Senna: benefits, side effects, dosages and interactions


The herb senna has been used for thousands of years to combat constipation. It is approved by the FDA as an over-the-counter stimulant laxative to treat constipation or to cleanse the intestines before surgery or gastrointestinal diagnostic tests.

Senna's active agents are sennosides, a plant compound from the anthraquinone family. Sennosides act by irritating the intestinal mucosa, creating a strong laxative effect. When taken orally, senna generally causes a bowel movement in 6-12 hours, but when taken rectally, it can be effective in as little as 10 minutes.

Also know as

  • Sennoside
  • Senna glycoside
  • Cassia senna
Get Medication Information / Gary Foerster

Health benefits

Senna is considered effective for the short-term treatment of constipation in adults and children. The herb is also indicated for the treatment of anal fissures and hemorrhoids, as well as for weight loss, although the amount of research supporting these claims is limited.

Constipation in adults

Senna is effective for treating constipation in adults when used alone or in combination with psyllium or docusate sodium, according to the National Institutes of Health (NIH).

Constipation in the elderly

In older patients, senna, used with psyllium or docusate sodium, is effective for treating ongoing constipation, according to the NIH.

Constipation in children

Natural laxatives are often prescribed for children. A 2018 literature review and analysis published in the Journal of Pediatric Surgery found that long-term use of senna appears to be safe for children with chronic constipation, although side effects such as diaper blistering can occur on contact. prolonged skin with stool. .

Opioid-related constipation

Constipation is a common side effect in people taking opioid pain relievers. Senna effectively treats constipation, as well as lactulose, psyllium and docusate sodium in opioid users, notes the NIH.

Preparing for a colonoscopy

Senna is often recommended for bowel prep before colonoscopy. According to the NIH, when used to cleanse the intestines, senna is most effective with polyethylene glycol, sodium picosulfate, or a combination of the three.

Possible side effects.

Senna side effects can include abdominal cramps and pain from muscle contractions, dark or discolored urine, electrolyte imbalances, nausea, skin rashes, and swelling of the face, lips, or tongue.

Long-term use of senna can cause a dark pigmentation in the colon called intestinal melanosis . In high doses and with prolonged use, senna can be toxic to the liver.

The American Herbal Products Association (AHPA) recommends stopping senna if you experience diarrhea or watery stools.

In children who can't go to the bathroom, senna use has been linked to blistering diaper rash, which can be serious. Health professionals recommend changing your baby's diaper immediately after defecation by taking senna and thoroughly cleaning the diaper area. If your baby develops a diaper rash with blisters or cracked skin, see your pediatrician.

Senna should not be used for more than seven days in a row, unless under the supervision of a doctor. Stop using it and call your doctor if you experience bloody diarrhea or prolonged abdominal pain after using senna.


Senna or other herbs containing anthraquinone should not be used by people with abdominal pain, diarrhea, diverticular disease, ulcerative colitis, Crohn's disease , severe hemorrhoids , blood vessel disease, congestive heart failure , heart disease, severe anemia, abdominal hernia , gastrointestinal cancer. , recent colon surgery, liver or kidney disease.

AHPA also recommends consulting a healthcare professional prior to use if you are pregnant or breastfeeding.

Senna can interact with medications called calcium channel blockers and the drug Indocin (indomethacin).

Dosage and preparation

Medicinal senna is obtained from the leaves and fruits of senna. Senna products made with fruit are milder than leafy products.

Senna comes in pill and liquid form, as well as in tea .

The dose depends on the age of the patient and why senna is used. Talk to your doctor to find the correct dose (and not exceed it).

Here are some general guidelines:

Adults Constipation 17.2 milligrams (mg) per day maximum: 34.4 mg twice daily
Adults (postpartum) Constipation 28 mg daily in two doses of 14 mg
Adults (older people) Constipation 17.2 mg per day
Adults Bowl preparation

75 mg of sennosides the day before the colonoscopy; maximum: 150 mg in one or two doses

Children (2 to 5 years) Constipation 1/2 tablet (4.3 mg of sennosides) per day; maximum: 1 tablet (8.6 mg sennosides) twice a day
Children (6-11 years) Constipation

1 tablet (8.6 mg of sennosides) per day; maximum: 2 tablets (17.2 mg sennosides) twice daily

Children (12 years +) Constipation

2 tablets (8.6 mg sennosides per tablet) once a day; maximum: 4 tablets (34.4 mg sennosides) twice daily

Other questions

Is it safe to take senna every day?
While the herb is generally considered safe and can be prescribed for daily use, prolonged use can raise concerns. Follow the advice of your healthcare professional.

Does Senna have a stomach ache?
Senna treats constipation by irritating the lining of the intestines, which stimulates the digestive tract to pass stool. Therefore, some people report abdominal cramps after taking senna, which disappear after a bowel movement is complete.

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