Senna SEN-a

What are other names for this remedy?

Type of medicine: natural remedy

Scientific and common names: Senna alexandrina, Cassia acutifolia, Cassia senna, Cassia angustifolia, Alexandrian senna, Indian senna, true senna

What is senna?

Senna is a low branching shrub that grows up to 3 feet tall. It has a straight woody stem and yellow flowers. The leaves and flowers are used medicinally.

What is it used for?

This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider. There may be other uses that are not listed below.

Senna has been used to treat constipation. It may also be used to cleanse the bowel before certain procedures.

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is it taken?

Senna leaves can be brewed and the tea used for its strong laxative effect. Tea made from the fruit instead of the leaves may have less of a laxative effect. It is often difficult to control the amount of active ingredients in the tea. For a more reliable effect, senna is available in standard dosage forms such as liquids, tablets, and powders. You can buy these laxative products without a prescription.

Follow the directions printed on the product label or given by your healthcare provider. Do not take more than recommended. If you need to take laxatives every day, or if you take them and have no results, check with your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Do not take senna if you have:

• appendicitis or stomach pain
• a blocked intestine, Crohn's disease, or ulcerative colitis
• diarrhea
• heart disease
• hemorrhoids
• problems with dehydration
• low levels of potassium in the blood

Do not use senna for more than 2 weeks. Longer use can cause dependence on laxatives. Using it for a long time can also cause low levels of electrolytes which can lead to heart problems and muscle weakness.

If you need emergency care, surgery, urine tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. Senna can change the color of your urine.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may have different strengths and effects. They may be contaminated.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Using too much senna can cause:

• stomach cramps, nausea, and diarrhea
• finger clubbing, which means your fingers and toes become broader and the nails get shiny (your fingers and toes return to normal when you stop taking senna)
• irregular heartbeat
• muscle weakness
• weight loss
• a need for the laxative in order to have bowel movements

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects. Before taking this remedy, talk to your healthcare provider if you are taking:

• digoxin (Lanoxin)
• diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• natural remedies such as aloe leaf, blackroot, butternut bark, cascara, horsetail, licorice, and rhubarb root
• other laxatives
• potassium supplements and salt substitutes
• warfarin (Coumadin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

Keep all natural remedies and medicines out of the reach of children.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.