Senokot and Senna are used in the treatment of constipation.

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Senna is an anthraquinone stimulant laxative that is used to treat constipation and for bowel evacuation before investigational procedures or surgery. The active anthraquinones are liberated into the colon from the sennoside glycosides by colonic bacteria and an effect usually occurs within 6 to 12 hours of administration by mouth.

For constipation, senna is usually given as tablets, granules, or syrup. It has also been given rectally as suppositories. In the UK, doses of senna preparations are usually expressed in terms of total sennosides calculated as sennoside B. The usual adult dose is 15 to 30 mg given by mouth as a single dose at bedtime. Children over 6 years of age have been given one-half the adult dose, and those aged 2 to 6 years one-quarter the adult dose. In the USA, the usual adult dose is 15 to 30 mg once or twice daily, expressed in terms of total sennosides.

For bowel evacuation before investigational procedures, a dose of 130 mg of sennosides may be given as a liquid preparation by mouth on the day before the procedure. A dose of 72 mg was formerly given in the UK, see Colonic Perforation under Precautions.

The purified sennosides (sennosides A and B), and their calcium salts (calcium sennoside A and calcium sennoside B) are used similarly to senna.


Senna should not be given to patients with undiagnosed abdominal pain or intestinal obstruction; care should also be taken in patients with inflammatory bowel disease. Prolonged use should generally be avoided.

Although anthraquinone derivatives may be distributed into breast milk the concentration achieved after usual maternal dosage is thought to be insufficient to affect the nursing infant.

Adverse Effects

Senna may cause mild abdominal discomfort such as colic or cramps. Prolonged use or overdosage can result in diarrhoea with excessive loss of water and electrolytes, particularly potassium; there is also the possibility of developing an atonic non-functioning colon. Anthraquinone derivatives may colour the urine yellowish-brown at acid pH, and red at alkaline pH. Reversible melanosis coli has been reported following chronic use.


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