LAXETTE

Indications

• Constipation
• Palliative care for bowel cleansing

Dosage

Children: Child 1 month–3 years: 3.75–15 mg once daily, adjusted according to response. Child 4–17 years: 3.75–30 mg once daily, adjusted according to response.

Adults: 7.5–15 mg once daily (max. per dose 30 mg daily), typically taken at bedtime. The initial dose should be low and increased gradually as needed, with higher doses prescribed under medical supervision.

Mechanism of action

Senna contains sennosides, which are metabolized in the colon to form active compounds that stimulate the peristaltic movement of the intestines. This promotes bowel evacuation by increasing the contraction of intestinal muscles and enhancing fluid secretion into the bowel, leading to softer stools.

Pharmacodynamics

The pharmacodynamic effect of senna includes increased intestinal motility and secretion of electrolytes and water into the intestines, resulting in softened stools and facilitation of bowel movements. Side effects may include abdominal cramps and gastrointestinal disturbances, as well as potential skin reactions.

Pharmacokinetics

Senna is not absorbed significantly in the gastrointestinal tract; its active metabolites exert their effects locally in the intestines. The onset of action is typically within 6 to 12 hours when taken orally. Metabolism occurs in the gut, and excretion is primarily via feces, with minimal systemic absorption.

Contra-indications

• Acute abdominal conditions
• Acute inflammatory bowel disease
• Intestinal obstruction
• Severe dehydration

Adverse effects

• Abdominal cramps
• Asthenia
• Gastrointestinal disorders
• Skin reactions
• Urine discolouration

Precautions

• Excessive use of stimulant laxatives can cause diarrhea and related effects such as hypokalaemia
• Local irritation - avoid prolonged contact with skin (incontinent patients or infants wearing nappies, risk of irritation and excoriation)
• Rodent studies indicate potential carcinogenic risk

Pregnancy

Manufacturers advise to avoid - limited information available.

Breast-feeding

Manufacturers advise to avoid - no information available.

Storage

Store at room temperature, away from moisture and heat.

Formulations

• Oral suspension
• Tablets
• Syrup
• Suppositories