senna/docusate

Senna/docusate is an over-the-counter (OTC) stimulant laxative and stool softener used to treat occasional constipation. Senna/docusate is a combination of senna and docusate, both laxatives that work in different ways to promote bowel movement.

Senna stimulates intestinal contractions that move the bowel contents, while docusate softens the stool, making it easier to pass.

The senna component of the medication contains sennosides, compounds extracted from the leaves or fruits of the plant Senna alexandrina. Sennosides irritate the intestinal lining stimulating peristalsis, a series of contractions by which intestines propel their contents, resulting in bowel movement.

Docusate is a surfactant/detergent that softens the stool by reducing the surface tension of the oil-water interface in the stool, which increases the absorption of water and fat into the stool. Studies indicate that docusate may also stimulate the secretion of water, sodium, chloride, and potassium and inhibit the absorption of bicarbonate and glucose in the small intestine, allowing the bowel contents to retain more fluid.

• Do not use senna/docusate in the following conditions:
  • Hypersensitivity to senna, sennosides, docusate or any of the components in the formulation
  • Fecal impaction
  • Inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease
  • Gastrointestinal (GI) obstruction or perforation
  • Symptoms of appendicitis or any other abdominal condition that requires immediate surgical intervention (acute surgical abdomen)
  • GI bleeding
  • Rectal bleeding
• Do not use senna/docusate concurrently with mineral oil.
• OTC use of senna/docusate is not recommended in children younger than 2 years of age.
• If you self-medicate with OTC senna/docusate, do not take for longer than a week.
• Long-term use of senna/docusate may cause finger clubbing.

Common side effects of senna/docusate include:

• Nausea
• Vomiting
• Abdominal cramps
• Diarrhea
• Red/brown urine discoloration

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Tablet

• 8.6 mg/50 mg

Constipation

Adult:

• 2-4 tablets orally once daily; may increase to 4 tablets every 12 hours

Pediatric:

• Children under 2 years: Safety and efficacy not established
• Children 2-6 years: One-half tablet orally once daily; may increase to maximum 1 tablet every 12 hours
• Children 6-12 years: One tablet orally once daily may increase as necessary; not to exceed 2 tabs every 12 hours
• Children over 12 years: 2-4 tablets orally once daily; may increase to 4 tablets every 12 hours

Overdose

• Most laxative overdoses in children are accidental, however, some people may take overdoses of laxatives to try to lose weight.
• Senna/docusate overdose may cause severe abdominal pain and/or cramping, persistent nausea, vomiting, diarrhea, and bloody stools, and may lead to dehydration and electrolyte imbalance, particularly in children.
• Overdose may be treated with fluid replenishment, and symptomatic and supportive care.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Senna/docusate has no listed severe interactions with other drugs.
• Serious interactions of senna/docusate include:
  • sodium sulfate/magnesium sulfate/potassium chloride
  • sodium sulfate/potassium sulfate/magnesium sulfate
  • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
• Moderate interactions of senna/docusate include:
  • deflazacort
  • dichlorphenamide
  • digoxin
  • lily of the valley
• Mild interactions of senna/docusate include:
  • mineral oil

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.

• Constipation during pregnancy should ideally be managed with moderate exercise and dietary intake of fiber and fluid. Use senna/docusate with caution only occasionally for short periods if you are pregnant, it can increase the risk for electrolyte imbalances. Use for prolonged periods during pregnancy is not recommended.
• It is not known if senna/docusate is present in breast milk, avoid use if you are breastfeeding.
• Check with your healthcare provider before taking any OTC product including senna/docusate if you are pregnant or breastfeeding.

• Senna/docusate is generally safe for occasional use in recommended doses in patients older than 2 years.
• Avoid chronic use of senna/docusate, it may lead to laxative dependence, and fluid and electrolyte imbalance.
• Do not take OTC senna/docusate if you have nausea, vomiting, stomach pain, or changes in bowel habits that persist for longer than 2 weeks.
• Do not use senna/docusate for longer than 1 week. If you do not have a bowel movement within a week or if you have diarrhea or rectal bleeding, discontinue and see your doctor.
• Keep senna out of reach of children.
• In case of overdose, get medical help or contact Poison Control Center.