Drug & supplement interaction

Senna + Amitriptyline

Amitriptyline brand name: Elavil.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Senna and Amitriptyline in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Senna and Amitriptyline

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Amitriptyline and Senna in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Senna safety at a glance

Senna overall Use caution Generally safe for short-term occasional use but not for long-term daily use without medical advice.
Pregnancy Possibly Safe When used orally and appropriately, short-term. POSSIBLY UNSAFE...when used orally long-term or in high doses. Long-term, frequent use, or use of high doses has... Read the full pregnancy detail
Breastfeeding Possibly Safe When used orally and appropriately, short term. Although small amounts of constituents of senna cross into breast milk, senna has been taken while breast-feedin... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Amitriptyline and Senna? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Amitriptyline

Interactions in our licensed database are recorded against drug classes, not just single drug names. Amitriptyline is filed under 15 classifications — including tricyclic antidepressants (tcas), antidepressant drugs, cytochrome p450 2c19 (cyp2c19) substrates. Senna has documented interactions with 5 drug classes — the most serious being digoxin (lanoxin) (moderate), diuretic drugs (moderate) and estrogens (moderate) — and none of Amitriptyline’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Senna Does Interact With Other Medications

Senna has 140 moderate known drug interactions in our database — Amitriptyline isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Senna

Covers the 2,830 medications we’ve checked against Senna. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Senna and Amitriptyline May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Hives Worth acting on Additional detail

    Senna

    “In adults, there are rare case reports of skin eruptions associated with senna, including erythema multiforme, fixed drug eruption, lichenoid reaction, toxic epidermal necrolysis, urticaria, photosensitivity, and contact dermatitis. Infants and young children given senna products have experienced contact reactions on the buttocks due to prolonged exposure to stool while wearing a diaper overnight.”

    Senna · Natural Medicines adverse-effect record, reported in burns.

    2 sources cited
    1. 96558. Vilanova-Sanchez A, Gasior AC, Toocheck N, et al. Are Senna based laxatives safe when used as long term treatment for constipation in children? J Pediatr Surg 2018;53(4):722-7. PubMed
    2. 96559. Cogley K, Echevarria A, Correa C, De la Torre-Mondragón L. Contact Burn with Blister Formation in Children Treated with Sennosides. Pediatr Dermatol 2017;34(2):e85-e88. PubMed

    “In one case report, a 19-year-old male developed anaphylaxis with dyspnea, facial edema, and hives. This reaction was determined to be caused by the senna content in a specific combination product (Delgaxan Plus, Pompadour Ibérica) that the patient ingested.”

    Senna · Natural Medicines adverse-effect record, reported in pregnancy-related edema.

    1 source cited
    1. 105957. Irazábal B, Sánchez de Vicente J, Galán C, et al. Anaphylaxis Due to Senna (Cassia angustifolia). J Investig Allergol Clin Immunol 2021;31(1):71-73. PubMed

    Amitriptyline

    Listed in the ADVERSE REACTIONS section of the FDA label for Amitriptyline. Read the label on DailyMed ›

  • Liver problems Worth acting on Additional detail

    Senna

    “Chronic liver damage, portal vein thrombosis, and hepatitis have been reported following oral use of senna alkaloids, such as in tea made from senna leaves. There is a case report of hepatitis in a female who consumed moderate amounts of senna tea. The patient was a poor metabolizer of cytochrome P450 2D6 (CYP2D6).”

    Senna · Natural Medicines adverse-effect record, reported in hepatitis.

    6 sources cited
    1. 13057. Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med 2004;141:650-1. PubMed
    2. 13095. Vanderperren B, Rizzo M, Angenot L, et al. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Ann Pharmacother 2005;39:1353-7. PubMed
    3. 41431. Stickel, F. and Schuppan, D. Herbal medicine in the treatment of liver diseases. Dig.Liver Dis. 2007;39(4):293-304. PubMed
    4. 74560. Sonmez, A., Yilmaz, M. I., Mas, R., Ozcan, A., Celasun, B., Dogru, T., Taslipinar, A., and Kocar, I. H. Subacute cholestatic hepatitis likely related to the use of senna for chronic constipation. Acta Gastroenterol.Belg. 2005;68(3):385-387.
    5. 74564. Beuers, U., Spengler, U., and Pape, G. R. Hepatitis after chronic abuse of senna. Lancet 2-9-1991;337(8737):372-373. PubMed
    6. 74584. Soyuncu, S., Cete, Y., and Nokay, A. E. Portal vein thrombosis related to Cassia angustifolia. Clin.Toxicol.(Phila) 2008;46(8):774-777.

    Amitriptyline

    Listed in the ADVERSE REACTIONS section of the FDA label for Amitriptyline. Read the label on DailyMed ›

  • Sun sensitivity / Constipation / A skin rash Additional detail

    Senna

    Recorded for Senna in the same Natural Medicines adverse-effect record shown under Hives above.

    Amitriptyline

    Listed in the ADVERSE REACTIONS section of the FDA label for Amitriptyline. Read the label on DailyMed ›

  • Diarrhea / Nausea reported in 8.8% of FDA reports for Amitriptyline Additional detail

    Senna

    “Orally, senna can cause abdominal pain and discomfort, cramps, bloating, flatulence, nausea, fecal urgency, and diarrhea. Chronic use has also been associated with "cathartic colon," radiographically diagnosed anatomical changes to the colon such as benign narrowing, colonic dilation, and loss of colonic folds. The clinical relevance of these findings is unclear.”

    Senna · Natural Medicines adverse-effect record, reported in colorectal adenoma.

    6 sources cited
    1. 15427. Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease--benefits and dangers. Aliment Pharmacol Ther 2001;15:1239-52. PubMed
    2. 15434. Sondheimer JM, Gervaise EP. Lubricant versus laxative in the treatment of chronic functional constipation of children: a comparative study. J Pediatr Gastroenterol Nutr 1982;1:223-6. DOI
    3. 15435. Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin 1977;4:540-3. PubMed
    4. 15436. Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.
    5. 15439. Passmore AP, Davies KW, Flanagan PG, et al. A comparison of Agiolax and lactulose in elderly patients with chronic constipation. Pharmacology 1993;47:249-52. PubMed
    6. 15440. Passmore AP, Wilson-Davies K, Stoker C, Scott ME. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. BMJ 1993;307:769-71. PubMed

    Amitriptyline

    Listed in the ADVERSE REACTIONS section of the FDA label for Amitriptyline, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Swelling Additional detail

    Senna

    Recorded for Senna in the same Natural Medicines adverse-effect record shown under Hives above.

    Amitriptyline

    Listed in the ADVERSE REACTIONS section of the FDA label for Amitriptyline. Read the label on DailyMed ›

Reported for Senna but not commonly for Amitriptyline: a severe skin reaction, stomach pain, a severe allergic reaction and bloating or gas.

Effects for Amitriptyline come from the ADVERSE REACTIONS section of its FDA label; effects for Senna come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 17,459 voluntary FDA FAERS reports for Amitriptyline that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Senna in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used orally and appropriately, short-term. POSSIBLY UNSAFE...when used orally long-term or in high doses. Long-term, frequent use, or use of high doses has been linked to serious side effects including laxative dependence and liver toxicity.

Lactation Possibly Safe

When used orally and appropriately, short term. Although small amounts of constituents of senna cross into breast milk, senna has been taken while breast-feeding with apparent safety. Senna does not cause changes in the frequency or consistency of infants' stools..

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Senna or Amitriptyline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Senna or Amitriptyline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Amitriptyline

This page covers Senna only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline page lists 296 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 17 major · 228 moderate · 51 minor.

From our pharmacist’s overview on the Amitriptyline page

“Amitriptyline (Elavil), an older antidepressant now often prescribed for nerve pain, migraines, and sleep, is one of the drugs I genuinely want patients to be careful with, and 17 of the 296 supplement and herbal ingredients on this list carry a major rating. Most of the serious ones deepen the drowsiness amitriptyline already causes,…”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline interaction page

One more smart check

Taking Senna as Part of a Dietary Supplement Product? Check It for Interactions

We hold 120 real supplement products containing Senna, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Senna. Even though Senna itself has no known interaction with Amitriptyline, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Senna and Amitriptyline Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Senna
Top 25%

#225 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amitriptyline
Top 5%

#52 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Senna reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Senna and Amitriptyline records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Senna

What is Senna?

Senna
  • Short-term constipation relief
  • Bowel cleansing before procedures
  • Occasional irregularity
  • Traditional digestive remedy

Senna is a plant-based stimulant laxative that is widely used and generally effective for short-term relief of constipation. It is best used occasionally and for only a few days at a time, since long-term use can lead to dependence and other problems. Talk with a pharmacist or doctor before using it regularly or if you have ongoing constipation.

Senna alexandrina · Fabaceae · Leaves and pods (fruit) · Tablets, capsules, tea, liquid extract, syrup

An interaction check asks whether these two react with each other — it does not ask whether Senna is a good idea for someone in your situation. Here is what our Senna record says about it on its own.

Senna: dosing

There is no single "best" dose of senna for everyone, and the right amount depends on the specific product and the form used. The safest approach is to follow the directions on the product label or the advice of your pharmacist or doctor.Senna is usually taken at bedtime so a bowel movement occurs the next morning. Use the lowest amount that works, and avoid using it for more than about a week unless a healthcare provider advises otherwise.

From our Senna monograph — the full record covers uses, side effects and every documented interaction.

Read the full Senna monograph & all interactions
Medication

About Amitriptyline

What Is Amitriptyline Used For?

Brand name: Elavil

Amitriptyline HCL and Amitriptyline Hydrochloride tablets are used to relieve symptoms of depression. Depression that originates from within the body (called endogenous depression) tends to respond better than other types of depression.

Most-Reported Side Effects for Amitriptyline

From FAERS, the FDA’s public side-effect reporting system (17,459 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 1,535 reports
Headache 1,476 reports
Fatigue 1,448 reports
Dyspnea 1,442 reports
Dizziness 1,227 reports
See full Amitriptyline drug information
Keep checking

Other Drugs & Senna

Browse every other medication we’ve checked against Senna — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
140Moderate
0Minor
2,689No known interaction
Moderate

140 interactions

Showing 60 of 140 moderate interactions — see all 140 on the Senna page.

No interaction 2,689 drugs checked — show the list
Evidence & sources

Senna References

The 42 references that drive our Senna monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  3. American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89. PubMed
  4. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  5. Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med 2004;141:650-1. PubMed
  6. Vanderperren B, Rizzo M, Angenot L, et al. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Ann Pharmacother 2005;39:1353-7. PubMed
  7. Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. PubMed
  8. Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet 1978;2:947. PubMed
  9. Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease--benefits and dangers. Aliment Pharmacol Ther 2001;15:1239-52. PubMed
  10. Joo JS, Ehrenpreis ED, Gonzalez L, et al. Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited. J Clin Gastroenterol 1998;26:283-6. PubMed
  11. Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230-6. PubMed
  12. van Os FH. Anthraquinone derivatives in vegetable laxatives. Pharmacology 1976;14:7-17. PubMed
  13. Sondheimer JM, Gervaise EP. Lubricant versus laxative in the treatment of chronic functional constipation of children: a comparative study. J Pediatr Gastroenterol Nutr 1982;1:223-6. DOI
  14. Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin 1977;4:540-3. PubMed
  15. Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Senna and Amitriptyline Together: Common Questions

Is it safe to take Senna with Amitriptyline?
We do not list a known interaction between Senna and Amitriptyline. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Senna and Amitriptyline have any of the same side effects?
Yes — our sources link each of them separately to 8 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Senna and Amitriptyline combination checked?
Interactions in our licensed database are recorded against drug classes. Amitriptyline is filed under 15 classifications, and Senna has documented interactions with 5 drug classes — none of Amitriptyline's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Senna interact with any other medications?
Yes. Senna has 140 documented drug interactions in our database — Amitriptyline is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Amitriptyline interact with any supplements?
Yes. Amitriptyline has documented interactions with 296 supplements in our database — Senna is not one of them. The Amitriptyline interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Amitriptyline and Senna?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.