Does Senna (Senokot) Cause Dependency?

In our latest question and answer, the pharmacist discusses whether or not Senna (Senokot) can cause dependency.

Question

I have ulcerative colitis and have just changed to a new treatment. My treatment is an Entyvio Infusion. I have been extremely constipated since beginning this treatment. I was asked to do a colon cleanse with Magnesium citrate and then to take two senokote tablets at bedtime. Can senokote cause dependency? What is the dosage for Miralax and would this be a better alternative? Can you take Miralax and senokote at the same time?

Asked by deedee On Apr 30, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On May 03, 2018

Senna PlantSenna (Senokot) is considered to be a "mild" stimulant laxative that is generally well tolerated if used for short periods of time.


However, long-term, or chronic use of senna can potentially cause dependence on the laxative, leading to problems with constipation when use is interrupted or stopped abruptly. This is also known as "cathartic colon". However, most studies suggest that senna has a relatively low risk of causing this would need to be used consistently for periods exceeding one year.


Senna Information

Senna is classified as an anthraquinone laxative, derived from the leaf or fruit of the Senna alexandrina plant.


Senna is used to relieve occasional constipation and also for reversing the constipating effects of opioids, such as oxycodone.


Senna works by causing stimulation of smooth muscle of the colon, which increases intestinal motility. Senna is also thought to work by changing fluid balance and electrolyte absorption. It is considered a mild laxative, with an onset of action around 6 to 12 hours after taking by mouth.


Short term use of senna is generally well tolerated but can cause some of the following side effects:

  • Urine discoloration 
  • Abdominal pain
  • Nausea/vomiting
  • Loss of weight
  • Hypokalemia
  • Hypocalcemia


Senna and Miralax are safe to take together. There is no interaction between the two medications. Miralax is not considered a stimulant laxative, but an osmotic laxative, that works by causing water to be retained in the stool. There is a possible risk of increased abdominal cramping and bloating when using Senna and Miralax together, but this should be minor for most individuals.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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