Is senokot the same as senna?

Generic Name: senna (SEN nah)
Brand Name: Black Draught, Dr Caldwell Laxative, Ex-Lax Chocolated, Ex-Lax Maximum Relief Formula, Ex-Lax Regular Strength Pills, Fletchers Castoria, Innerclean, Little Tummys Laxative Drops, Pedia-Lax, Perdiem Overnight, Senexon, Senna Lax, Senna Smooth, Senna-gen, Senokot, Senokot Extra, Senokot To Go, SenokotXTRA, SenoSol, SenoSol-X

Medically reviewed by Drugs.com on Jun 3, 2019 – Written by Cerner Multum

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What is senna?

Senna is also known as Cassia senna, tinnevelly senna, Indian senna, Alexandrian senna, and Khartoum senna.

Senna has been used in alternative medicine as an aid to treat constipation.

Not all uses for senna have been approved by the FDA. Senna should not be used in place of medication prescribed for you by your doctor.

Senna is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Senna may also be used for purposes not listed in this product guide.

Important Information

Not all uses for senna have been approved by the FDA. Senna should not be used in place of medication prescribed for you by your doctor.

Senna is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Use senna as directed on the label, or as your healthcare provider has prescribed. Do not use this product in larger amounts or for longer than recommended.

Call your healthcare provider if your symptoms do not improve, or if they get worse while using senna. Do not use this product for longer than 1 week without the advice of a healthcare provider.

Before taking this medicine

Ask a doctor, pharmacist, herbalist, or other healthcare provider if it is safe for you to use this product if you have:

  • a bowel disorder such as Crohn’s disease or ulcerative colitis;

  • heart disease; or

  • stomach pain, nausea, or vomiting.

It is not known whether senna will harm an unborn baby. Do not use this product without medical advice if you are pregnant.

It is not known whether senna passes into breast milk or if it could harm a nursing baby. Do not use this product without medical advice if you are breast-feeding a baby.

Some forms of senna are made for use by children. Do not give any herbal/health supplement to a child without the advice of a doctor.

How should I take senna?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use senna, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Senna is usually taken before bed to produce a bowel movement 6 to 12 hours later when you wake up.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not use different formulations of senna (such as tablets and liquid) at the same time without medical advice. Using different formulations together increases the risk of an overdose of senna.

Call your healthcare provider if your symptoms do not improve, or if they get worse while using senna. Do not use this product for longer than 1 week without the advice of a healthcare provider.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking senna?

Follow your healthcare provider’s instructions about any restrictions on food, beverages, or activity.

Senna side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your healthcare provider at once if you have a serious side effect such as:

  • severe stomach pain, severe diarrhea, watery diarrhea;

  • weight loss;

  • worsening constipation after you stop taking senna;

  • enlargement of your fingers and toes;

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • stomach cramps, bloating, gas, mild diarrhea;

  • numbness or tingly feeling;

  • joint pain; or

  • discolored urine.

This is not a complete list of side effects and others may occur. Tell your doctor, pharmacist, herbalist, or other healthcare provider about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect senna?

Do not take senna without the advice of a healthcare provider if you are using any of the following medications:

  • digoxin (Lanoxin);

  • a diuretic (water pill); or

  • a blood thinner such as warfarin (Coumadin, Jantoven).

This list is not complete and other drugs may interact with senna. Tell your healthcare provider about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Further information

  • Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 1.08.

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More about Senokot (senna)

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  • En Español
  • 86 Reviews
  • Drug class: laxatives
  • FDA Alerts (1)

Consumer resources

  • Senokot (Sennosides Capsules and Tablets)
  • Senokot (Sennosides Liquid and Syrup)
  • Senokot (Advanced Reading)
  • Senokot Syrup (Advanced Reading)

Other brands: Senexon, Senna Lax, Ex-Lax, Swiss Kriss, … +17 more

Professional resources

  • Senna (AHFS Monograph)

Other Formulations

  • Senokot S
  • Senokot To Go

Related treatment guides

  • Bowel Preparation
  • Constipation

Laxatives: OTC Products for Constipation

Constipation is a common condition that makes it difficult to have a bowel movement. It can be caused by:

  • your diet
  • certain medicines
  • dehydration
  • too little physical activity
  • intestinal problems.

Constipation can usually be treated with medicines called laxatives. Many laxatives are available over-the-counter (OTC). This means you can buy them at the store without a prescription from your doctor. Some may be called stool softeners or fiber supplements.

Path to improved health

How do laxatives work?

There are several different kinds of laxatives. Each one works a different way. These are the most common types.

Bulk-forming laxatives

These laxatives add “soluble” fiber to the stool. This causes the stool to absorb more water. It creates larger, softer stools. The larger stools help trigger the bowel (intestines) to contract. This moves the stools out. Bulk-forming laxatives generally are the safest type of laxative.

Examples of bulk-forming laxatives include:

  • psyllium (1 brand name: Metamucil)
  • polycarbophil (1 brand name: FiberCon)
  • methylcellulose (1 brand name: Citrucel)

To reduce your risk of side effects, you should start slowly. Make sure to drink plenty of fluids while taking bulk-forming laxatives. Gradually increase how much you use until you get the results you want.

Lubricant laxatives

These coat the surface of the stools to make them slippery. This helps the stools move out of the body more easily. Glycerin suppositories lubricate the inside of the anus (the outside opening of the intestine). This makes it easier to pass hard stools out of the body.

Stool softeners

These help mix fluid into stools to soften them. This makes stools easier to pass out of the body. An example of a stool softener is docusate (1 brand name: Colace).

Osmotic laxatives

These cause the intestine to hold more fluid. This softens stools and helps the bowel move them out. Examples include polyethylene glycol (1 brand name: Miralax) and magnesium hydroxide solution (milk of magnesia).

Stimulant laxatives

These are the harshest type of laxatives. They cause the bowel to squeeze or contract to move the stools out. Bisacodyl (1 brand name: Dulcolax) and sennosides (1 brand name: Senokot) are examples of stimulant laxatives. Stimulant laxatives should not be used for more than a few days. When these laxatives are taken for a long time, the bowel can lose its muscle tone. It can “forget” how to push the stool out on its own.

Should I use a laxative to treat constipation?

Most of the time, constipation doesn’t require treatment with laxatives. It will usually go away on its own. Or you can make changes in your diet and other habits. You can prevent or treat constipation by:

  • Eating foods rich in soluble and insoluble fiber (bran, oats, foods made with whole grains, fruits, and vegetables).
  • Drinking enough fluids.
  • Getting enough exercise.

You may try all of these things and still be constipated. That is when taking a laxative may help you.

How do I safely take OTC laxatives?

Before you take an OTC laxative, read the directions on the drug facts label. This will tell you how much medicine to take and how often to take it. If you have any questions about how much medicine to take, call your family doctor or pharmacist. Keep a record of the OTC medicines you are using and when you take them. If you need to go to the doctor, take this list with you.

Follow these tips to make sure you are taking the right amount of an OTC laxative:

  • Take only the amount recommended on the medicine’s label. Don’t assume that more medicine will work better or quicker. Taking more than the recommended amount can be dangerous.
  • If you are taking a prescription medicine, ask your doctor if it’s okay to also take an OTC laxative.

How can I safely store OTC laxatives?

Store all medicines up and away, out of reach and sight of young children. Keep medicines in a cool, dry place. This will help prevent them from becoming less effective before their expiration dates. Do not store medicines in bathrooms or bathroom cabinets. They are often hot and humid.

Things to consider

Most laxatives don’t have side effects if you use them correctly. However, sometimes they can cause cramping, gas, bloating, nausea, or diarrhea.

Laxatives aren’t meant for long-term use. Don’t use laxatives for longer than 1 week unless your doctor recommends it. Long-term use or overuse of laxatives can cause health problems. Overusing laxatives may also hide symptoms your doctor should know about. This could delay finding out about other health problems and starting treatment.

Some people are at risk for electrolyte imbalances while taking certain laxatives. These include children and people who have diabetes or kidney disease. Electrolytes are substances in your body. They help your nerves, organs, and muscles work properly. Taking laxatives can cause you to eliminate too many electrolytes. When this happens, you may have side effects. These could include nausea, vomiting, headache, confusion, fatigue, and muscle weakness or spasms. Electrolyte imbalance can be serious. Check with your child’s doctor before giving him or her a laxative. If you have a chronic condition, be sure to talk to your doctor before taking a laxative.

Who shouldn’t take laxatives?

Don’t take laxatives if you are allergic to any of the ingredients. Some people may be allergic to psyllium, a key ingredient in 1 type of bulk-forming laxative.

If you have a condition called phenylketonuria, you shouldn’t take a laxative that contains phenylalanine.

Could laxatives cause problems with any medicines or supplements I take?

Laxatives can get in the way of how your body absorbs certain medicines and nutrients. Don’t take any other medicines within 2 hours of taking a laxative. If you’re taking a prescription medicine of any kind, talk to your doctor before taking a laxative. You also shouldn’t mix different types of laxatives. This includes oral laxatives (taken by mouth) and suppositories. Don’t take bisacodyl within 1 hour of taking antacids or drinking milk.

Mineral oil and castor oil are sometimes used as laxatives. They shouldn’t be used often. If mineral oil is used often, it can cause deficiencies of vitamins A, D, E, and K. Castor oil is a stimulant laxative. Using it a lot can cause you to lose muscle tone in your bowel. This can lead to long-term constipation. Mineral oil and castor oil also interact with some medicines. These include blood-thinners, antibiotics such as tetracycline, and certain heart and bone medicines.

When should I call my doctor?

If you have any of the following symptoms, talk to your doctor before using an OTC laxative:

  • nausea
  • stomach pain
  • sudden change in your bowel habits that lasts 2 weeks or longer
  • vomiting.

Stop taking laxatives and call your doctor if you have any bleeding from your rectum. Also call your doctor if you don’t have a bowel movement after using a laxative. These could be signs of a more serious problem.

Questions to ask your doctor

  • What kind of laxative is best for me?
  • Am I taking any other medicines that will interact with a laxative?
  • Do I need a prescription laxative or can I buy one over the counter?
  • How long should I take a laxative?
  • Can I use a bulk-forming laxative every day?

Laxatives, Stool Softeners, and Prokinetic Agents 

Constipation is a symptom with various etiologies and can be associated with many factors. Primary constipation may be characterized by normal or slow intestinal transit or may be caused by an anatomical issue (eg, pelvic flow dysfunction). Secondary constipation is associated with endocrine or metabolic disorders (eg, hypercalcemia, hypothyroidism, pregnancy, diabetes mellitus), neurologic disorders (stroke, Parkinson disease, multiple sclerosis), connective tissue disorders (eg, scleroderma, amyloidosis), and eating disorders.

Commonly identified medications that may contribute to constipation include antidepressants, iron, bismuth, anticholinergics, opioids, antacids, calcium channel blockers, nonsteroidal anti-inflammatory drugs (NSAIDs), sympathomimetics, and antipsychotics. Chronic use of cholestyramine or stimulant laxatives may lead to a dilated atonic laxative colon, resulting in constipation and the presumed need for more laxatives.

The choice of laxative for treatment or prevention of constipation depends on the etiology. Medications to treat constipation include bulk-forming agents, lubricant laxatives, stool softeners, stimulant laxatives, osmotic laxatives, saline laxatives, and prokinetic agents.

Bulk-producing laxatives

These agents contain soluble fiber that absorbs water within the intestine. This promotes intestinal peristalsis. Bulk-forming agents are used for long-term prophylaxis, treatment of constipation, or both in patients without anatomic outlet obstruction. Bulk-producing laxatives include the following:

Lubricant laxatives are used for acute or subacute management of constipation. They lubricate the intestine and facilitate passage of stool by decreasing water absorption from the intestine. Lubricant laxatives include the following:

  • Mineral oil

Emollient stool softeners are used for prophylaxis against constipation in acute and subacute settings (eg, postoperative opioid-induced constipation).

  • Docusate is a surfactant laxative; it reduces tension of oil-water interface of the stool and enhances incorporation of water and fat into the stool, resulting in a softer stool

Stimulant laxatives include the following:

  • Bisacodyl or bisacodyl rectal – Stimulates peristalsis potentially by stimulating the colonic intramural neuronal plexus; alters water and electrolyte secretion, resulting in net intestinal fluid accumulation and laxation; provokes defecation within 24 hours and may cause abdominal cramping

  • Senna – Sennosides induce defecation by acting directly on the intestinal mucosa or nerve plexus, which stimulates peristaltic activity, increasing intestinal motility; senna usually produces its action 8-12 hours after administration

Small doses of osmotic agents are useful for long-term treatment of constipation with slow colonic transit in patients who are refractory to dietary fiber supplementation. In large doses, these agents may also be used as part of a bowel evacuation protocol for invasive procedures or surgery. Osmotic laxatives include the following:

Saline laxatives are used for acute treatment of constipation in the absence of bowel obstruction. These agents may also be used as part of a bowel evacuation protocol for invasive procedures or surgery. These agents increase peristaltic activity of the colon by promoting osmotic retention of fluid. Saline laxatives include the following:

Prokinetic agents

Prokinetic agents promote intestinal motility and are used for severe constipation-predominant symptoms associated with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). Prokinetic agents include the following:

  • Linaclotide – Guanylate cyclase C (GC-C) agonist that activates GC-C located on the luminal surface of intestinal epithelial cells; stimulation leads to increased cyclic guanosine monophosphate (cGMP), anion secretion, fluid secretion, and intestinal transit

  • Lubiprostone – Locally acting chloride channel activator that increases intestinal fluid secretion and intestinal motility; acts locally at apical portion of the intestine

Laxatives, other

See the list below:

  • Castor oil – Castor oil is reduced to ricinoleic acid; it decreases net absorption of fluid and electrolytes and stimulates peristalsis; acts on the small intestine

Combination laxatives

Combination laxatives include the following:

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