Drug Detail:Fletchers castoria (Senna [ sen-nah ])
Drug Class: Laxatives
Usual Adult Dose for Constipation - Acute
ORAL:
Liquid (8.8 mg/5 mL): 10 to 15 mL orally once a day
- Maximum dose: 30 mL/day
Senna Leaves: 5 to 15 mL orally once a day to 2 times a day as needed OR as directed
Sennoside Extract Tea: 23 mg (approximately 5 mL [1 rounded teaspoon]) per cup orally once a day
Tablets:
Sennosides 8.6 mg: 2 tablets orally once a day at bedtime
- Maximum dose: 8 tablets/day
Sennosides 15 mg: 2 tablets orally once a day to 2 times a day
Sennosides 17.2 mg: 1 tablet orally once a day at bedtime
- Maximum dose: 4 tablets/day
Sennosides 20 mg: 1 tablet orally once a day
Sennosides 25 mg: 2 tablets orally once a day to 2 times a day
Duration of therapy: Up to 1 week
Comments:
- Tea and oral liquid formulations are recommended to be given at night.
- This drug usually produces effects within 6 to 12 hours.
Use: For relief of occasional constipation/irregularity
Usual Adult Dose for Constipation
ORAL:
Liquid (8.8 mg/5 mL): 10 to 15 mL orally once a day
- Maximum dose: 30 mL/day
Senna Leaves: 5 to 15 mL orally once a day to 2 times a day as needed OR as directed
Sennoside Extract Tea: 23 mg (approximately 5 mL [1 rounded teaspoon]) per cup orally once a day
Tablets:
Sennosides 8.6 mg: 2 tablets orally once a day at bedtime
- Maximum dose: 8 tablets/day
Sennosides 15 mg: 2 tablets orally once a day to 2 times a day
Sennosides 17.2 mg: 1 tablet orally once a day at bedtime
- Maximum dose: 4 tablets/day
Sennosides 20 mg: 1 tablet orally once a day
Sennosides 25 mg: 2 tablets orally once a day to 2 times a day
Duration of therapy: Up to 1 week
Comments:
- Tea and oral liquid formulations are recommended to be given at night.
- This drug usually produces effects within 6 to 12 hours.
Use: For relief of occasional constipation/irregularity
Usual Pediatric Dose for Constipation - Acute
ORAL:
Liquid (8.8 mg/5 mL):
2 to less than 6 years: 2.5 to 3.75 mL orally once a day
- Maximum dose: 7.5 mL/day
- Maximum dose: 15 mL/day
- Maximum dose: 30 mL/day
Senna Leaves:
12 years and older: 5 to 15 mL orally once a day to 2 times a day as needed OR as directed
Sennoside Extract Tea:
6 years and older: 23 mg (approximately 5 mL [1 rounded teaspoon]) per cup orally once a day
Tablets:
Sennosides 8.6 mg:
2 to less than 6 years: 0.5 tablet orally once a day at bedtime
- Maximum dose: 2 tablets/day
- Maximum dose: 4 tablets/day
- Maximum dose: 8 tablets/day
Sennosides 15 mg:
6 to less than 12 years: 1 tablet orally once a day to 2 times a day
12 years and older: 2 tablets orally once a day to 2 times a day
Sennosides 17.2 mg:
6 to less than 12 years: 0.5 tablet orally once a day at bedtime
- Maximum dose: 2 tablets/day
- Maximum dose: 4 tablets/day
Sennosides 20 mg:
12 years and older: 1 tablet orally once a day
Sennosides 25 mg:
6 to less than 12 years: 1 tablet orally once a day to 2 times a day
12 years and older: 2 tablets orally once a day to 2 times a day
Duration of therapy: Up to 1 week
Comments:
- Tea and oral liquid formulations are recommended to be given at night.
- This drug usually produces effects within 6 to 12 hours.
Use: For relief of occasional constipation/irregularity
Usual Pediatric Dose for Constipation
ORAL:
Liquid (8.8 mg/5 mL):
2 to less than 6 years: 2.5 to 3.75 mL orally once a day
- Maximum dose: 7.5 mL/day
- Maximum dose: 15 mL/day
- Maximum dose: 30 mL/day
Senna Leaves:
12 years and older: 5 to 15 mL orally once a day to 2 times a day as needed OR as directed
Sennoside Extract Tea:
6 years and older: 23 mg (approximately 5 mL [1 rounded teaspoon]) per cup orally once a day
Tablets:
Sennosides 8.6 mg:
2 to less than 6 years: 0.5 tablet orally once a day at bedtime
- Maximum dose: 2 tablets/day
- Maximum dose: 4 tablets/day
- Maximum dose: 8 tablets/day
Sennosides 15 mg:
6 to less than 12 years: 1 tablet orally once a day to 2 times a day
12 years and older: 2 tablets orally once a day to 2 times a day
Sennosides 17.2 mg:
6 to less than 12 years: 0.5 tablet orally once a day at bedtime
- Maximum dose: 2 tablets/day
- Maximum dose: 4 tablets/day
Sennosides 20 mg:
12 years and older: 1 tablet orally once a day
Sennosides 25 mg:
6 to less than 12 years: 1 tablet orally once a day to 2 times a day
12 years and older: 2 tablets orally once a day to 2 times a day
Duration of therapy: Up to 1 week
Comments:
- Tea and oral liquid formulations are recommended to be given at night.
- This drug usually produces effects within 6 to 12 hours.
Use: For relief of occasional constipation/irregularity
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Precautions
CONTRAINDICATIONS:
- Patients with abdominal pain, nausea, or vomiting unless otherwise directed
Safety and efficacy of 8.6 mg tablet formulations have not been established in patients younger than 2 years.
Safety and efficacy of other tablet formulations and tea have not been established in patients younger than 6 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Patients should drink plenty of water during treatment.
- Single doses should be taken at bedtime.
- Tablets should be swallowed whole with water, and without breaking, chewing, or crushing.
- Honey or lemon may be added to teas to taste.
Storage requirements:
- Oral liquid: Protect from excessive heat (e.g., above 30C)
- Oral syrup: Protect from freezing
- Tablets: Protect from excessive heat (e.g., above 30C); store in original packaging
- Tea: Protect from heat and moisture
Reconstitution/preparation techniques:
- Teas should be prepared with cold or lukewarm waster and should be stirred.
- Senna leaves (tea): The manufacturer product information should be consulted.
General:
- LIMITATION OF USE: This drug should be used as a short-term treatment to establish bowel activity; indefinite use and/or with excessive doses should be avoided.
Patient advice:
- Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
- Patients should be instructed to avoid using products if the tamper evident feature(s) are torn, broken, and/or missing.
Frequently asked questions
- Which drugs cause opioid-induced constipation?
