-IBIS-1.5.0-
rx
herb
Cassia spp. (Senna)
botanicals
definition
botanical name(s): Cassia acutifolia, C. angustifolia
synonyms: senna, locust plant, wild senna, Alexandrian senna, Alexandriner-senna, sene d'Alexandrie, sene de Khartoum
part(s) used: leaf, pods
qualities: bitter, sweet, cold
affinities:
actions: purgative
dosage:
» powder: 0.5 - 2 g
» tincture: 0.3 - 4 ml.
therapy: mix with carminatives
AHPA Botanical Safety Rating: 2b, 2c, 2d
toxicity: 3; see sennoside toxidrome
» contraindicated in colitis, spastic constipation (Felter and Lloyd, p. 457)
» contraindicated in intestinal obstruction due to stimulation of peristalsis by its anthroquinones (sennosides)
» contraindicated in stomach inflammation (Brinker, Felter and Lloyd) due to griping (Felter and Lloyd) and intestinal inflammatory diseases (Brinker, Felter and Lloyd, DeSmet) such as ulcerative colitis and Crohn's disease (DeSmet) due to irritation caused by anthroquinones (Wichtl)
» contraindicated in anal prolapse due to aggravation by enhancing the bowel's expulsive force (Wichtl)
» contraindicated in hemorrhoids due to possible induction of stenosis, thrombosis, and prolapse (DeSmet)
» contraindicated in pregnancy (Wichtl) due to possible endometrial stimulation (DeSmet, Brooks) and passage of genotoxic aloeemodin across placenta (DeSmet)
» contraindicated in children under age 12 due to water and electrolyte loss (DeSmet)
» contraindicated in extended use for more than 8-10 days (DeSmet, Brooks) due to decreased peristalsis from intestinal smooth muscle damage (DeSmet); prolonged use leads to colon problems (Duke, p. 102)
» contraindicated in nursing mothers; milk may cause nausea, flatulence, griping in the infant (Morton, p. 149) due to passage of anthroquinones into mother's milk (Wichtl, Felter and Lloyd, DeSmet)
» contraindicated in appendicitis and abdominal pain whose cause is unknown due to possibly inducing a rupture from contraction of the inflamed organ (Brooks)
» may cause dizziness, abdominal pain, nausea and vomiting, and diarrhea (Fuller and McClintock, p. 157)
» changes in urine occur from emodin: acidic urine is yellow-brown, basic urine is red to violet (AMA, p. 50)
» hypokalemia: In one case a female patient presented with severe hypokalemia and muscle weakness following chronic abuse of laxatives (Folia Sennae). (Vierhapper H, Waldhausl. Wien Klin Wochenschr 1980 Feb 1;92(3):101-103)
constituents: anthraquinones, flavones, tartaric acid, mucin, essential oil, traces of tannin and resin
drug interactions:
» sennosides aggravate nephropathy from analgesics associated with dehydration (DeSmet)
» decrease in absorption of oral drugs due to decrease in bowel transit time (DeSmet)» aggravates loss of potassium associated with use of diuretics (DeSmet)
» overuse or misuse can cause potassium loss leading to increased toxicity of cardiac glycosides (Wichtl, DeSmet) such as those in Adonis, Convallaria,Urginea, (Brinker, DeSmet) Helleborus, Strophanthus, and Digitalis (Brinker)
footnotes
Brinker F. 1989. To Health With Herbs (from Eclectic Dispensatory of Botanical Therapeutics. vol. I, Alstat E (comp.)), Portland, Oregon: Eclectic Medical Publications.
Brooks S (ed.). 1995. Botanical Toxicology. Protocol J Bot. Med, 1:147-58.
De Smet PAGM et al. (eds.). 1993. Adverse Effects of Herbal Drugs 2, Berlin: Springer-Verlag
Duke, J.A. 1985. C.R.C. Handbook of Medicinal Herbs. Boca Raton, FL: The C.R.C. Press.
Felter, H. W.; Lloyd, J. U. 1983. King's American Dispensatory, Vols. I and II. Portland, OR: Eclectic Medical Publications.
Fuller, T.C., and McClintock, E. 1986. Poisonous Plants of California. Los Angeles: University of Southern California Press.
Morton, J.F. 1972. Further associations of plant tannins and human cancer. Quarterly Journal of Crude Drug Research. 12: 1829-1841.
Vierhapper H, Waldhausl. [Laxative-induced hypokalemic myopathy. A case history]. Wien Klin Wochenschr 1980 Feb 1;92(3):101-103. [Article in German]
Abstract: A female patient presented with severe hypokalemia and muscle weakness following chronic abuse of laxatives (Folia Sennae). Parenteral substitution of potassium resulted in complete normalisation of the clinical signs and of the pathologically elevated serum concentrations of CPK, LDH and GOT. The importance of laxatives as a possible cause of severe hypokalaemic conditions is underlined by this case report.
Wichtl M (ed.). 1994. Herbal Drugs and Phytopharmaceuticals, Boca Raton: CRC Press.