may be covered by FSA/HSA.
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. 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 this medication, don't hesitate to discuss them with 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.