PDR for Herbal Medicines

686 /SENNA

Occupational Sensitization: IgE-mediated allergy, asthma,

and rhinoconjunctivitis have been reported after occupational

exposure to senna products (Helin, 1996, Marks, 1991).

Tissue Damage: Chronic treatment with anthranoids in high

doses reduces vasoactive intestinal polypeptide and somato-

statin levels in the colon, which may represent damage to the

enteric nervous tissue (Tzavella, 1985).

Drug Interactions:

Digitalis Glycosides — With prolonged use or abuse of

Senna, loss of potassium may potentiate digitalis toxicity.

Antiarrythmics — Loss of potassium associated with pro-

longed use of Senna may potentiate arrhythmias when given

concomitantly with antiarrhythmic medications.

Estrogen — The serum level of estrogen is decreased when

given concomitantly with Senna due to the effect of

intestinal transit on the absorption of estrogens (Lewis,

1998).

Indomethacin (NSAIDS) — Indomethacin given concomi-

tantly with Senna pod extract had a dose-dependent inhibi-

tion of net fluid transport due to~ the v inhibition of

prostaglandin E2 (SEE EFFECTS), which decreases the

therapeutic effect of the Senna (Beubler, 1985).

Nifedipine (calcium channel blocker) — Therapeutic effects

induced by rhein anthrone also involve the calcium channel

which can be blocked by nifedipine, but not verapamil (SEE

EFFECTS) (Yamauchi, 1993).

Pregnancy: The drug should not be used during pregnancy

or while nursing.

Pediatric Use: Not to be used by children under 2 years of

age. Children between the ages of 2-12 years should follow

proper dosage recommendations.

Elderly: Elderly patients should initially take half of the

normal prescribing dose.

DOSAGE

Mode of Administration: Comminuted herb, powder or dried

extracts for teas, decoctions, cold macerates, or elixirs.

Liquid or solid forms of medication exclusively for oral use.

How Supplied:

Capsule — 25 mg, 450 mg

Chewable tablet — 15 mg sennosides

Granules — 15 mg sennosides per teaspoon

Liquid — 2.5 oz. (alcohol 7% by volume), 8.8 mg
sennosides per teaspoon

Tablet — 8.6 mg sennosides, 15 mg sennosides, 17 mg

sennosides, 25 mg sennosides

Preparation: To prepare an infusion, pour hot water (not

boiling) over 0.5 to 2 gm of comminuted drug, steep for 10

minutes, then strain; or steep in cold water for 10 to 12

hours, then strain. The cold water method, according to

various authors, should result in a solution containing less

resin, which is responsible for abdominal pain. The drug

takes effect after a latency period of 10 to 12 hours.

Daily Dosage:

Constipation — The average dose is 20 to 60 mg sennosides.

Chewable Tab — Adults and children 12 years of age and

over, chew 2 tabs once or twice daily. Children 6 to under 12

years of age, chew 1 tab once or twice daily (Prod Info Ex-

Lax®, 1998).

Granules (15 mg sennosides per teaspoon) — Adults and

children 12 years of age, administer 1 teaspoon once daily

with a maximum of 2 teaspoons twice daily. Children 6 to 12

years of age, administer xh teaspoon once daily with a-

maximum of 1 teaspoon twice a day. Children 2 to 6 years of

age, administer lU teaspoon daily with a maximum of lh

teaspoon twice daily (Prod Info Senokot®, 1993).

Liquid (8.8 mg sennoside per teaspoon) — Children 6 to 12

years of age, administer 1 to 1 'h teaspoon once daily witii a

maximum of 1 xh teaspoon twice daily. Children 2 to 6 years

of age, administer lh to^3 A teaspoon once daily with a

maximum of^3 A teaspoon twice daily (Prod Info Senokot®,

1991).

Pills — Adults and children 12 years of age and over should

take 2 pills once or twice daily with a glass of water.

Children 6 to under 12 years of age: take 1 pill once or twice

daily with a glass of water. Children under 6 years of age:

consult a doctor (Prod Info Ex-Lax®, 1998).

Tablets (8.6 mg sennosides) — Adults and children 12 years

of age, administer 2 tablets once daily with a maximum of 4

tablets twice daily. Children 6 to 12 years of age, administer

1 tablet once daily, with a maximum of 2 tablets twice daily.

Children 2 to 6 years of age, adminster xh tablet once daily

with a maximum of 1 tablet twice daily (Prod Info

Senokot®, 1993).

Tablets (17 mg sennosides) — Adults and children 12 years

of age, administer 1 tablet once daily with a maximum of 2

tablets twice daily. Children 6 to 12 years of age, administer

xh tablet once daily with a maximum of 1 tablet twice daily

(Prod Info SenokotXTRA®, 1993).