Senna

Senna is a plant used in traditional Chinese medicine and Ayurvedic medicine. The leaves are used to make a stimulant laxative that increases the frequency of bowel movements and relieves constipation. It is widely used in over-the-counter laxatives. Latin name: Senna alexandrina.

Information about Senna

Senna is a popular herbal laxative that is available without prescription. 

Liver safety of Senna

Senna is generally safe and well tolerated, but can cause adverse events including clinically apparent liver injury when used in high doses for longer than recommended periods.  

Mechanism of action of Senna

Senna belongs to a large genus of flowering plants found throughout the tropics, commonly used species being Cassia acutifolio (Alexandrian senna) and C. angustifolio (Indian or Tinnevelly senna).  Extracts of the leaves, flowers and fruit of senna have been used for centuries in folk medicine as a laxative and stimulant.  Senna is also included in several herbal teas, used for purging and in weight loss.  The active components in senna extracts are anthraquinone derivatives and their glucosides, referred to as senna glycosides or sennosides.  They appear to act as a local irritant on the colon, which promotes peristalsis and evacuation.  Senna may also enhance intestinal fluid accumulation and increase the moisture content of stool by inhibiting electrolyte and water reabsorption from the colon.  Senna is minimally absorbed. 

Clinical use of Senna

Senna is used in many over-the-counter laxatives in combination with other agents under trade names such as Ex-lax, Fletcher’s Castoria and Senokot.  The typical dose is 15 to 30 mg of sennosides twice a day, but is recommended for short term use only (less than one week). 

Side effects of Senna

Side effects include abdominal cramps and electrolyte imbalance.  Long term use or abuse can lead to “cathartic” colon with diarrhea, cramps, weight loss and darkened pigmentation of the colonic mucosa.

Herbal and dietary supplements

• Aloe Vera, Ashwagandha, Astragalus, Bilberry, Black Cohosh, Butterbur, Cat's Claw, Cascara, Chaparral, Comfrey, Crofelemer, Echinacea, Ephedra, Fenugreek, Flavocoxid, Garcinia cambogia, Germander, Ginkgo, Ginseng, Greater Celandine, Green Tea, Hoodia, Hops, Horse Chestnut, Hyssop, Kava Kava, Kratom, Lavender, Maca, Margosa Oil, Melatonin, Milk Thistle, Noni, Passionflower, Pennyroyal Oil, Red Yeast Rice, Resveratrol, Saw Palmetto, Senna, Skullcap, Spirulina, St. John's Wort, Turmeric, Usnic Acid, Valerian, Yohimbine

Chinese and Other Asian Herbal Medicines

• Ba Jiao Lian, Bol Gol Zhee, Chi R Yun, Jin Bu Huan, Ma Huang, Sho Saiko To and Dai Saiko To, Shou Wu Pian

Multi-Ingredient Nutritional Supplements

• Herbalife, Hydroxycut, Move Free, OxyELITE Pro, SLIMQUICK

See also Nutritional supplements
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Articles on Senna

• UpToDate on Senna
• NIH NLH drug info on Senna

Learn more about Senna

• Dailymed label info on Senna
• Scientific articles on Senna