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{{Short description|Constipation and surgery medication}} |
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{{Use dmy dates|date=December 2021}} |
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{{cs1 config |name-list-style=vanc |display-authors=6}} |
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{{Drugbox |
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{{Drugbox |
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| Verifiedfields = changed |
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| verifiedrevid = 447981195 |
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| verifiedrevid = 448895765 |
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| IUPAC_name = |
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| image = |
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| image = Sennoside.png |
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| width = |
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| alt = |
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| caption = |
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<!--Clinical data--> |
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<!-- Clinical data --> |
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| tradename = |
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| tradename = Ex-Lax, Senokot, others<ref name=AHFS2015/> |
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| Drugs.com = {{drugs.com|MTM|senna_glycosides}} |
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| Drugs.com = {{drugs.com|monograph|senna}} |
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| MedlinePlus = a601112 |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_US = <!-- A / B / C / D / X --> |
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| DailyMedID = Senna |
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| pregnancy_AU = A |
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| pregnancy_category = |
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| pregnancy_AU_comment = <ref>{{cite web|url=https://www.tga.gov.au/products/medicines/find-information-about-medicine/prescribing-medicines-pregnancy-database|title=Prescribing medicines in pregnancy database |website=Therapeutic Goods Administration (TGA)|publisher=Australian Government, Department of Health and Aged Care}}</ref> |
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| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 --> |
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| pregnancy_category = |
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| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| routes_of_administration = ], ] |
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| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C --> |
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| ATC_prefix = A06 |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| ATC_suffix = AB06 |
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| legal_status = |
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| routes_of_administration = |
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| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII --> |
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<!--Pharmacokinetic data--> |
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| legal_UK = P<!-- GSL / P / POM / CD / Class A, B, C --> |
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| bioavailability = |
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| legal_US = OTC |
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| protein_bound = |
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| metabolism = |
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| legal_US_comment = |
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| legal_status = OTC |
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| elimination_half-life = |
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| excretion = |
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<!--Identifiers--> |
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<!-- Pharmacokinetic data --> |
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| CAS_number = |
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| bioavailability = |
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| protein_bound = |
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| ATC_prefix = A06 |
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| metabolism = |
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| ATC_suffix = AB06 |
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| onset = Minutes (by rectum), 6 to 12 hours (by mouth)<ref name=Nav2010/> |
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| PubChem = |
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| elimination_half-life = |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank = |
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| duration_of_action = |
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| excretion = |
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<!--Chemical data--> |
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<!-- Identifiers --> |
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| CAS_number_Ref = {{cascite|correct|??}} |
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| chemical_formula = |
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| CAS_number = 66575-30-2 |
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| PubChem = 5199 |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank = DB11365 |
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| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} |
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| ChemSpiderID = 65892 |
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| KEGG = D02171 |
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<!-- Chemical data --> |
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| molecular_weight = |
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| IUPAC_name = 9-oxy-9H-anthracen-9-yl]-4-hydroxy-10-oxo-5-oxy-9H-anthracene-2-carboxylic acid |
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| C = 42 | H = 38 | O = 20 |
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| chemical_formula_ref = <ref>{{cite web|title=Senna(Powdered)|url=https://pubchem.ncbi.nlm.nih.gov/compound/171194| work = PubChem | publisher = U.S. National Library of Medicine }}</ref> |
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}} |
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}} |
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<!-- Definition and uses --> |
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'''Senna glycosides''' or '''sennosides''' are a number of ] derivatives useful as a ]. They are ]ic ]s named after their abundant occurrence in ]s of the ] '']''. |
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'''Senna glycoside''', also known as '''sennoside''' or '''senna''', is a ] used to treat ] and empty the ] before surgery.<ref name=AHFS2015>{{cite web|author1=American Society of Health-System Pharmacists|title=Senna|url=https://www.drugs.com/monograph/senna.html| work = Drugs.com|access-date=11 August 2015|date=1 January 2008|url-status=live|archive-url=https://web.archive.org/web/20150906045617/http://www.drugs.com/monograph/senna.html|archive-date=6 September 2015}}</ref><ref name="Wald2016"/> The medication is taken ] or via the ].<ref name=AHFS2015/><ref name=Ham2010/> It typically begins working in around 30 minutes when given by rectum and within twelve hours when given by mouth.<ref name=Nav2010/> It is a weaker laxative than ] and ].<ref name=AHFS2015/> |
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<!-- Adverse effects and mechanism --> |
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Senna is on the ]'s ]. |
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Common side effects of senna glycoside include abdominal cramps.<ref name=Nav2010/> It is not recommended for long-term use, as it may result in poor bowel function or ].<ref name=AHFS2015/> While no harm has been found to result from use while breastfeeding, such use is not typically recommended.<ref name=AHFS2015/> It is not typically recommended in children.<ref name=AHFS2015/> Senna may change urine to a somewhat reddish color.<ref name=AHFS2015/> Senna derivatives are a type of ] and are of the ] type.<ref name=AHFS2015/> While its mechanism of action is not entirely clear, senna is thought to act by increasing fluid secretion within and contraction of the large intestine.<ref name=AHFS2015/> |
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<!-- Society and culture --> |
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Sennosides come from the group of plants '']''.<ref name=Nav2010>{{cite book| vauthors = Navti P |title=Pharmacology for pharmacy and the health sciences : a patient-centred approach|date=2010|publisher=Oxford University Press|location=Oxford|isbn=9780199559824|page=337|url=https://books.google.com/books?id=KVicAQAAQBAJ&pg=PA337|url-status=live|archive-url=https://web.archive.org/web/20160305023955/https://books.google.ca/books?id=KVicAQAAQBAJ&pg=PA337|archive-date=5 March 2016}}</ref> In plant form, it has been used at least since the 700s AD.<ref>{{cite book| vauthors = Khare CP |title=Indian Herbal Remedies Rational Western Therapy, Ayurvedic and Other Traditional Usage, Botany|date=2004|publisher=Springer Berlin Heidelberg|location=Berlin, Heidelberg|isbn=9783642186592|page=133|url=https://books.google.com/books?id=njLtCAAAQBAJ&pg=PA133|url-status=live|archive-url=https://web.archive.org/web/20160305030839/https://books.google.ca/books?id=njLtCAAAQBAJ&pg=PA133|archive-date=5 March 2016}}</ref> It is on the ].<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref> It is available as a ].<ref name=AHFS2015/><ref name=Ham2010>{{cite book| vauthors = Hamilton RJ | title = Tarascon pharmacopoeia |date=2010 |publisher=Jones and Bartlett |location=Sudbury, Mass. |isbn=9780763777685 |page=181 |edition=2010 |url= https://books.google.com/books?id=Urmh7ylCXnoC&pg=PA181|url-status=live|archive-url=https://web.archive.org/web/20160305014932/https://books.google.ca/books?id=Urmh7ylCXnoC&pg=PA181|archive-date=5 March 2016}}</ref> In 2022, it was the 280th most commonly prescribed medication in the United States, with more than 600,000 prescriptions.<ref name="The Top 300 of 2022" /><ref>{{cite web | title = Sennosides Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/Sennosides | access-date = 30 August 2024 }}</ref> In 2022, the combination with ] was the 261st most commonly prescribed medication in the United States, with more than 1{{nbsp}}million prescriptions.<ref name="The Top 300 of 2022">{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref>{{cite web | title = Senna; Docusate Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/SennaDocusate | access-date = 30 August 2024 }}</ref> It is sold under a number of brand names including '''Ex-Lax''' and '''Senokot'''.<ref name=AHFS2015/> |
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==Medical uses== |
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Senna is used for episodic and chronic ] though there is a lack of high-quality evidence to support its use for these purposes.<ref name="Wald2016">{{cite journal | vauthors = Wald A | title = Constipation: Advances in Diagnosis and Treatment | journal = JAMA | volume = 315 | issue = 2 | pages = 185–91 | date = January 2016 | pmid = 26757467 | doi = 10.1001/jama.2015.16994 | type = Review }}</ref> It may also be used to aid in the evacuation of the bowel prior to surgery or invasive rectal or colonic examinations.<ref name="Lexi2014Name"/><ref name="drugs.com">Drugs.com {{cite web |url=https://www.drugs.com/ppa/senna.html |title=Senna (Professional Patient Advice) |access-date=17 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20140419013432/http://www.drugs.com/ppa/senna.html |archive-date=19 April 2014 }}</ref> |
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===Administration=== |
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==External links== |
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Oral senna products typically produce a bowel movement in 6 to 12 hours. Rectal suppositories can act within minutes or take up to two hours.<ref name="accessmedicine.mhmedical.com">{{cite book | vauthors = McQuaid KR | chapter = Chapter 62. Drugs Used in the Treatment of Gastrointestinal Diseases. | veditors = Katzung BG, Masters SB, Trevor AJ | title = Basic & Clinical Pharmacology | edition = 12th | location = New York, NY | publisher = McGraw-Hill | date = 2012 | url = http://accessmedicine.mhmedical.com/content.aspx?bookid=388&Sectionid=45764290 |access-date=18 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20140419013030/http://accessmedicine.mhmedical.com/content.aspx?bookid=388&Sectionid=45764290 |archive-date=19 April 2014 }}</ref> |
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* {{cite journal |author=Vanderperren B, Rizzo M, Angenot L, Haufroid V, Jadoul M, Hantson P |title=Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides |journal=The Annals of pharmacotherapy |volume=39 |issue=7–8 |pages=1353–7 |year=2005 |pmid=15956233 |doi=10.1345/aph.1E670}} |
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* {{cite journal |author=Mereto E, Ghia M, Brambilla G |title=Evaluation of the potential carcinogenic activity of Senna and Cascara glycosides for the rat colon |journal=Cancer Lett. |volume=101 |issue=1 |pages=79–83 |year=1996 |pmid=8625286 |doi=10.1016/0304-3835(96)04129-8}} |
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* http://chemicalland21.com/lifescience/phar/CALCIUM%20SENNOSIDE.htm |
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==Contraindications== |
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{{Laxatives}} |
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According to ], senna is contraindicated in cases of ], acute intestinal inflammation (e.g., ]), ], ], and ] of unknown origin.<ref name="Lexi2014Name"/> |
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Senna is considered contraindicated in people with a documented allergy to ]. Such allergies are rare and typically limited to dermatological reactions of redness and itching.<ref name="Lexi2014Name"/> |
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] |
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==Adverse effects== |
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Adverse effects are typically limited to gastrointestinal reactions and include abdominal pain or cramps, diarrhea, nausea, and vomiting.<ref name="Lexi2014Name"/> |
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Regular use of senna products can lead to a characteristic brown pigmentation of the internal colonic wall seen on ]. This abnormal pigmentation is known as ].<ref name="accessmedicine.mhmedical.com"/> |
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{{gastrointestinal-drug-stub}} |
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=== Interactions === |
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] |
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Senna glycosides can increase ] toxicity in patients taking digoxin by ], thereby enhancing the effects of digoxin.<ref>{{cite web|url=https://www.nlm.nih.gov/medlineplus/druginfo/natural/652.html|title=Senna: MedlinePlus Supplements|url-status=live|archive-url=https://web.archive.org/web/20150406045004/http://www.nlm.nih.gov/medlineplus/druginfo/natural/652.html|archive-date=6 April 2015}}</ref> |
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] |
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==Mechanism of action== |
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The breakdown products of senna act directly as irritants on the colonic wall to induce fluid secretion and colonic motility.<ref>{{cite book | vauthors = Sharkey KA, Wallace JL | chapter = Chapter 46. Treatment of Disorders of Bowel Motility and Water Flux; Anti-Emetics; Agents Used in Biliary and Pancreatic Disease. | veditors = Brunton LL, Chabner BA, Knollmann BC | title = Goodman & Gilman's The Pharmacological Basis of Therapeutics | edition = 12th | location = New York, NY | publisher = McGraw-Hill | date = 2011 | url= http://accessmedicine.mhmedical.com/content.aspx?bookid=374&Sectionid=41266256 | access-date=18 April 2014 |url-status=live |archive-url=https://web.archive.org/web/20140419013258/http://accessmedicine.mhmedical.com/content.aspx?bookid=374&Sectionid=41266256 |archive-date=19 April 2014 }}</ref> |
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==Pharmacology== |
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They are ]s derivatives and ]ic ]s.<ref>{{cite journal | vauthors = Franz G | title = The senna drug and its chemistry | journal = Pharmacology | volume = 47 | issue = Suppl. 1 | pages = 2–6 | date = October 1993 | pmid = 8234429 | doi = 10.1159/000139654 }}</ref> |
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==Society and culture== |
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===Formulations=== |
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Senna is an ] available in multiple formulations, including oral formations (liquid, tablet, granular) and rectal suppositories. Senna products are manufactured by multiple generic drug makers and sold under various brand names.<ref name="drugs.com"/> |
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===Brand names=== |
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Ex-Lax, Geri-kot, Perdiem Overnight Relief, Senexon, Pursennid, Senna Smooth, Senna-Gen, Senna-GRX, Senna-Lax, Senna-Tabs, Senna-Time, SennaCon, Senno, Senokot.<ref name=Lexi2014Name>Lexicomp Online, Lexi Drugs Online, Hudson, Ohio: Lexi-Comp, Inc.; 17 April 2014.</ref> |
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== References == |
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{{reflist}} |
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{{Laxatives}} |
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{{Portal bar | Medicine}} |
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{{Authority control}} |
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