Explaining senna

The differences between senna and sennosides are:

• products containing senna are made from the powdered fruit of Alexandrian or Tinnevelly Senna
• products labelled as sennosides contain sennosides extracted from the fruit then purified and isolated as calcium salts

There are two potential sources of confusion to clinicians and patients:

• between senna and sennosides
• around how sennosides are described on labels

Labelling of senna and sennosides

A number of products containing sennosides (rather than ‘senna’) were recently approved. Their labels accurately describe the contents in terms of sennosides.

• Products labelled as senna must meet the BP monograph description, which means they contain the powdered fruit of Senna, Alexandrian or Tinnevelly.
• Products labelled as sennosides cannot be labelled as senna.
• Products labelled as senna and sennosides, however, are interchangeable because both contain the same amount of active substance of known therapeutic effect. A product labelled as containing 7.5 mg sennosides is interchangeable with a product labelled as containing 7.5 mg senna

Sennoside product names

There is also a risk of confusion because sennosides may be described in different ways on product labels:

• Sennosides
• Sennosides (as calcium salt)
• Calcium sennosides

The generic description “sennosides” includes all the above.

• Products labelled as containing 7.5mg sennosides, 7.5mg sennosides (calcium salt) or 7.5mg calcium sennosides contain the same amount of the same active ingredient and are therefore interchangeable.

Actions for pharmacy teams

Pharmacists in all care settings should ensure that:

• Prescribing and dispensing systems reflect the approved generic names “senna” or “sennosides”.
• Staff dispensing and administering senna and sennosides are aware that these products are interchangeable.

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