|Trade names||Ex-Lax, Senokot, and others|
|By mouth (PO), rectal (PR)|
|Onset of action||Minutes (PR), 6 to 12 hours (PO)|
|Defined daily dose||not established|
|Chemical and physical data|
|Molar mass||862.75 g·mol−1|
|(what is this?)|
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 glycoside include abdominal cramps. It is not recommended for long-term use, as it may result in poor bowel function or electrolyte problems. While no harm has been found to result from use while breastfeeding, such use is not typically recommended. It is not typically recommended in children. Senna 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. It is available as a generic medication and is relatively inexpensive. The wholesale cost in the developing world 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 700s CE. In 2017, it was the 287th most commonly prescribed medication in the United States, with more than one million prescriptions. It is sold under a number of brand names including Ex-Lax and Senokot.
Senna is used for episodic and chronic constipation though there is a lack of high-quality evidence to support its use for these purposes. It may also be used to aid in the evacuation of the bowel prior to surgery or invasive rectal or colonic examinations. Oral senna products typically produce a bowel movement in 6 to 12 hours. Rectal suppositories act within two hours.
The defined daily dose is not established. In the United States the adult dose is 17.2 mg once to twice per day. The dose in children 2 to 6 years old is 4.3 mg once to twice per day and in children 6 to 12 years old is 8.6 mg once to twice per day.
According to Commission E 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.
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.
Mechanism of action
The breakdown products of senna act directly as irritants on the colonic wall to induce fluid secretion and colonic motility.
Society and culture
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.
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, Pursennid, Senna Smooth, Senna-Gen, Senna-GRX, Senna-Lax, Senna-Tabs, Senna-Time, SennaCon, Senno, Senokot To Go, Senokot XTRA, Senokot, Kayam churna.
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