Indications
This is a herbal laxative combination of Ispaghula (isabgol) husk, Senna leaf, Haritaki (Terminalia chebula fruit), Sonali (Cassia fistula fruit pulp), Jasthimadhu (licorice root) and Mouri (fennel seed). It is used for the short term relief of occasional constipation and hard stools. Ispaghula is a well studied bulk forming fibre and Senna is an established stimulant laxative; evidence for the other herbs is mainly traditional.
How It Works
Ispaghula husk absorbs water in the gut and swells into a soft gel, making stools bulkier and easier to pass. Senna contains sennosides, which are activated by gut bacteria and stimulate the bowel muscles to push stools along; it usually works within 6 to 12 hours. Haritaki and Cassia fistula pulp have a mild traditional laxative action, licorice soothes the gut lining, and fennel helps reduce wind and cramping.
Dosage and Administration
Take as directed on the label, usually at bedtime, mixed with or followed by a full glass of water. Always drink plenty of fluids during the day. Do not take it dry or lying down, as the husk can swell and cause choking. Use for short periods only; if constipation lasts more than one week despite treatment, see a doctor. Do not give to children under 12 years unless a doctor advises it.
Interactions
Ispaghula can reduce the absorption of other medicines, so take other medicines at least two hours before or after this product. Senna and licorice can lower potassium, especially with water tablets (diuretics) such as Furosemide or Hydrochlorothiazide, steroid medicines such as Prednisolone, and Digoxin, where low potassium increases the risk of side effects. Licorice may also raise blood pressure. People with diabetes may need to check blood sugar, as fibre can change sugar absorption.
Contraindications
- Blockage or narrowing of the bowel, or difficulty swallowing
- Unexplained stomach pain, nausea or vomiting, or suspected appendicitis
- Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
- Severe dehydration or low potassium
- Children under 12 years, unless a doctor advises it
- Allergy to any ingredient
Side Effects
Common effects include wind, bloating, stomach cramps and loose stools. Long term or heavy use of Senna can cause diarrhoea, loss of fluids and salts (especially potassium), and dependence on laxatives. Senna may make urine reddish brown, which is harmless.
Get urgent medical help if you have chest pain, choking or difficulty swallowing or breathing after taking it, severe stomach pain or swelling, vomiting, rectal bleeding, black stools, or muscle weakness and an irregular heartbeat.
Pregnancy and Lactation
Bulk fibre such as Ispaghula is the preferred laxative in pregnancy, but stimulant laxatives such as Senna and large amounts of licorice should be used only on a doctor’s advice. Small amounts of Senna pass into breast milk and may occasionally cause loose stools in the baby; ask a doctor before use while breastfeeding.
Precautions and Warnings
A sudden change in bowel habit lasting more than two weeks, blood in the stool, weight loss or constipation in older adults needs a doctor’s check. Do not use regularly for weight loss. Older people, people with heart or kidney disease, and those taking several medicines should take advice before use. Eating more fibre, drinking enough water and staying active help prevent constipation.
Overdose
Overdose may cause severe diarrhoea, stomach cramps, dehydration and low potassium. Drink fluids and contact a doctor. If a child has swallowed the product, or the person is weak or dizzy, go to the nearest hospital and take the pack with you.
Therapeutic Class
Herbal laxative (bulk forming and stimulant combination).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep the container tightly closed to protect from moisture.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.