Senna glycoside

Senna glycoside

Clinical data
Trade names	Ex-Lax, Senokot, and others
AHFS/Drugs.com	monograph
Pregnancy category	C
Legal status	US: OTC
Routes of administration	By mouth (PO), rectal (PR)
Pharmacokinetic data
Onset of action	Minutes (PR), 6 to 12 hours (PO)
Identifiers
ATC code	A06AB06 (WHO)
NY (what is this?)  (verify)

Senna glycoside, also known as sennoside or senna, is a medication used to treat constipation and empty the large intestine before surgery. The medication is taken by mouth or via the rectum. It typically begins working in minutes when given by rectum and within twelve hours when given by mouth. It is a weaker laxative than bisacodyl or castor oil.

Common side effects of senna glycosides include abdominal cramps. It is not recommended for long term use as it may result in poor bowel function or electrolyte problems. While no harms have been found for use while breastfeeding, such use is not typically recommended. They are not typically recommended in children. May change urine to a somewhat reddish color. Senna derivatives are a type of stimulant laxative and are of the anthraquinone type. While its mechanism of action is not entirely clear, senna is thought to act by increasing fluid secretion within and contraction of the large intestine.

It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system. They are available as a generic medication and are not very expensive. The wholesale cost is about 0.01 USD per pill. Sennosides come from the group of plants Senna. In plant form it has been used at least since the 700 CE.

Medical uses

Senna is used for the short-term treatment of symptomatic constipation. It may also be used to aide in the evacuation of the bowel prior to surgery or invasive rectal or colonic examinations.

Administration

It should be taken once daily at bedtime. Oral senna products typically produce a bowel movement in 6 to 12 hours. Rectal suppositories act within 2 hours.

Contraindications

According to Commission E, the German equivalent of the U.S. Food and Drug Administration, senna is contraindicated in cases of intestinal obstruction, acute intestinal inflammation (e.g., Crohn's disease), ulcerative colitis, appendicitis, and abdominal pain of unknown origin.

Senna is considered contraindicated in people with a documented allergy to anthraquinones. Such allergies are rare and typically limited to dermatological reactions of redness and itching.

Adverse effects

Adverse effects are typically limited to gastrointestinal reactions and include abdominal pain or cramps, diarrhea, nausea, and vomiting. Regular use of senna products can lead to a characteristic brown pigmentation of the internal colonic wall seen on colonoscopy. This abnormal pigmentation is known as melanosis coli.

Interactions

Can increase digoxin toxicity in patients taking digoxin by reducing serum potassium levels, thereby enhancing the effects of digoxin.

Mechanism of action

The breakdown products of senna act directly as irritants on the colonic wall to induce fluid secretion and colonic motility.

Pharmacology

They are anthraquinone derivatives and dimeric glycosides.

Society and culture

Formulations

Senna is an over-the-counter medication available in multiple formulations, including oral formations (liquid, tablet, granular) and rectal suppositories. Senna products are manufactured by multiple generic drug makers as various brand names.

Brand names

Ex-Lax Maximum Strength, Ex-Lax, Geri-kot, GoodSense Senna Laxative, Natural Senna Laxative, Perdiem Overnight Relief, Senexon, Senna Lax, Senna Laxative, Senna Maximum Strength, Senna Smooth, Senna-Gen, Senna-GRX, Senna-Lax, Senna-Tabs, Senna-Time, SennaCon, Senno, Senokot To Go, Senokot XTRA, Senokot.