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Senna

Senna

Botanical Description & Habitat

Cassia acutifolia

Family
Leguminosae

Habitat
Native of southern Arabia and found in Africa and the United States. It is a perennial plant flourishing in rich soils.

Description
Has an erect, 2 to 3-feet high woody stem and hairy, pinnate leaves. The leaves have lanceolate-ovate, pale, gray-green leaflets. Large yellow flowers grow in axillary racemes from June to September. The fruit is a 2 to 4 inch long pod that is dark green, membranous, and contains a single ash-colored seed.

Medicinal parts
Leaflets, dried, collected before flowering and
Pods, dried.

The German Commission E provides two separate monographs.

Historical Properties & Uses

Senna was used by Arabian physicians in the 9th century.

Senna is a stimulant laxative or cathartic acting in much the same manner as cascara sagrada, and contains many of the same anthraquinone glycosides.

The main difference between the two herbs is the presence of high concentrations of rhein dianthrone glycoside in senna, as opposed to large amounts of cascarosides A & B in cascara. Senna is more potent than cascara and produces considerably more griping.

Senna is the active component of Fletcher's castoria, Garfields Tea, Gentlax B & S, Nytilax, Senokap DSS, Senokot, Swiss Kriss, and Dr. Caldwell's Senna Laxative (Please refer to Cascara Sagrada for a more detailed discussion of anthraquinones).

Senna leaf and pod have approval status by the German Commission E specifically for constipation.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Method of Action

Senna Is A Good Laxative
The mode of action of senna is similar to cascara sagrada, but their slightly different chemistry does produce a few differences in action. For example, whereas the cascara product is not activated until it reaches the intestines, senna glycosides are readily released by microflora of the stomach. And, whereas cascara glycosides are resistant to activation in mice, rats and other small mammals, senna is very active. Finally, cascara is only about one third as active a laxative as senna.

Drug Interactions & Precautions

Known Interactions

Senna (Senekot), due to its cathartic activity, may potentiate anticoagulant therapy by reducing absorption of vitamin K from the gut. The herb may also inhibit absorption of dextrose from the intestines.

As a cathartic, senna may also increase intestinal transit time of digitalis glycosides, inhibiting their absorption and cardiac action.

Cathartic-induced hypokalemia, however, increases toxicity and potency of absorbed digitalis, and potentiates muscle relaxants.

The German Commission E notes the possibility hypokalemia [from chronic usage (abuse?)] to potentiate the action of cardiac glycosides and antiarrhythmic agents.

Potassium deficiency can be further accelerated with simultaneous administration of e.g. corticosteroids, licorice root or thiazide diuretics.

In addition to the specific interactions listed, the cathartic action of senna tends to hasten the passage of all oral medications through the gut, thereby inhibiting their action.

Possible Interactions

Laxative-induced diarrhea may result in decreased absorption of isoniazid. The same is true with sulfisoxazole, but this appears to be a clinically unimportant interaction effect.

By sequestering senna, mineral oil may reduce the herb's anthelmintic effects. The same may be true, to a lesser extent, of antacids.

Comments

The laxative-induced increased speed of intestinal emptying from senna may result in decreased absorption of vitamin K and/or anticoagulants. In addition, the absorbent nature of this herb may inhibit absorption of lincomycin and digitalis.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Safety Factors & Toxicity

The oral toxicity of senna is very low. Toxicity experiments with the senna glycosides have failed to kill mice and LD50 values cannot be obtained.

In humans, prolonged, excessive use of anthraquinone laxatives (and all other laxatives) can give rise to the metabolic disturbances that inevitably accompany persistent diarrhea. The extreme effect of addictive purgation is the so-called 'cathartic colon,' characterized by loss of myenteric plexus neurones, dilatation and structural damage, and to marked hypokalemia. Such cases are very rare. Normally, the only adverse effect to be seen from using athraquinone laxatives is gripping, which occurs much more frequently from senna use than from the use of cascara.

Senna leaf and pod have approval status by the German Commission E.

The German Commission E recommends a limited duration for the use of this herb of not over 2 weeks without medical advice.

Case reports do exist of senna toxicity and occupaitonal allergies.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.


Preparation & Administration

Three times a day

Dried leaflet
0.5-2 grams

Tea
made from 1/2 tsp of dried leaflets

Fluid extract
1:1 in 25% alcohol, 0.5-2 ml

This herb has approval status by the German Commission E.

Recommended daily dosages in Germany are as follows:

Leaf or Pod:        20 - 30 mg calculated as sennoside B.

The German Commission E recommends a limited duration for the use of this herb (leaf or pod) of not over 2 weeks without medical advice.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.

Abstracts

References

Am Hospital Formulary Service. Am Soc of Hosp Pharm. Wash, D.C.

Azarnoff, D.L. & A. Hurwitz. 1970. Drug interactions. Pharmacol Physicians, 4(2). pp. 1-7.

Beckman, H. 1967. Dilemmas in drug therapy. Saunders, Philadelphia.

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Bressler, R., M.D. Bogdonoff & G.J. Subak-Sharpe. 1981. The Physicians Drug Manual. Doubleday & Co, Inc. Garden City, NY. 1213 pp.

Cohen, M.S. 1970. Therapeutic Drug Interactions. University of Wisconsin Medical Center. Madison, Ws.

Committee on Pharmocopaeia of the Am Institute of Homeopathy, The Homeopathic Pharmacopaeia of the United States. 8th ed., Vol 1. Otis Clapp and Son, Agents, Boston, l981.

Facts and Comparisons. The Lawrence Review of Natural Products. Jul, 1998.

Godding, E.W. Therapeutics of laxative agents with special reference to the anthraquinones. Pharmacoloty, 14(Suppl. 1), 78-101, 1976.

Goodman, L.S. & A. Gilman. 1975. Pharm Basis of Thera. MacMillan, NY.

Hansten, P.D. 1979. Drug Interactions, 4th ed. Lea & Febiger, Phila.

Hansten, P.D. 1969. Oral anticoagulant drug interactions. Hospital Form. Management, 4(1). pp. 20-22.

Hyde, F.F. British Herbal Pharmacopoeia. British Herbal Medicine Assoc: West Yorks, England, 1983

Interactions of drugs. Med Let Drugs Ther, 12(11). pp. 93-96.

Kastrup, E.K., ed. 1981. Drug Facts and Comparisons, 1982 edition. Facts and Comparisions Division, J.P. Lippincott Co, Phila (St. Louis).

List, P. & L. Hoerhammer. 1969-1976. Hagers Hanbuch der Pharmazeutischen Praxis, vols. 2-5. Springer-Verlag, Berlin.

Martin, E. Drug Interactions Index, 1978/79. J.B. Lippincott Co., Phila.

Mattila, M.J., et.al. 1974. Effect of sodium sulphate and castor oil on drug absorbtion from the human intestine. Ann of Clin Rsrch, 6.

Mowrey, Daniel B., Ph.D. Exper. Psych., Brigham Young University. Director of Nebo Institute of Herbal Sciences. Director of Behavior Change Agent Training Institute. Director of Research, Nova Corp.

Prescott, L.F. Dec. 6, 1969. Pharmacokinetic drug interactions. Lancet, 2. pp. 1239-1243.

Scientific Committee, British Herbal Pharmocopaeia, British Herbal Med Assoc, Lane House, Cowling, Na Keighley, West Yorks, Bd Bd220lx, l983

Stuart, D.M. 1968. Drug metabolism Part 2. Drug interactions. PharmIndex, 10(10). pp. 4-16.


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Cassia acutifolia

? Southwest School of Botanical Medicine

 


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