senna glycoside
{{Short description|Constipation and surgery medication}}
{{Use dmy dates|date=December 2021}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Drugbox
| Verifiedfields = changed
| verifiedrevid = 448895765
| image = Sennoside.png
| image_class = skin-invert-image
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| tradename = Ex-Lax, Senokot, others
| Drugs.com = {{drugs.com|monograph|senna}}
| MedlinePlus = a601112
| DailyMedID = Senna
| pregnancy_AU = A
| pregnancy_category =
| routes_of_administration = By mouth, rectal
| ATC_prefix = A06
| ATC_suffix = AB06
| legal_CA =
| legal_UK = P
| legal_US = OTC
| legal_US_comment =
| legal_status = OTC
| bioavailability =
| protein_bound =
| metabolism =
| onset = Minutes (by rectum), 6 to 12 hours (by mouth)
| elimination_half-life =
| duration_of_action =
| excretion =
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 66575-30-2
| PubChem = 5199
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB11365
| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
| ChemSpiderID = 65892
| KEGG = D02171
| IUPAC_name = 9-[2-carboxy-4-hydroxy-10-oxo-5-[3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-9H-anthracen-9-yl]-4-hydroxy-10-oxo-5-[3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-9H-anthracene-2-carboxylic acid
| C = 42 | H = 38 | O = 20
| chemical_formula_ref = {{cite web|title=Senna(Powdered)|url=https://pubchem.ncbi.nlm.nih.gov/compound/171194| work = PubChem | publisher = U.S. National Library of Medicine }}
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Senna glycoside, also known as sennoside or senna, is a medication used to treat constipation and empty the large intestine before surgery.{{cite web|author1=American Society of Health-System Pharmacists|title=Senna|url=https://www.drugs.com/monograph/senna.html| work = Drugs.com|access-date=11 August 2015|date=1 January 2008|url-status=live|archive-url=https://web.archive.org/web/20150906045617/http://www.drugs.com/monograph/senna.html|archive-date=6 September 2015}} The medication is taken by mouth or via the rectum. It typically begins working in around 30 minutes when given by rectum and within twelve hours when given by mouth. It is a weaker laxative than bisacodyl and 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.
Sennosides come from the group of plants Senna.{{cite book| vauthors = Navti P |title=Pharmacology for pharmacy and the health sciences : a patient-centred approach|date=2010|publisher=Oxford University Press|location=Oxford|isbn=9780199559824|page=337|url=https://books.google.com/books?id=KVicAQAAQBAJ&pg=PA337|url-status=live|archive-url=https://web.archive.org/web/20160305023955/https://books.google.ca/books?id=KVicAQAAQBAJ&pg=PA337|archive-date=5 March 2016}} In plant form, it has been used at least since the 700s AD.{{cite book| vauthors = Khare CP |title=Indian Herbal Remedies Rational Western Therapy, Ayurvedic and Other Traditional Usage, Botany|date=2004|publisher=Springer Berlin Heidelberg|location=Berlin, Heidelberg|isbn=9783642186592|page=133|url=https://books.google.com/books?id=njLtCAAAQBAJ&pg=PA133|url-status=live|archive-url=https://web.archive.org/web/20160305030839/https://books.google.ca/books?id=njLtCAAAQBAJ&pg=PA133|archive-date=5 March 2016}} It is on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }} It is available as a generic medication.{{cite book| vauthors = Hamilton RJ | title = Tarascon pharmacopoeia |date=2010 |publisher=Jones and Bartlett |location=Sudbury, Mass. |isbn=9780763777685 |page=181 |edition=2010 |url= https://books.google.com/books?id=Urmh7ylCXnoC&pg=PA181|url-status=live|archive-url=https://web.archive.org/web/20160305014932/https://books.google.ca/books?id=Urmh7ylCXnoC&pg=PA181|archive-date=5 March 2016}} In 2022, it was the 280th most commonly prescribed medication in the United States, with more than 600,000 prescriptions.{{cite web | title = Sennosides Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/Sennosides | access-date = 30 August 2024 }} In 2022, the combination with docusate was the 261st most commonly prescribed medication in the United States, with more than 1{{nbsp}}million prescriptions.{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}{{cite web | title = Senna; Docusate Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/SennaDocusate | access-date = 30 August 2024 }} It is sold under a number of brand names including Ex-Lax and Senokot.
Medical uses
Senna is used for episodic and chronic constipation though there is a lack of high-quality evidence to support its use for these purposes.{{cite journal | vauthors = Wald A | title = Constipation: Advances in Diagnosis and Treatment | journal = JAMA | volume = 315 | issue = 2 | pages = 185–91 | date = January 2016 | pmid = 26757467 | doi = 10.1001/jama.2015.16994 | type = Review }} It may also be used to aid in the evacuation of the bowel prior to surgery or invasive rectal or colonic examinations.Drugs.com {{cite web |url=https://www.drugs.com/ppa/senna.html |title=Senna (Professional Patient Advice) |access-date=17 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20140419013432/http://www.drugs.com/ppa/senna.html |archive-date=19 April 2014 }}
=Administration=
Oral senna products typically produce a bowel movement in 6 to 12 hours. Rectal suppositories can act within minutes or take up to two hours.{{cite book | vauthors = McQuaid KR | chapter = Chapter 62. Drugs Used in the Treatment of Gastrointestinal Diseases. | veditors = Katzung BG, Masters SB, Trevor AJ | title = Basic & Clinical Pharmacology | edition = 12th | location = New York, NY | publisher = McGraw-Hill | date = 2012 | url = http://accessmedicine.mhmedical.com/content.aspx?bookid=388&Sectionid=45764290 |access-date=18 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20140419013030/http://accessmedicine.mhmedical.com/content.aspx?bookid=388&Sectionid=45764290 |archive-date=19 April 2014 }}
Contraindications
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.
Senna is considered contraindicated in people with a documented allergy to anthraquinones. Such allergies are rare and typically limited to dermatological reactions of redness and itching.
Adverse effects
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.
= Interactions =
Senna glycosides can increase digoxin toxicity in patients taking digoxin by reducing serum potassium levels, thereby enhancing the effects of digoxin.{{cite web|url=https://www.nlm.nih.gov/medlineplus/druginfo/natural/652.html|title=Senna: MedlinePlus Supplements|url-status=live|archive-url=https://web.archive.org/web/20150406045004/http://www.nlm.nih.gov/medlineplus/druginfo/natural/652.html|archive-date=6 April 2015}}
Mechanism of action
The breakdown products of senna act directly as irritants on the colonic wall to induce fluid secretion and colonic motility.{{cite book | vauthors = Sharkey KA, Wallace JL | chapter = Chapter 46. Treatment of Disorders of Bowel Motility and Water Flux; Anti-Emetics; Agents Used in Biliary and Pancreatic Disease. | veditors = Brunton LL, Chabner BA, Knollmann BC | title = Goodman & Gilman's The Pharmacological Basis of Therapeutics | edition = 12th | location = New York, NY | publisher = McGraw-Hill | date = 2011 | url= http://accessmedicine.mhmedical.com/content.aspx?bookid=374&Sectionid=41266256 | access-date=18 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20140419013258/http://accessmedicine.mhmedical.com/content.aspx?bookid=374&Sectionid=41266256 |archive-date=19 April 2014 }}
Pharmacology
Society and culture
=Formulations=
Senna is an over-the-counter drug available in multiple formulations, including oral formations (liquid, tablet, granular) and rectal suppositories. Senna products are manufactured by multiple generic drug makers and sold under various brand names.
=Brand names=
Ex-Lax, Geri-kot, Perdiem Overnight Relief, Senexon, Pursennid, Senna Smooth, Senna-Gen, Senna-GRX, Senna-Lax, Senna-Tabs, Senna-Time, SennaCon, Senno, Senokot.Lexicomp Online, Lexi Drugs Online, Hudson, Ohio: Lexi-Comp, Inc.; 17 April 2014.
References
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Category:Anthraquinone glycosides