Senokot

Sen·o·kot (sn-kt)

An over-the-counter laxative containing senna.

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senna, sennosides

Argoral (CA), Black Draught, Ex-Lax Gentle, Fletcher's, Maximum Relief Ex-Lax, Senexon, Senna-Gen, Sennatural, Senokot, Senokot Granules, SenokotXTRA, Senolax, Sure-Lax (UK), Uni-Senna, X-Prep Liquid (CA)

Pharmacologic class: Anthraquinone laxative

Therapeutic class: Laxative (stimulant)

Pregnancy risk category C

Action

Causes local irritation in colon, which promotes peristalsis and bowel evacuation. Softens feces by increasing water and electrolytes in large intestine.

Availability

Granules: 15 mg/tsp

Liquid: 8.8 mg/5 ml, 25 mg/5 ml, 33.3 mg/ml (concentrate)

Tablets: 8.6 mg, 10 mg, 15 mg, 17 mg, 25 mg

Tablets (chewable): 15 mg

⊘Indications and dosages

➣ Acute constipation; preparation for bowel examination

Adults and children ages 12 and older: For acute constipation, 12 to 50 mg P.O. daily or b.i.d. For bowel preparation, 105 to 157.5 mg (concentrate) 12 to 14 hours before scheduled procedure.

Children ages 6 to 11: 50% of adult dosage

Children ages 2 to 5: 33% of adult dosage

Contraindications

• Hypersensitivity to drug or its components
• GI bleeding or obstruction
• Suspected appendicitis or undiagnosed abdominal pain
• Acute surgical abdomen
• Fecal impaction
• Inflammatory bowel disease (such as Crohn's disease)

Precautions

Use cautiously in:
• pregnant or breastfeeding patients
• children.

Administration

• Give with a full glass of cold water.
• To prepare patient for bowel examination, give 12 to 14 hours before procedure, followed by a clear liquid diet.

Route	Onset	Peak	Duration
P.O.	6-24 hr	Variable	Variable

Adverse reactions

GI: nausea, vomiting, diarrhea, abdominal cramps, nutrient malabsorption, yellow or yellowish-green feces, loss of normal bowel function (with excessive use), dark pigmentation of rectal mucosa (with long-term use), protein-losing enteropathy

GU: reddish-pink discoloration of alkaline urine, yellowish-brown discoloration of acidic urine

Metabolic: electrolyte imbalances (such as hypokalemia)

Other: laxative dependence (with long-term or excessive use)

Interactions

Drug-diagnostic tests. Calcium, potassium: decreased levels

Patient monitoring

• Assess bowel movements to determine laxative efficacy.
• In long-term use, monitor fluid balance, nutritional status, and electrolyte levels and watch for laxative dependence.

Patient teaching

• Tell patient using drug for constipation to take at bedtime with a glass of water.
• In long-term use, advise patient to watch for and report signs and symptoms of nutritional deficiencies and fluid and electrolyte imbalance.
• If patient will undergo bowel examination, advise him to take drug 12 to 14 hours before procedure, followed by a clear liquid diet.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the tests mentioned above.