However, senna may be used in select situations. Additional data may be necessary to further define the role of senna as an adjunct in colonic cleansing before colonoscopy.īased on the recommendations for Optimizing Adequacy of Bowel Cleansing for Colonoscopy, the US Multi-Society Task Force on Colorectal Cancer by the American College of Gastroenterology, American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy, the use of adjunctive agents for precolonoscopy cleansing of the mucosa such as simethicone, flavored electrolyte solutions (eg, Gatorade), prokinetics, spasmolytics, bisacodyl, senna, olive oil, and probiotics is not recommended for routine use since none have consistently shown improved efficacy, safety, or tolerability of the bowel preparation. While the advantage of a lower amount of PEG solution with the use of senna is tolerated better by patients, the lower volumes of PEG solution may reduce the quality of the bowel preparation as was seen in one randomized controlled trial Hookey 2006. Oral: Within 6 to 24 hours Use: Labeled IndicationsĬonstipation: Relieves occasional constipation (irregularity) generally causes bowel movement in 6 to 12 hours Use: Off LabelĬolonic cleansing before colonoscopy (adjunct)cĭata from one uncontrolled study evaluating the use of senna as an adjunct to reduce the amount of polyethylene glycol (PEG) solution necessary suggests that the use of senna as an adjunct in this setting may be beneficial Iida 1992. Pharmacokinetics/Pharmacodynamics Metabolism Stimulant laxatives typically induce defecation by stimulating peristaltic activity on the intestine by direct action on intestinal mucosa or nerve plexus, therefore increasing motility. The anthraquinone group of stimulant laxatives includes the plant-derived agents such as senna. Excipient information presented when available (limited, particularly for generics) consult specific product labeling.
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