There are no reports of undesirable or damaging effects during pregnancy and on the foetus when used at the recommended dosage. Call your healthcare provider if your constipation does not improve after 1 week of using senna, or if constipation gets worse. Do not take senna for longer than 1 week, unless your healthcare provider has told you to. Prolonged use may precipitate the onset of an atonic, non-functioning colon. Prolonged excessive use may lead to fluid and electrolyte imbalance and hypokalaemia.

NON-MEDICINAL INGREDIENTS: Chocolate flavour, citric acid monohydrate, peppermint flavour, sodium citrate dihydrate, sodium metabisulfite, sodium methylparaben, sodium propylparaben, sorbitol (3 g/100 mL equivalent to 7.8 kcal), sucralose (110 mg/100 mL), water, xanthan gum. NON-MEDICINAL INGREDIENTS: Corn starch, glycerin, hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, iron oxide red, titanium dioxide. Tell your doctor if you are pregnant before using this medication. Using it for long periods during pregnancy is not recommended. Consult your doctor for more details. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. Constipation can affect anyone, at any age. About 63 million people in North America say they have issues with constipation. Constipation affects almost everyone at some point in their lives. 1

Senokot Max Strength warnings

ACTIVE INGREDIENTS: Each SENOKOT ® for Women tablet contains 8.6 mg standardized sennosides from natural senna. Senna is likely effective in alternative medicine as an aid in treating occasional constipation in adults and children at least 2 years old. SENOKOT ®•S should not be taken within two hours of another medicine as it may reduce the effectiveness of other medicine. Drugs that may interact with SENOKOT ®•S include: cardiac medications such as cardiac glycosides (drugs that increase the force of contraction of the heart) or antiarrhythmic medications (drugs that restore the normal rhythm of the heart); mineral oil; thiazide diuretics (drugs used to treat high blood pressure), corticosteroids, licorice root or other medications or health products which may aggravate electrolyte imbalance. This medication may cause your urine to turn reddish-brown. This effect is harmless and will disappear when the medication is stopped. Chewable tablets or dissolving strips may contain sugar. Caution is advised if you have diabetes or any other condition that requires you to limit/avoid sugar in your diet. Ask your doctor or pharmacist about using this product safely.

The product contains lactose monohydrate. One tablet contains 15.82mg lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Take senna for a few days only and no longer than a week. If you take it for longer, your body can start to rely on it, rather than your bowels doing the work on their own. However, as a consequence of experimental data concerning a genotoxic risk of several anthranoids, e.g emodin and aloe-emodin, use is not recommended in pregnancy.Prolonged excessive use or misuse of these products may also result in the development of atonic colon. For patients on a sodium-restricted diet, there is a very small amount of sodium in SENOKOT ® Syrup. See Non-Medicinal Ingredients on label. If you are pregnant or breast-feeding, consult a healthcare practitioner before use. Drug Interactions: There are no known drug interactions with sennosides. In cases of intestinal obstructions and stenosis, atony, appendicitis, inflammatory colon diseases (e.g Crohn's disease, ulcerative colitis), abdominal pain of unknown origin, severe dehydration state with water and electrolyte depletion.

influence on secretion processes by two concomitant mechanisms viz. inhibition of absorption of water and electrolytes (Na +, Cl -) into the colonic epithelial cells (antiabsorptive effect) and increase of the leakiness of the tight junctions and stimulation of secretion of water and electrolytes into the lumen of the colon (secretagogue effect) resulting in enhanced concentrations of fluid and electrolytes in the lumen of the colon. The sugar moiety of the sennosides is removed by bacteria in the large intestine releasing the active anthrone fraction. This stimulates peristalsis via the submucosal and myenteric nerve plexuses.

Other side effects

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/ tongue/throat), severe dizziness, trouble breathing. If you are using the chewable tablets, chew each tablet well and swallow. If you are using the dissolving strips, allow each strip to dissolve on the tongue and then swallow, with or without water. If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/cup. Do not use a household spoon because you may not get the correct dose. Stomach/ abdominal pain or cramping, nausea, diarrhea, or weakness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. NON-MEDICINAL INGREDIENTS: cornstarch, D&C Yellow No. 10 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake, guar gum, lecithin, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, silicon dioxide, sodium benzoate, talc and titanium dioxide.