Fletchers Castoria

Senna is an herb that is also known as Alexandrian Senna, Casse, Fan Xie Ye, Indian Senna, Khatoum Senna, Sen, Sena Alejandrina, Sennae Folium, Sennae Fructus, Sennosides, Tinnevelly Senna, True Senna, and other names.

Senna is likely effective in alternative medicine for treating occasional constipation in adults and children who are at least 2 years old.

Senna has been used in alternative medicine as a possibly effective aid in emptying the bowel before a colonoscopy.

Other uses that have not been proven with research include weight loss, irritable bowel syndrome, hemorrhoids, and other conditions.

It is not certain whether senna is effective in treating any medical condition. The FDA has not approved medicinal use of this product. Senna should not be used instead of medication prescribed by your doctor.

Senna is often sold as an herbal supplement. Many herbal compounds do not have regulated manufacturing standards, and some supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be bought from a reliable source to reduce the risk of contamination.

Senna may also be used for purposes that are not listed in this product guide.

When thinking about using senna, talk to your doctor. You might also want to consult someone who is trained in herbal or health supplements.

If you decide to use senna, follow the instructions on the package or those given by your doctor, pharmacist, or other healthcare provider. Do not take more of this product than what is recommended on the label.

Swallow the tablet whole with a full glass of water and do not crush, chew, or break it.

You must chew the chewable tablet before swallowing it.

Use the measuring device that comes with the liquid product (not a kitchen spoon) to measure your dose.

Taking more than your recommended dose will not make this product work better and may lead to serious side effects.

Senna should cause a bowel movement within 6 to 12 hours after you take it.

Do not use different forms of senna (tablets, liquids, and others) at the same time, as this could lead to an overdose.

Contact your healthcare provider if your constipation does not improve after 1 week of using senna, or if it gets worse. Do not use senna for more than 1 week unless your healthcare provider has advised you to.

Store at room temperature away from moisture, heat, and light.

Follow all the instructions on the product label and package. Inform each of your healthcare providers about all your medical conditions, allergies, and all medicines you are using.

You should not use senna if you are allergic to it, or if you have:

• diarrhea;
• hemorrhoids;
• stomach pain;
• a blockage in your intestines;
• inflammatory bowel disease; or
• appendicitis.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have ever had:

• an electrolyte imbalance (such as low levels of potassium in your blood);
• any change in bowel habits that has lasted longer than 2 weeks;
• long-term bowel problems;
• stomach pain, nausea, or vomiting; or
• if you are taking mineral oil.

Ask a doctor before using this product if you are pregnant or breastfeeding.

Do not give any herbal/health supplement to a child without medical advice.

Get emergency medical help if you have signs of an allergic reaction: hives, difficulty breathing, swelling of your face, lips, tongue, or throat.

Senna may cause serious side effects. Stop using senna and call your doctor immediately if you have:

• rectal bleeding;
• no bowel movement within 12 hours after using senna; or
• low blood potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or a limp feeling.

Common side effects of Fletchers Castoria may include:

• stomach pain, discomfort, or cramps;
• diarrhea, or an urgent need to have a bowel movement;
• nausea, gas; or
• discoloration of your urine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

If you miss a dose, just skip it and take your next dose at the regular time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include electrolyte imbalance (muscle spasms, changes in the shape of your fingers), muscle weakness, heart problems, liver damage, and other side effects.

Avoid taking this product within 2 hours before or after you take other medicines. Senna can make it harder for your body to absorb certain medicines you take by mouth.

Avoid using senna together with other herbal/health supplements that can lower potassium levels. This includes horsetail, licorice, aloe, buckthorn, gossypol, rhubarb, and other stimulant laxative herbs.

Do not use other laxatives while taking senna unless your doctor has told you to.

Do not take senna without medical advice if you are using the following medications:

• warfarin (Coumadin, Jantoven); or
• a diuretic (water pill).

This list is not complete. Other drugs may affect senna, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.