Indian Brands of Anthraquinone Laxatives
The most common anthraquinone laxatives available in India include senna, cascara, and dantron preparations, with senna being the most widely used and physiologically appropriate non-fiber laxative option. 1
Available Anthraquinone Laxative Brands in India
Senna-based Products:
- Sofsena (Senna extract tablets)
- Senokot (Standardized senna concentrate)
- Glaxenna (Senna extract)
- Pursennid (Sennosides)
- Softovac (Senna with ispaghula husk)
Cascara-based Products:
- Cascara Sagrada (Various generic formulations)
- Laxcara (Cascara extract)
Mechanism of Action
Anthraquinone laxatives work through a unique targeting mechanism:
- They are administered orally in glycoside form
- Travel unabsorbed to the large intestine
- Converted by intestinal bacteria to active forms (sennosides)
- Function by stimulating the myenteric plexus in the colon
- Inhibit colonic water absorption
- Principal effect is in the descending and sigmoid colon 1
Clinical Applications
Anthraquinone laxatives are particularly useful in:
- Opioid-induced constipation when combined with stool softeners
- Palliative care settings for constipation management
- Situations requiring stimulant laxatives when osmotic laxatives are inadequate 1
Dosing Considerations
- Start with lower doses and titrate as needed
- Goal: One non-forced bowel movement every 1-2 days 1
- Can be combined with stool softeners, though evidence suggests senna alone may be sufficient 1
Important Cautions
- Avoid in intestinal obstruction
- Excessive use can cause diarrhea and hypokalemia
- Dantron is rarely used due to potential carcinogenicity concerns 1
- Contrary to previous beliefs, there is no clinical or animal evidence that long-term sennoside use damages intestinal muscle or myenteric neurons 1
Alternative Options
If anthraquinone laxatives are ineffective or contraindicated, consider:
- Osmotic laxatives (polyethylene glycol, lactulose, magnesium salts)
- Diphenylmethane derivatives (bisacodyl, sodium picosulfate)
- For opioid-induced constipation: peripherally acting μ-opioid receptor antagonists (methylnaltrexone) 1
Anthraquinone laxatives remain an important component of constipation management, particularly in palliative care settings, with senna being the most commonly used agent in this class in India.