Senna dosage

Stimulant laxatives Bisacodyl, 5-15 mg daily. Senna, dosage varies, consult product labeling Correctol, Dulcolax, Ex-Lax, Senokot, various generic Stimulant laxative actions include direct irritation of intestinal mucosa or stimulation of the myenteric plexus, resulting in peristalsis. These agents may also cause alteration of fluid and electrolyte absorption, resulting in luminal fluid accumulation and bowel evacuation. 

Reduce the senna dosage to 1-2 tablets once daily initially (also check Mrs CR s current bowel habits if diarrhoea then senna should be stopped, ffowever, as Mrs CR will continue to receive opiate analgesia then it is likely that prophylactic laxative therapy will need to be continued, due to opiates causing constipation in almost all patients). Monitor Mrs CR s bowel habits during her inpatient stay in order to ensure the appropriateness of the laxative therapy. 

SENNOSIDES The following dosages are for senna concentrate only. For other forms of senna, consult labeling. Dosages are different. 

Anthraquinone derivatives (e.g., cascara, aloe, senna, and rhubarb) are among the oldest laxatives known. They act on the colon rather than on the ileum and produce evacuation 8 to 10 hours after administration. This makes them particularly suitable for dosage overnight. Cascara sagrada is one of the mildest of the anthraquinone-containing laxatives. 

This may be due to liver capsular pain from liver metastases. Mrs CR s abnormal liver function tests may indicate this. If metastatic cancer has spread to her liver, the resultant disease within the liver capsule may cause pain. Another possible cause could be the high dosage of senna that she is taking (8 tablets a day) -excessive dosages of stimulant laxatives such as senna can cause abdominal cramp and pain due to their effect of increasing intestinal motility. 

Senna is widely used in fairly low doses without serious problems it has also been used in a very high dosage form to clear the colon before radiological examination. In this form it is generally well tolerated, but it should not be used if there is any predisposition to colonic rupture. 

Herbal medicines or teas often contain senna, which may produce diarrhea. In patients with disease persistence following dietary modification, loperamide may be used for episodic management of urgent diarrhea, or in situations in which the patient wishes to avoid the possibility of an acute onset of symptoms. This drug decreases intestinal transit, enhances water and electrolyte absorption, and strengthens rectal sphincter tone. Some patients may require continuous therapy, and careful dosage titration can usually be undertaken to prevent the development of constipation. Cholestyramine may be useful in patients with diarrhea related to idiopathic bile acid malabsorption or following cholecystectomy. ... 

Senna fruit or leaf containing the following dose of the compounds sennosides A and B Adults and children 12 years of age and over, oral dosage is 12-50 mg of sennosides once or twice daily children 6 to under 12 years of age, oral dosage is 6-25 mg of sennosides once or twice daily children 2 to under 6 years of age, oral dosage is 3-12.5 mg of sennosides once or twice daily (FDA 1985). 

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