Natural Vegetable Laxative (senna/fennel)
Stimulant Laxatives Oral Tablet
Last reviewed · Source: First Databank (FDB) drug data
Overview
The anthraquinone group of stimulant laxatives includes the plant-derived compounds aloe (preparations containing aloe are no longer commercially available in the US), cascara sagrada (preparations containing cascara sagrada are no longer commercially available in the US), frangula, and senna.
Generic name: senna/fennel
Drug class: Stimulant Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Natural Vegetable Laxative
Indications
No indications are available for this drug.
Dosing
No dosing information is available for this tab.
Anthraquinone laxatives are administered orally, usually in a single dose at bedtime.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
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Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
Stimulant Laxatives/Selected Bowel Preparations
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Osmotic laxatives and stimulant laxatives may have additive adverse effects.(1)
CLINICAL EFFECTS: Concurrent use of stimulant laxatives and Sutab tablets (sodium sulfate, magnesium sulfate, and potassium chloride) may increase the risk of mucosal ulceration, ischemic colitis, gastric ulcerations, or gastritis.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The manufacturer of Sutab tablets (sodium sulfate, magnesium sulfate and potassium chloride) recommends avoiding the use of stimulant laxatives while using this bowel preparation product.(1)
DISCUSSION: Osmotic laxative products may produce colonic mucosal aphthous ulcerations which reports have shown can lead to ischemic colitis requiring hospitalization. Using stimulant laxatives in addition may increase this risk.(1)
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Laxatives/Trofinetide
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Trofinetide commonly causes diarrhea of mild to moderate severity. Laxatives may increase the incidence or severity of diarrhea.(1)
CLINICAL EFFECTS: Concurrent use of laxatives with trofinetide may increase the risk of severe diarrhea.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Patients should stop laxatives before starting trofinetide. If diarrhea occurs, consider anti-diarrheal treatment and monitor hydration status. If severe diarrhea or dehydration occurs, interrupt, reduce dose, or discontinue trofinetide.(1)
DISCUSSION: In clinical trials, 85% of patients on trofinetide developed diarrhea. Concurrent use of laxatives may increase this risk.(1)
Laxatives; Stool Softeners/Tenapanor
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Tenapanor commonly causes diarrhea of mild to moderate severity. Laxatives and stool softeners may increase the incidence or severity of diarrhea.(1)
CLINICAL EFFECTS: Concurrent use of laxatives or stool softeners with tenapanor may increase the risk of severe diarrhea.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of tenapanor states that patients should be instructed to avoid stool softeners and laxatives with tenapanor. If severe diarrhea occurs, tenapanor should be discontinued.(1)
DISCUSSION: In clinical trials, 43-53% of CKD patients on dialysis treated with tenapanor developed diarrhea. Diarrhea usually occurred soon after treatment initiation and was severe in 5% of patients.(1)
There are no moderate interactions for this drug.
Contraindications
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- Appendicitis
- Gastrointestinal obstruction
- Gastrointestinal perforation
- Toxic colitis
- Toxic megacolon
- Inflammatory bowel disease
- Fecal incontinence
Adverse reactions
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Rare or Very Rare
- Hypocalcemia
- Hypokalemia
- Metabolic acidosis
- Metabolic alkalosis
- Proteinuria
- Tetany
More Frequent
- Abdominal pain with cramps
Less Frequent
- Diarrhea
- Eructation
- Nausea
Rare or Very Rare
- Allergic dermatitis
- Arthritis
- Cachexia
- Hematuria
- Melanosis of colon
- Osteomalacia
- Pruritus of skin
- Skin rash
- Urine discoloration
- Urticaria
Precautions
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No enhanced messaging available.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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