- Adverse effects
- Food Interactions
Sennosides (also known as senna glycoside or senna) is a medication used to treat constipation[FDA Label] and empty the large intestine before surgery....
Sennosides (also known as senna glycoside or senna) is a medication used to treat constipation[FDA Label] 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. 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 .Read more
Senna stimulates peristalsis and increases fecal water content to increase motility of feces through... Senna stimulates peristalsis and increases fecal water content to increase motility of feces through the large intestine[6,2,12]. Read more
Mechanism of action
Sennoside A and B, the components of senna, are metabolized by gut bacteria into the active metaboli... Sennoside A and B, the components of senna, are metabolized by gut bacteria into the active metabolite rheinanthrone [DB13175]. Rheinanthrone [DB13175] appears to increase cyclooxegenase 2 (COX2) expression in macrophage cells leading to an increase in prostaglandin E2 (PGE2). This increase in PGE2 is associated with a decrease in aquaporin 3 expression in mucosal epithelial cells of the large intestine. A decrease in aquaporin 3 expression likely produces the laxative effect by restricting water reabsorption by the large intestine thereby increasing fecal water content. The exact mechanism by which rheinanthrone increases COX2 expression is unknown. Rheinanthrone [DB13175] also stimulates peristalsis in the large intestine although the mechanism behind this effect is unknown. Rhein [DB13174], another active metabolite is thought to excite submucosal acetylcholinergic neurons resulting in increased chloride and prostaglandin secretion[8,9]. The movement of chloride ions into the large intestine would also help to draw water into the lumen. Read more
Because sennosides are ingested and their action occurs in the gut, it is generally not thought to b... 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[ The volume of distribution of radiolabelled intravenous sennoside B in rats was 0.802±0.124L/kg. Read more
Route of elimination
3-6% of metabolites are excreted in urine with some in bile. >90% of sennosides are excreted in the... 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. Read more
Senna causes increased amounts of apoptosis in the large intestine shortly after use due to upregula...
Senna causes increased amounts of apoptosis in the large intestine shortly after use due to upregulated p53 activity. This is normally reversed after 18 hours however chronic use has been shown to be associated with p53 resistance and potential carcinogenicity leading to colon cancer. The LD50 value in rats was 5000mg/kg. Subacute studies in rats receiving 20mg/kg and dogs receiving 500mg/kg did not produce signs of toxicity. Tests for mutagenicity and reproductive toxicity do not indicate toxic effects.
Sennosides are not recommended for use in pregnancy due to genotoxic risks associated with chemically similar compounds. The active metabolite of sennosides is excreted in breast milk, though there are no reports of the laxitive effect in breast fed babies. There is no data on the effects of sennosides on fertility. Read more
|Effect||Regions||Age Groups||Incidences||Evidence Type|
Information currently not available.
- 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 . 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 . 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 . 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 . Mengs U: Toxic effects of sennosides in laboratory animals and in vitro. Pharmacology. 1988;36 Suppl 1:180-7. [PubMed: 3368517]
- 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 . 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 . 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 . 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 . 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 . 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 . Senokot Tablet Product Information [Link]
I am 73 yrs old and in fairly good health. I get...Sep 01, 2019
Three months ago I developed shingles on my scalp....Sep 09, 2019