Senna - Coumadin (Warfarin Sodium) Interaction
Herbal: Senna
Also Known As: Senna alexandrina, Alexandrian Senna, Alexandrinische Senna, Casse, Fan Xie Ye, Indian Senna, Khartoum Senna, Khatoum Senna, Sen, Sena Alejandrina, Séné, Sennae Folium, Sennae Fructus, Sennosides, Tinnevelly Senna, True Senna
Drug: Warfarin Sodium
Brand names:
Coumadin, Panwarfin, Sofarin
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Warfarin Sodium is classified as belonging to the following category: Warfarin (Coumadin)
Theoretically, excessive use of senna might increase the effects of warfarin.
Senna has stimulant laxative effects and can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. In one case report, excessive use of senna for 3 weeks resulted in diarrhea, bloody stools, and an elevated INR of 11.9.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Kittisupamongkol W, Nilaratanakul V, Kulwichit W. Near-fatal bleeding, senna, and the opposite of lettuce. Lancet 2008;371:784.
Senna Overview
Senna is a plant that belongs to the legume family. It is native to tropical and subtropical regions of the world, and it is widely cultivated for its medicinal properties. Senna contains compounds called sennosides, which are found in the leaves, stem, and pods of the plant. These compounds stimulate the muscles in the walls of the intestine, causing the bowel to contract and move waste through the intestines.
Senna is used as a natural laxative to help relieve constipation. It is often marketed as a 'natural vegetable laxative'. It is available in a number of forms, including tablets, capsules, and a liquid extract.
Although it can cause dependence with long-term use (i.e., the body becomes dependent on it for regular bowel movements), when compared to other stimulant laxatives, like bisacodyl, it is considered safer in that regard.
Warfarin Sodium Overview
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Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic (replacement or mechanical) heart valves, and people who have suffered a heart attack. Warfarin is also used to treat or prevent venous thrombosis (swelling and blood clot in a vein) and pulmonary embolism (a blood clot in the lung). Warfarin is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood.
Senna - More Interactions
Senna interacts with 140 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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