Senna

Senna is used on a short-term basis to treat constipation. It also is used to empty the bowels before surgery and certain medical procedures. Senna is in a class of medications called stimulant laxatives. It works by increasing activity of the intestines to cause a bowel movement.

Senna comes as a liquid, powder, granules, chewable pieces, and tablets to take by mouth. It is may be taken once or twice daily. Senna normally causes a bowel movement within 6 to 12 hours, so it may be taken at bedtime to produce a bowel movement the next day. Do not take senna for more than 1 week without talking to your doctor. Follow the directions on your package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take senna exactly as directed. Frequent or continued use of senna may make you dependent on laxatives and cause your bowels to lose their normal activity. If you do not have a regular bowel movement after taking senna, do not take any more medication and talk to your doctor.

If you are taking certain senna products (Ex-Lax^® regular ormaximum strength tablets or Perdiem Overnight Relief), swallow the pills whole with a glass of water; do not split, chew, or crush them.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking senna,

• tell your doctor and pharmacist if you are allergic to senna, any other medications, or any of the ingredients in these senna products. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking senna. Your doctor may need to change the doses of your medications or monitor you carefully for side effects..
• take certain senna products (Ex-Lax^®, Perdiem Overnight Relief) at least 2 or more hours before or after taking other medications by mouth; some senna products may affect how other medications work.
• the following nonprescription product may interact with senna: mineral oil. Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking senna. Do not start this medication while taking senna without discussing with your healthcare provider.
• tell your doctor if you have stomach pain, nausea, vomiting, or a sudden change in bowel movements lasting more than 2 weeks.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking senna, call your doctor.
• talk to your doctor about the risks and benefits of taking senna if you are 65 years of age or older. Older adults should not usually take senna products over a long period of time because they are not as safe as other medications that can be used to treat the same condition.

A regular diet and exercise program is important for regular bowel function. Eat a high-fiber diet and drink plenty of liquids (eight glasses) each day as recommended by your doctor.

This medication usually is taken as needed. If your doctor has told you to take senna regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Senna may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• brown discoloration of urine
• faintness
• stomach discomfort
• nausea
• stomach cramps

Some side effects can be serious. If you experience this symptom, stop taking senna and call your doctor immediately:

• rectal bleeding

Senna may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Ask your pharmacist any questions you have about senna.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Black Draught^®
• Ex-Lax^®
• Fletcher's Castoria^®
• Nature's Remedy^®
• Perdiem Overnight Relief^®
• Senexon^®
• Senna X-Prep^®
• Senokot^®

• Correctol 50 Plus^® (containing Docusate, Sennosides)
• Ex-Lax Gentle Strength^® (containing Docusate, Sennosides)
• Gentlax S^® (containing Docusate, Sennosides)
• Peri-Colace^® (containing Docusate, Sennosides)
• Senokot S^® (containing Docusate, Sennosides)

• sennosides