Senna: Benefits, Dosage, Contraindications
Other name(s)
Senna alexandrina, Cassia angustifolia
Scientific name(s)
cassia angustifolia
Family or group:
Plants
Active ingredients:
Sennosides
Indications
Rating methodology
EFSA approval.
Constipation ✪✪✪✪✪
Senna is FDA approved as an over-the-counter medication for short-term treatment of constipation in adults and children from 2 years old. It is generally effective 6 to 10 hours after oral administration. Although senna is often compared to alternatives like mineral oil, lactulose in children, and psyllium, research indicates that senna combined with psyllium is particularly effective in increasing stool moisture more than psyllium alone. In the context of opioid or loperamide-induced constipation, senna is as effective as lactulose, psyllium, and docusate (a laxative). Research among specific populations, such as pediatric cancer patients on opioids, suggests senna may be more effective than docusate, polyethylene glycol, and lactulose in preventing constipation. A small study in middle-aged adults with chronic idiopathic constipation demonstrated that 500 mg of senna taken twice daily for 4 weeks was as effective as 500 mg of magnesium oxide taken three times a day. The EMA and ESCOP recommend short-term use of senna to treat occasional constipation. Senna is generally used at a rate of 15 mg of sennosides, once a day. The maximum dose is 30 mg of sennosides per day.
Posologie
Synergies
Senna Versus Magnesium Oxide for the Treatment of Chronic Constipation: A Randomized, Placebo-Controlled Trial
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
European Union herbal monograph on Senna alexandrina Mill. (Cassia senna L.; Cassia angustifolia Vahl) 1, folium
Properties
Laxative
Senna is used as a stimulant laxative due to its sennosides contained in its leaves and fruit. It acts selectively on the nerve plexus of smooth intestinal muscles, increasing colonic motility and accelerating transit. This laxative effect generally occurs between 6 to 10 hours after ingestion. Proposed mechanisms also include modulation of prostaglandins and serotonin in the colon.
Usages associés
Safety dosage
Adult from 18 years: 15 mg - 30 mg (standardized extract in sennosides)
In the context of using senna to treat occasional constipation, the recommended dosage for adults and children over 10 years is to take preparations equivalent to 15-30 mg of sennosides once a day, preferably in the evening. Elderly individuals can follow the same dosage as adults.
Child from 10 to 18 years: 15 mg - 30 mg (standardized extract in sennosides)
It is important to note that the use of senna is not recommended for children under 10 years old.
Pregnant women: 15 mg - 30 mg (standardized extract in sennosides)
For pregnant women, the oral and appropriate short-term use of senna is considered safe. However, long-term, frequent, or high-dose use can be potentially dangerous, being associated with severe side effects such as laxative dependency and liver toxicity.
Breastfeeding women: 15 mg - 30 mg (standardized extract in sennosides)
During breastfeeding, the oral and appropriate short-term use of senna is also considered safe. Although small amounts of senna components pass into breast milk, it has been taken during breastfeeding without apparent problems for babies. Senna does not cause changes in the frequency or consistency of infant stools.
Interactions
Médicaments
Estrogens: moderate interaction
Some preliminary clinical data suggest that senna reduces the absorption of estradiol by reducing intestinal transit time.