Description

Simple

A medication used to treat constipation.

Clinical

A laxative used to treat constipation.

Overview

Sennosides (also known as senna glycoside or senna) is a medication used to treat constipation[FDA Label][12] and empty the large intestine before surgery. The medication is taken by mouth or via the rectum[FDA Label]. It typically begins working in minutes when given by rectum and within twelve hours when given by mouth[FDA Label]. It is a weaker laxative than bisacodyl or castor oil[11]. Sennoside A, one of the sennosides present in the laxative medication, has recently proven effective in inhibiting the ribonuclease H (RNase H) activity of human immunodeficiency virus (HIV) reverse transcriptase [1].

Pharmacology

Indication

For the over the counter treatment of constipation[FDA Label][12].

Pharmacodynamic

Senna stimulates peristalsis and increases fecal water content to increase motility of feces through the large intestine[ Read more

Mechanism of action

Sennoside A and B, the components of senna, are metabolized by gut bacteria into the active metabolite rheinanthrone [DB13175][ Read more

Absorption

Protein binding

Because sennosides are ingested and their action occurs in the gut, it is generally not thought to be protein bound[ Read more

Volume of distribution

The volume of distribution of radiolabelled intravenous sennoside B in rats was 0.802±0.124L/kg[ Read more

Clearance

The clearance of radiolabelled intravenous sennoside B in rats was 0.065±0.007L/h/kg[ Read more

Half life

The half life of radiolabelled intravenous sennoside B in rats was 8.568±0.651h[ Read more

Route of elimination

3-6% of metabolites are excreted in urine with some in bile. >90% of sennosides are excreted in the feces as polymers with 2-6% of the parent compounds excreted unchanged[12].

Toxicity

Senna causes increased amounts of apoptosis in the large intestine shortly after use due to upregulated p53 activity[ Read more

Adverse Effects

Contraindications

  • Route:
    • Oral
    • Rectal
  • Dose Form:
    • Syrup
    • Tablet
  • Sex Group: all
  • Regions: US
  • Patient Conditions:
      • Name: Intestinal Obstruction
      • Drugbank Id: DBCOND0031423
  • Route:
    • Oral
  • Dose Form:
    • Tablet
  • Hypersensitivity:
    • true
  • Sex Group: all
  • Regions: EU

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Sennosides
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
Acetazolamide
The risk or severity of adverse effects can be increased when Acetazolamide is combined with Sennosides.
Aclidinium
The therapeutic efficacy of Sennosides can be decreased when used in combination with Aclidinium.
Agmatine
The therapeutic efficacy of Sennosides can be decreased when used in combination with Agmatine.
Alcuronium
The therapeutic efficacy of Sennosides can be decreased when used in combination with Alcuronium.
Alfentanil
The therapeutic efficacy of Sennosides can be decreased when used in combination with Alfentanil.
Alloin
The risk or severity of adverse effects can be increased when Sennosides is combined with Alloin.
Alphacetylmethadol
The therapeutic efficacy of Sennosides can be decreased when used in combination with Alphacetylmethadol.
Alphaprodine
The therapeutic efficacy of Sennosides can be decreased when used in combination with Alphaprodine.
Amantadine
The therapeutic efficacy of Sennosides can be decreased when used in combination with Amantadine.
Amiloride
The risk or severity of adverse effects can be increased when Amiloride is combined with Sennosides.
Amiodarone
The therapeutic efficacy of Sennosides can be decreased when used in combination with Amiodarone.
Amitriptyline
The therapeutic efficacy of Sennosides can be decreased when used in combination with Amitriptyline.
Amlodipine
The therapeutic efficacy of Sennosides can be decreased when used in combination with Amlodipine.
Amobarbital
The therapeutic efficacy of Sennosides can be decreased when used in combination with Amobarbital.
Amoxapine
The therapeutic efficacy of Sennosides can be decreased when used in combination with Amoxapine.
Anisotropine methylbromide
The therapeutic efficacy of Sennosides can be decreased when used in combination with Anisotropine methylbromide.
Aprobarbital
The therapeutic efficacy of Sennosides can be decreased when used in combination with Aprobarbital.
Aranidipine
The therapeutic efficacy of Sennosides can be decreased when used in combination with Aranidipine.
Aripiprazole
The therapeutic efficacy of Sennosides can be decreased when used in combination with Aripiprazole.
Atracurium
The therapeutic efficacy of Sennosides can be decreased when used in combination with Atracurium.
12 References
  1. 1 . Esposito F, Carli I, Del Vecchio C, Xu L, Corona A, Grandi N, Piano D, Maccioni E, Distinto S, Parolin C, Tramontano E: Sennoside A, derived from the traditional chinese medicine plant Rheum L., is a new dual HIV-1 inhibitor effective on HIV-1 replication. Phytomedicine. 2016 Nov 15;23(12):1383-1391. doi: 10.1016/j.phymed.2016.08.001. Epub 2016 Aug 10.PubMed: 27765358
  2. 2 . Kon R, Ikarashi N, Nagoya C, Takayama T, Kusunoki Y, Ishii M, Ueda H, Ochiai W, Machida Y, Sugita K, Sugiyama K: Rheinanthrone, a metabolite of sennoside A, triggers macrophage activation to decrease aquaporin-3 expression in the colon, causing the laxative effect of rhubarb extract. J Ethnopharmacol. 2014 Feb 27;152(1):190-200. doi: 10.1016/j.jep.2013.12.055. Epub 2014 Jan 8.PubMed: 24412547
  3. 3 . van Gorkom BA, Karrenbeld A, van der Sluis T, Zwart N, de Vries EG, Kleibeuker JH: Apoptosis induction by sennoside laxatives in man; escape from a protective mechanism during chronic sennoside use? J Pathol. 2001 Aug;194(4):493-9.PubMed: 11523059
  4. 4 . Dreessen M, Eyssen H, Lemli J: The metabolism of sennosides A and B by the intestinal microflora: in vitro and in vivo studies on the rat and the mouse. J Pharm Pharmacol. 1981 Oct;33(10):679-81.PubMed: 6117629
  5. 5 . Mengs U: Toxic effects of sennosides in laboratory animals and in vitro. Pharmacology. 1988;36 Suppl 1:180-7.PubMed: 3368517
  6. 6 . Hardcastle JD, Wilkins JL: The action of sennosides and related compounds on human colon and rectum. Gut. 1970 Dec;11(12):1038-42.PubMed: 4929273
  7. 7 . de Witte P, Lemli J: Metabolism of 14C-rhein and 14C-rhein anthrone in rats. Pharmacology. 1988;36 Suppl 1:152-7.PubMed: 3368514
  8. 8 . Zhou YX, Xia W, Yue W, Peng C, Rahman K, Zhang H: Rhein: A Review of Pharmacological Activities. Evid Based Complement Alternat Med. 2015;2015:578107. doi: 10.1155/2015/578107. Epub 2015 Jun 22.PubMed: 26185519
  9. 9 . Frieling T, Rupprecht C, Schemann M: Rhein stimulates electrogenic chloride secretion by activation of submucosal neurons in guinea pig colon. Pharmacology. 1993 Oct;47 Suppl 1:70-6.PubMed: 8234445
  10. 10 . Zhang D, Huang D, Ji Y, Jiang C, Li Y, Gao M, Yao N, Liu X, Shao H, Jing S, Ni Y, Yin Z, Zhang J: Experimental evaluation of radioiodinated sennoside B as a necrosis-avid tracer agent. J Drug Target. 2015 Feb;23(2):180-90. doi: 10.3109/1061186X.2014.971328. Epub 2014 Oct 20.PubMed: 25330022
  11. 11 . Portalatin M, Winstead N: Medical management of constipation. Clin Colon Rectal Surg. 2012 Mar;25(1):12-9. doi: 10.1055/s-0032-1301754.PubMed: 23449608
  12. 12 . Senokot Tablet Product Information Link