The ß-linked glucosides ( sennosides ) are not absorbed in the upper gut ; they are converted by the bacteria of the large intestine into rhein anthrone (1,8 dihydroxyanthracene derivative which is the active metabolite) .There are two different mechanisms of action : (i) an influence on the motility of the large intestine (stimulation of peristaltic contractions and inhibition of local contractions) resulting in accelerated colonic transit , thus reducing fluid absorption , and (ii) an influence on secretion processes (stimulation of mucus and active chloride secretion) resulting in enhanced fluid secretion.
550mg senna leaf and extract ( equivalent to 15 mg sennoside B )
Foeniculum vulgare oil : 3 mg
ADMINISTRATION AND DOSAGE
The average dose is 15 to 40 mg sennosides
As a Laxative :
Adults & children 12 years of age and over should take one to two tablets daily .
Children 10 to 12 years of age administer ½ dose . Children 2 to 10 years of age should take C-Lax syrup.
As a Purgative : 2-3 tablets before bedtime With a plenty of water .
There is an interaction with cardiac glycosides and Anti arrhythmic agents.
It can cause abdominal spasms & pain , yellow or red-brown discoloration of urine , which is not clinically significant.
CONTRAINDICATIONS & PRECAUTIONS
As for all laxatives , it should not be given in cases of : abdominal pain (with unknown reson) , intestinal obstruction , acute inflammatory intestinal diseases or appendicitis .
It is contraindicated under 2 years old.
PREGNANCY AND LACTATION
Avoid during pregnancy . It is not recommended in lactation , as there are insufficient data.
If laxatives are needed every day the cause of the constipation should be investigated . Use for more than 2 weeks requires medical supervision . Intake of anthranoid-containing laxatives for more than a short time may result in aggravation of constipation or possible need for increased dosages.
Defection takes place after a delay of 8-12 hours due to the time taken for transport to the colon & metabolization into the active compound .
Store below 30˚C and protect from moisture and light.
1) PDR for herbal medicines (2005), 726 – 727.
2) European Scientific Cooperative on Phytotherapy (E/S/C/O/P monographs), (2003), 456-458.
3) Remington’s pharmaceutical sciences (1990), 785-6.
4)Martindale, the complete drug reference (2002), 1248-1249.