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standards of non-Merck sources.
Medication Safety Issues
Sound-alike/look-alike issues:
Perdiem® may be confused with Pyridium®
Senexon® may be confused with Cenestin®
Senokot® may be confused with Depakote®
Pronunciation
(SEN na)
U.S. Brand Names
Index Terms
Generic Available
Yes
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Short-term treatment of constipation; evacuate the colon for bowel or rectal examinations
Contraindications
Per Commission E: Intestinal obstruction, acute intestinal inflammation (eg, Crohn's disease), colitis ulcerosa, appendicitis, abdominal pain of unknown origin; pregnancy
Warnings/Precautions
Other warnings/precautions:
• Self-medication (OTC use): Not recommended for use in patients experiencing stomach pain, nausea, vomiting, or a sudden change in bowel movements which lasts >2 weeks. Not recommended for OTC use in children <2 years of age.
Adverse Reactions
Frequency not defined: Gastrointestinal: Abdominal cramps, diarrhea, nausea, vomiting
Drug Interactions
There are no known significant interactions.
Dosage
Oral:
Bowel evacuation: OTC labeling: Children ?12 years and Adults: Usual dose: Sennosides 130 mg between 2-4 PM the afternoon of the day prior to procedure
Constipation: OTC ranges:
Children:
2-6 years:
Sennosides: Initial: 3.75 mg once daily (maximum: 15 mg/day, divided twice daily)
Senna concentrate: 33.3 mg/mL: 5-10 mL up to twice daily
6-12 years:
Sennosides: Initial: 8.6 mg once daily (maximum: 50 mg/day, divided twice daily)
Senna concentrate: 33.3 mg/mL: 10-30 mL up to twice daily
Children ?12 years and Adults: Sennosides 15 mg once daily (maximum: 70-100 mg/day, divided twice daily)
Elderly: Consider half the initial dose in older, debilitated patients.
Administration: Oral
Once daily doses should be taken at bedtime. Granules may be eaten plain, sprinkled on food, or mixed in liquids
Dietary Considerations
Liquid may be administered with fruit juice or milk to mask taste.
Patient Education
Take exactly as directed. DO NOT exceed recommended dosage; may cause dependence with prolonged or excessive use. Your urine may be discolored (red-brown) this is normal. Stop use and contact prescriber if you develop nausea, vomiting, persistent diarrhea, or abdominal cramps. If constipation worsens or you experience no relief contact prescriber. Note: Increased fluids, fruits, fiber, and exercise may help relieve constipation. OTC labeling does not recommend for use longer than 1 week in children <2 years of age or in women who are pregnant or nursing.
Geriatric Considerations
Elderly are often predisposed to constipation due to disease, immobility, drugs, and a decreased “thirst reflex” with age enhancing the possibility of dehydration. Avoid stimulant cathartic use on a chronic basis if possible. Use osmotic, lubricant, stool softeners, and bulk agents as prophylaxis. Patients should be instructed for proper dietary fiber and fluid intake as well as regular exercise. Monitor closely for fluid/electrolyte imbalance, CNS signs of fluid/electrolyte loss, and hypotension.
Additional Information
Some products that may have previously been labeled as standardized senna concentrate are now labeled as sennosides. For example, Senokot® tablets, previously labeled as standardized senna concentrate 187 mg, are now labeled as sennosides 8.6 mg. The actual content of senna in this product did not change. Individual product labeling should be consulted prior to dosing.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
None reported
Nursing: Physical Assessment/Monitoring
Determine cause of constipation before treating. Teach patient proper use, side effects/interventions, and symptoms to report.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Liquid:
Senexon®: Sennosides 8.8 mg/5 mL (240 mL) [contains propylene glycol]
Liquid [concentrate]:
Fletcher's®: Senna concentrate 33.3 mg/mL (75 mL) [alcohol free; contains sodium benzoate; root beer flavor]
Liquid [concentrate; drops]:
Little Tummys® Laxative: Sennosides 8.8 mg/1 mL (30 mL) [alcohol free, dye free; contains propylene glycol and soya lecithin; chocolate flavor]
Strip, orally disintegrating:
Fleet® Pedia-Lax™ Quick Dissolve: Sennosides 8.6 mg (12s) [grape flavor]
Syrup: Sennosides 8.8 mg/5 mL (240 mL)
Tablet: Sennosides 8.6 mg
ex-lax®: Sennosides USP 15 mg
ex-lax® Maximum Strength: Sennosides USP 25 mg
Perdiem® Overnight Relief: Sennosides USP 15 mg
Senokot®, Senexon®, Senna-Gen®, SenoSol™ [DSC], Uni-Cenna [DSC]: Sennosides 8.6 mg
SenokotXTRA®, SenoSol™-X [DSC]: Sennosides 17 mg
Tablet, chewable:
Black-Draught™: Sennosides 10 mg
ex-lax®: Sennosides USP 15 mg [chocolate flavor]
Evac-U-Gen: Sennosides 10 mg
Pricing: U.S. (www.drugstore.com)
Tablets (Senna-Gen)
8.6 mg (100): $11.99
International Brand Names
Lexi-Comp.com
Last full review/revision September 2009
Content last modified September 2009
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