This combination product contains two medications: senna and docusate sodium. Senna belongs to the class of medications called stimulant laxatives. Docusate sodium belongs to the family of medications known as stool softeners. Senna works by increasing the muscle activity in the digestive system, causing waste material to be eliminated as stool. Docusate sodium works by increasing the amount of water in the stool, making stools softer and easier to pass.

This combination medication is used to treat occasional constipation due to hard stools. Specifically, it is recommended for women who have recently given birth; people for whom hard, dry stools should be avoided (e.g., people with hemorrhoids or anal fissures); and people for whom stool straining should be avoided (e.g., people with heart disease). This combination usually produces a stool between 6 and 12 hours after taking the medication.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual dose of senna - docusate sodium for adults and children 12 years and older is 1 to 2 tablets, taken once a day at bedtime. No more than 4 tablets twice a day should be taken.

For children from 6 to 12 years of age, the recommended dose is 1/2 to 1 tablet taken once daily at bedtime. The maximum dose is 1 tablet twice a day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

This medication should be taken at bedtime, with a stool being produced sometime after waking. If there is no bowel movement after using senna, or there is rectal bleeding, contact your doctor as soon as possible.

If you are taking this medication regularly and miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to senna, docusate sodium, or any ingredients of this medication
• have a blockage in the digestive tract
• have appendicitis
• have Crohn's disease, ulcerative colitis, or inflammatory colon disease
• have severe dehydration
• have undiagnosed abdominal pain, fever, nausea or vomiting
• have weakened muscle activity of the digestive system
• have undiagnosed bleeding from the rectum
• have an abdominal condition that may require urgent surgery

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal cramps
• discolouration of body fluids (e.g., breast milk, urine, stools)
• irritation of skin around the anus
• itchy skin
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• bleeding from the rectum
• ongoing diarrhea
• rash

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Fluid and electrolyte balance: If senna - docusate sodium is taken for too long a period of time, it may cause diarrhea and affect the levels of fluid and electrolytes in the body.

If you experience symptoms of fluid and electrolyte imbalance such as thirst, muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. Inform your doctor of any medications for heart or blood pressure that you may be taking, as these also increase the risk of fluid and electrolyte changes.

General: If you experience a sudden change in your bowel movements that lasts for 2 weeks or more, do not take this medication without first talking to your doctor. If you take senna - docusate sodium and it does not seem to help with your constipation, or if rectal bleeding occurs, stop using this medication and contact your doctor.

Other medications: Although senna - docusate sodium does not directly affect the actions of other medications, taking it too close to other medications may change how much of the other medication is absorbed by the body. Avoid taking senna - docusate sodium within 2 hours of any other medications.

Overuse of medication: As with any stimulant laxative, ongoing use of senna - docusate sodium may cause the bowel to become dependent on the medication to produce stools. Unless you doctor has recommended a specific schedule, do not take senna for more than 1 week.

Pregnancy: This medication is considered safe to use during pregnancy, however is should only be used when recommended by a doctor. Lower than usual adult doses should be used.

Breast-feeding: Although this medication is considered safe to use while breast-feeding, it should only be used when recommended by a doctor. This medication passes into breast milk. If you are breast-feeding and are taking senna - docusate, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.

There may be an interaction between senna - docusate sodium and digoxin.

If you are taking either of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.