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Monograph for senna leaf drug

Leaf drug name : Senna
: Photos of the flowering plant

Syn. : Cassia acutifolia , Cassia angustifolia , Indian senna ,

.Alexandrian senna or Senna alexandrina

Botanical origin : Senna leaf consists of dried leaflets of Senna

.alexandrina
Family Leguminosae , Subfamily Caesalpinoideae(Fabaceae)
.Habitat : Native to Egypt , India , KSA , Sudan and Somalia

: Active constituents
Anthraquinones : All anthraquinones in Senna are [1
Dianthrones (glycosides or aglycone). Dianthrone
glycosides are major A and B sennosides , with a smaller
.amount of C and D sennosides free anthraquinones
Carbohydrates : Pectose type , gives red stain with [2
(.Ruthium Red

Naphthalene glycosides : 6-hydroxymusizin glucoside and [3

.Tennevellin-6-glucoside
.Flavonoids : Derivatives of Kaempferol and isorhamnetin [4

Action of Senna : Stimulating laxative in colon due to the

.action of Sennosides and their active metabolites
Inhibits water and electrolyte absorption from large [1
intestine , leading to increasing the volume and pressure of
the intestine content and increasing the motility of the
.colon
Stimulation of mucus and active chloride secretion which [2
results in increasing the concentration of water and
.electrolytes in the colon
Irritation of the lining of the large intesting leading to [3
.prestalsis

: Uses

Short term use (not longer than 2 weeks) in occasional [1

.constipation
Provide soft stool for easy defecation in cases of Anal [2
.fissures , hemorroids or after recto-anal operations
For bowel evacuation before X-ray examinations or[3
diagnostic test of gastrointestinal area , or before and after
.abdominal surgery

: Adverse effects

Hypersenstivity is known to occur , discontinue use in such

.case
Abdominal discomfort such as colics, cramps and nausea.
.Use belladonna in such cases

Discoloration of urine , harmless but patient must be

warned before taking the drug. No diagnostic tests done
.during treatment

: Contraindications
Pregnancy and breastfeedingDo not use if you have abnormal constrictions of the gastrointestinal tract, potential or existing intestinal blockage,
atonic bowel, appendicitis, inflammatory colon disease such as
Crohn's disease or ulcerative colitis, abdominal pain of unknown
.origin, undiagnosed rectal bleeding
.Children under 12 years old-

: Interaction with other drugs

In cases of chronic use or abuse due to loss of potassium on
: prolonged use
.Cardiac glycosides (Digitalis) potentiates digitalis toxicity .Antic arrhythmic medication : potentiates arrhythmiaconcomitant use with other drugs inducing hypokalaemia suchas thiazide diuretics , corticosteroids or licorice root may
.aggravate electrolyte imbalance

: Pregnancy and lactation

.Senna should not be used during pregnancy and lactation

: Method of administration
.Liquid or solid forms of medication are exclusively for oral use

: Dosage

g dried leaflets or other preparations equivalent to 20 0.2 0.6

.30 mg hydroxyanthracene per day

Overdose : griping and severe diarrhea with consequent losses

of fluid and electrolytes. Treatment should be supportive with
generous amounts of fluid. Electrolytes, particularly potassium,
.should be monitored

: Special warning
Stimulant laxative products should not be used when abdominal
pain, nausea, or vomiting are present. Rectal bleeding or failure

to have a bowel movement after use of a laxative may indicate a

.serious condition
Long term use of stimulating laxatives should be avoided. Don't
.use for more than 1-2 weeks without medical advice

: References
.Botany and medicinal plants book , Clinical program
http://apps.who.int/medicinedocs/en/d/Js2200e/26.html
http://www.pharmacopeia.cn/v29240/usp29nf24s0_m74880.html
http://webprod.hc-sc.gc.ca/nhpid-bdipsn/monoReq.do?id=162