Senna

Stimulant Laxative·Gastrointestinal - Laxatives

Opioid-induced constipation, acute severe constipation

STIMULANTSenokot, Coloxyl with Senna (combo)7.5 mg tabletUNSCHEDULEDTGA

Max Dose

4 tabs/day

Onset

6-12 h

Cramping

COMMON

Melanosis Coli

CHRONIC USE

Rapid Summary

Overview

Plant-based anthraquinone stimulant laxative. Directly irritates the bowel to force peristalsis. The ultimate 'push' laxative.

Maximum Dose

Max 4 tablets/day.

Clinical Focus

Indispensable for opioid-induced constipation. Must be given at night so the bowel moves in the morning.

Bottom Line

Senna is a cheap and effective stimulant laxative for opioid-induced and simple constipation, but causes abdominal cramping and should not be used long-term due to dependence risk.

Formulation & Access

Brand Names

Senokot, Coloxyl with Senna (combo)

Oral Routes

Tablets (7.5 mg sennosides).

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Opioid-induced constipation, acute severe constipation.

Clinical Place

Opioids paralyze the gut. You cannot just use a softener; you MUST use a stimulant (Senna) to force the paralyzed bowel to move.

Quick reference

Class & Role

Stimulant Laxative — Plant-based anthraquinone stimulant laxative.

Route / Formulation

Tablets (7.5 mg sennosides). (Senokot, Coloxyl with Senna (combo))

Usual Dose & Max

PO 2-4 tablets NOCTE (often prescribed alongside Docusate as Coloxyl & Senna). Max 4 tablets/day.

Best Uses

Senna is a cheap and effective stimulant laxative for opioid-induced and simple constipation, but causes abdominal cramping and should not be used long-term due to dependence risk.

Avoid / Cautions

Intestinal obstruction, undiagnosed severe abdominal pain, inflammatory bowel disease flares. Pregnancy Category A, but strong stimulants can theoretically trigger uterine contractions. Osmotics (Lactulose/Movicol) are preferred.

Key Risks

Gastrointestinal: Severe abdominal cramping, griping pain, explosive diarrhea. Other: Melanosis coli (benign, harmless black/brown pigmentation of the colon lining seen on endoscopy after chronic use). Metabolic: Hypokalemia (due to chronic diarrhea/abuse).

Key Interactions

Minimal direct interactions, but chronic diarrhea can deplete potassium, increasing Digoxin toxicity risk.

Monitoring

Monitor bowel chart. Cease once bowels are opening smoothly to prevent griping pain.

Clinical Pearl

Docusate is the 'Mush' (softens stool). Senna is the 'Push' (forces it out). The combination is the gold standard for opioid constipation.

Access

Senokot, Coloxyl with Senna (combo)7.5 mg tablet

Brand: Senokot, Coloxyl with Senna (combo)
Formulation: Tablets (7

Senna

Stimulant Laxative·Gastrointestinal - Laxatives

Opioid-induced constipation, acute severe constipation

STIMULANTSenokot, Coloxyl with Senna (combo)7.5 mg tabletUNSCHEDULEDTGA

Max Dose

4 tabs/day

Onset

6-12 h

Cramping

COMMON

Melanosis Coli

CHRONIC USE

Rapid Summary

Overview

Plant-based anthraquinone stimulant laxative. Directly irritates the bowel to force peristalsis. The ultimate 'push' laxative.

Maximum Dose

Max 4 tablets/day.

Clinical Focus

Indispensable for opioid-induced constipation. Must be given at night so the bowel moves in the morning.

Bottom Line

Senna is a cheap and effective stimulant laxative for opioid-induced and simple constipation, but causes abdominal cramping and should not be used long-term due to dependence risk.

Formulation & Access

Brand Names

Senokot, Coloxyl with Senna (combo)

Oral Routes

Tablets (7.5 mg sennosides).

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Opioid-induced constipation, acute severe constipation.

Clinical Place

Opioids paralyze the gut. You cannot just use a softener; you MUST use a stimulant (Senna) to force the paralyzed bowel to move.

Quick reference

Class & Role

Stimulant Laxative — Plant-based anthraquinone stimulant laxative.

Route / Formulation

Tablets (7.5 mg sennosides). (Senokot, Coloxyl with Senna (combo))

Usual Dose & Max

PO 2-4 tablets NOCTE (often prescribed alongside Docusate as Coloxyl & Senna). Max 4 tablets/day.

Best Uses

Senna is a cheap and effective stimulant laxative for opioid-induced and simple constipation, but causes abdominal cramping and should not be used long-term due to dependence risk.

Avoid / Cautions

Key Risks

Key Interactions

Minimal direct interactions, but chronic diarrhea can deplete potassium, increasing Digoxin toxicity risk.

Monitoring

Monitor bowel chart. Cease once bowels are opening smoothly to prevent griping pain.

Clinical Pearl

Docusate is the 'Mush' (softens stool). Senna is the 'Push' (forces it out). The combination is the gold standard for opioid constipation.

Access

Senokot, Coloxyl with Senna (combo)7.5 mg tablet

Brand: Senokot, Coloxyl with Senna (combo)
Formulation: Tablets (7