What is the tolerance for constipation with Sennosides (8.6 milligrams)?

From the Guidelines

Sennosides 8.6 mg is generally well-tolerated for constipation, but tolerance can develop with regular use over time. For occasional constipation, taking sennosides 8.6 mg at bedtime is appropriate, with effects typically occurring within 6-12 hours 1. However, this medication should not be used for more than 7 consecutive days without medical supervision. If you find you need to increase the dose to achieve the same effect, this indicates tolerance development. To prevent tolerance, use sennosides intermittently rather than daily, incorporate lifestyle changes like increased fiber intake (25-30g daily), adequate hydration (6-8 glasses of water daily), and regular physical activity.

Key Considerations

• Sennosides work by stimulating intestinal contractions and increasing water content in the bowels, which can lead to dependence if used continuously 1.
• Side effects may include abdominal cramping, diarrhea, and electrolyte imbalances with prolonged use.
• If constipation persists despite treatment, consult a healthcare provider as this could indicate an underlying condition requiring different management.

Important Safety Information

• The dose evaluated in trials is higher than commonly used doses in practice, and the panel suggests starting at a lower dose and increasing if no response 1.
• Abdominal pain and cramping may occur with a higher dose of senna 1.
• Sennosides are not recommended in pregnant women because chemically similar substances have been found to exert weak genotoxic effects in animals, although the supporting evidence is controversial 1.

From the FDA Drug Label

Directions take preferably at bedtime or as directed by a doctor adults and children 12 years of age or older- starting dosage:2 tablets once a day, maximum dosage:4 tablets twice a day Uses relieves occasional constipation (irregularity) generally produces bowel movement in 6-12 hours

The tolerance for constipation with sennosides 8.6 mg is not directly addressed in the provided drug labels. However, the labels provide information on the dosage and uses of sennosides.

• The starting dosage for adults and children 12 years of age or older is 2 tablets once a day, with a maximum dosage of 4 tablets twice a day 2.
• Sennosides are used to relieve occasional constipation and generally produce a bowel movement in 6-12 hours 2. Since the labels do not provide information on tolerance development, no conclusion can be drawn about the tolerance for constipation with sennosides 8.6 mg.

From the Research

Tolerance for Constipation with Sennosides 8.6 mg

• The concept of tolerance to sennosides, a component of senna, is discussed in several studies 3, 4, 5.
• A study from 1988 mentions that standardized senna is safe when used in appropriate dosage, avoiding loose stools, but does not directly address tolerance 3.
• A more recent study from 2018 found no evidence of tolerance to senna in children when used as a long-term treatment for constipation 4.
• Another study from 2021 provides good evidence for the use of stimulant senna as an over-the-counter therapy for chronic constipation, without mentioning tolerance as a significant concern 5.

Sennosides Dosage and Tolerance

• The study from 2018 mentions that patients who developed blisters had higher doses of senna (60mg/day), but this does not directly relate to tolerance 4.
• The dosage of 8.6 mg of sennosides is relatively low compared to the doses mentioned in the studies (e.g., 60mg/day) 4, 6.
• There is no direct evidence in the provided studies to suggest that a dosage of 8.6 mg of sennosides would lead to tolerance.

Safety and Efficacy of Sennosides

• Sennosides are considered safe when used in appropriate dosages, with minor side effects such as abdominal cramping, vomiting, or diarrhea 4, 5.
• The efficacy of sennosides in treating constipation is supported by several studies, including a comparison with bisacodyl in intensive care unit patients 6.
• The 2021 study provides good evidence for the use of senna as a first-line laxative for chronic constipation, with a grade A recommendation 5.