Products
Senna-based laxatives are commercially available in many countries as tea, granules, tablets, capsules, and syrup (e.g., Midro, Darmol, Agiolax), among others. Senna fruits and senna leaves are available in pharmacies and drugstores in open form. An officinal mixture is the laxative tea PH.
Stem plant
The parent plants are and from the carob family (Caesalpiniaceae).
Medicinal drug
The senna leaves and senna fruits are used as a medicinal herb. Senna leaves (Sennae folium) consist of the dried leaflets of or from or a mixture of the two species. Senna fruits (Sennae fructus) are defined as follows:
- Alexandrine senna (Sennae fructus acutifoliae) consists of the dried fruits of .
- Tinnevelly senna (Sennae fructus angustifoliae) consist of the dried fruits of .
The leaves and fruits are used to make tea blends and dry and liquid extracts.
Ingredients
The ingredients relevant to the effect are dianthrone glycosides (the sennosides) and anthraquinone glycosides. These are prodrugs that are activated in the gut by bacteria. The figure shows sennoside B.
Effects
The preparations have laxative properties. The anthranoids promote the secretion of electrolytes and water into the intestinal lumen and inhibit their absorption from the colon. This results in an increase in volume, increased filling pressure, and stimulation of intestinal motility.
Indications for use
- For the treatment of occasional constipation. Senna should not be used for chronic symptoms.
- For short-term softening of the stool, for example in hemorrhoids.
- For bowel evacuation before diagnostic and surgical procedures.
Dosage
According to the package leaflet. Medicines are usually taken in the evening. Sufficient liquid should be drunk. The effect occurs after about eight to twelve hours. The medicines should be used only for a short time during a maximum of two weeks.
Contraindications
- Abdominal pain of unknown cause
- Spastic constipation, intestinal obstruction
- Disturbances of the electrolyte balance (hypokalemia).
- Severe dehydration with loss of water and electrolytes.
- Inflammatory diseases of the digestive tract.
- Hypersensitivity
- Pregnancy
- Lactation
- Children under 12 years
Full precautions can be found in the drug label.
Interactions
In particular, abusive, high-dose, prolonged use can lead to potassium deficiency and hypokalemia. This increases the risk of cardiac arrhythmias when taking cardiac glycosides, antiarrhythmics, and other arrhythmogenic drugs. Hypokalemia may be further exacerbated by other drugs that promote potassium excretion (eg, glucocorticoids, diuretics).
Adverse effects
Possible adverse effects include gastrointestinal symptoms such as abdominal pain, abdominal cramps, nausea, irritation of the intestinal mucosa, and flatulence. Other side effects include hypersensitivity reactions and a harmless discoloration of the mucous membrane of the colon (pseudomelanosis coli) in long-term therapy. Senna may cause the urine to turn red. Potassium deficiency may occur with long-term use and too high a dose (see above).