Drug & supplement interaction

Senna + Botulinum Toxin Type A

Botulinum Toxin Type A brand name: Botox.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Senna and Botulinum Toxin Type A 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.

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Interaction report

Senna and Botulinum Toxin Type A

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 Botulinum Toxin Type A 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 Botulinum Toxin Type A and Senna? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

Keep it in perspective

Senna Does Interact With Other Medications

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

Moderate 140 No known interaction 2,690 (incl. Botulinum Toxin Type A)

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

What Senna Itself Has Been Linked To

This is not an interaction — nothing below involves Botulinum Toxin Type A. It is the side-effect record for Senna on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Senna, this list is the first place to look. 4 entries are worth acting on rather than waiting out — marked below.

Blood clots / Liver problems Worth acting on Additional detail
“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

13057. Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med 2004;141:650-1. PubMed

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

41431. Stickel, F. and Schuppan, D. Herbal medicine in the treatment of liver diseases. Dig.Liver Dis. 2007;39(4):293-304. PubMed

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.

74564. Beuers, U., Spengler, U., and Pape, G. R. Hepatitis after chronic abuse of senna. Lancet 2-9-1991;337(8737):372-373. PubMed

74584. Soyuncu, S., Cete, Y., and Nokay, A. E. Portal vein thrombosis related to Cassia angustifolia. Clin.Toxicol.(Phila) 2008;46(8):774-777.
A severe skin reaction Worth acting on Additional detail
“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

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

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
Shortness of breath / A severe allergic reaction Worth acting on Additional detail
“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

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
Hives Worth acting on Additional detail

Recorded for Senna in the same Natural Medicines adverse-effect record shown under A severe skin reaction above.
Sun sensitivity / Constipation Additional detail

Recorded for Senna in the same Natural Medicines adverse-effect record shown under A severe skin reaction above.
Bloating or gas Additional detail
“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

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

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

15435. Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin 1977;4:540-3. PubMed

15436. Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.

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

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
Swelling Additional detail

Recorded for Senna in the same Natural Medicines adverse-effect record shown under Shortness of breath / A severe allergic reaction above.

Showing the 10 most notable of 14 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Senna — expand a row for the licensed statement it rests on. We haven’t matched Botulinum Toxin Type A to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Botulinum Toxin Type A.

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 Botulinum Toxin Type A

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 Botulinum Toxin Type A, 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.

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 Botulinum Toxin Type A, 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 Botulinum Toxin Type A 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 Botulinum Toxin Type A

Top half

#1,211 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 Botulinum Toxin Type A 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Senna

What is 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 OnabotulinumtoxinA Injection

What Is OnabotulinumtoxinA Injection Used For?

Brand name: Botox

Botox is approved to treat a wide range of conditions in adults and some children. These include overactive bladder (OAB) with urge incontinence, urinary incontinence caused by nerve-related bladder overactivity (in adults and in children aged 5 and older), prevention of headaches in adults with chronic migraine (15 or more headache days per month), muscle stiffness (spasticity) in patients aged 2 and older, cervical dystonia (abnormal head position and neck pain), severe underarm sweating (primary axillary hyperhidrosis) when topical treatments haven't worked, eyelid spasms (blepharospasm) in patients aged 12 and older, and crossed eyes (strabismus) in patients aged 12 and older.

BOTOX Cosmetic is a separate product containing the same active ingredient but with its own approved cosmetic uses. Both products are given by injection and are not interchangeable with other botulinum toxin products. Botox has not been shown to work for episodic migraine (14 or fewer headache days per month), and its safety for excessive sweating in body areas other than the underarms has not been established.

Most-Reported Side Effects for Botulinum Toxin Type A

From FAERS, the FDA’s public side-effect reporting system (12,344 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Headache 1,596 reports

Drug intolerance 1,333 reports

Nausea 1,266 reports

Migraine 1,176 reports

Dizziness 1,126 reports

See full OnabotulinumtoxinA Injection 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

140 Moderate 2,689 No 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

We also checked Senna against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,689 medications checked with no known interaction — see the full Senna list.

See the full Senna interactions page

See every supplement checked against Botulinum Toxin Type A, ranked by severity

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.

McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776-89. PubMed
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
Seybold U, Landauer N, Hillebrand S, Goebel FD. Senna-induced hepatitis in a poor metabolizer. Ann Intern Med 2004;141:650-1. PubMed
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
Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. PubMed
Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet 1978;2:947. PubMed
Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease--benefits and dangers. Aliment Pharmacol Ther 2001;15:1239-52. PubMed
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
Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230-6. PubMed
van Os FH. Anthraquinone derivatives in vegetable laxatives. Pharmacology 1976;14:7-17. PubMed
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
Perkin JM. Constipation in childhood: a controlled comparison between lactulose and standardized senna. Curr Med Res Opin 1977;4:540-3. PubMed
Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.
[No authors listed] Senna in the puerperium. Pharmacology 1992;44:23-5. PubMed
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
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
MacLennan WJ, Pooler AFWM. A comparison of sodium picosulphate ("Laxoberal") with standardised senna ("Senokot") in geriatric patients. Curr Med Res Opin. 1974;2:641-7. PubMed
Kittisupamongkol W, Nilaratanakul V, Kulwichit W. Near-fatal bleeding, senna, and the opposite of lettuce. Lancet 2008;371:784. PubMed
Prather CM. Pregnancy-related constipation. Curr Gastroenterol Rep 2004;6:402-4. PubMed
Werthmann WM Jr, Krees SV. Quantitative excretion of Senokot in human breast milk. Med Ann Dist Columbia 1973;42:4-5.
Hagemann TM. Gastrointestinal medications and breastfeeding. J Hum Lact 1998;14:259-62. PubMed
Faber P, Strenge-Hesse A. Senna-containing laxatives: excretion in the breast milk? Geburtshilfe Frauenheilkd 1989;49:958-62.
Faber P, Strenge-Hesse A. Relevance of rhein excretion into breast milk. Pharmacology 1988;36 Suppl 1:212-20. PubMed
Duncan AS. Standardized senna as a laxative in the puerperium; a clinical assessment. Br Med J 1957;1:439-41. PubMed
Stickel, F. and Schuppan, D. Herbal medicine in the treatment of liver diseases. Dig.Liver Dis. 2007;39(4):293-304. PubMed
BALDWIN, W. F. CLINICAL STUDY OF SENNA ADMINISTRATION TO NURSING MOTHERS: ASSESSMENT OF EFFECTS ON INFANT BOWEL HABITS. Can.Med Assoc.J 9-14-1963;89:566-568. DOI
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.
Beuers, U., Spengler, U., and Pape, G. R. Hepatitis after chronic abuse of senna. Lancet 2-9-1991;337(8737):372-373. PubMed
Lim, A. K., Hooke, D. H., and Kerr, P. G. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 1-21-2008;188(2):121-122. PubMed
McLaughlin, A. F. Anorexia nervosa and senna misuse: nephrocalcinosis, digital clubbing and hypertrophic osteoarthropathy. Med J Aust. 9-15-2008;189(6):348. PubMed
Soyuncu, S., Cete, Y., and Nokay, A. E. Portal vein thrombosis related to Cassia angustifolia. Clin.Toxicol.(Phila) 2008;46(8):774-777.
Levine, D., Goode, A. W., and Wingate, D. L. Purgative abuse associated with reversible cachexia, hypogammaglobulinaemia, and finger clubbing. Lancet 4-25-1981;1(8226):919-920. PubMed
Malmquist, J., Ericsson, B., Hulten-Nosslin, M. B., Jeppsson, J. O., and Ljungberg, O. Finger clubbing and aspartylglucosamine excretion in a laxative-abusing patient. Postgrad.Med J 1980;56(662):862-864. PubMed
Lewis, S. J., Heaton, K. W., Oakey, R. E., and McGarrigle, H. H. Lower serum oestrogen concentrations associated with faster intestinal transit. Br.J Cancer 1997;76(3):395-400. PubMed
Lewis, S. J., Oakey, R. E., and Heaton, K. W. Intestinal absorption of oestrogen: the effect of altering transit-time. Eur.J Gastroenterol.Hepatol. 1998;10(1):33-39. PubMed
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
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
Coskun Y, Yuksel I. Polyethylene glycol versus split high-dose senna for bowel preparation: A comparative prospective randomized study. J Gastroenterol Hepatol 2020;35(11):1923-1929.
Haoudar A, Chekhlabi N, El Kettani C, Dini N. Acute Hepatitis and Pancytopenia in a Child With Chronic Abuse of Senna. Cureus 2021;13(1):e12436. PubMed
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

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 Botulinum Toxin Type A Together: Common Questions

Is it safe to take Senna with Botulinum Toxin Type A?

We do not list a known interaction between Senna and Botulinum Toxin Type A. 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.

Does Senna interact with any other medications?

Yes. Senna has 140 documented drug interactions in our database — Botulinum Toxin Type A is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

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

Where next

Keep Exploring

Senna monograph Uses, safety profile, and every drug interaction in one place OnabotulinumtoxinA Injection drug information The full plain-English guide to this medication Botulinum Toxin Type A supplement interactions Every supplement checked against Botulinum Toxin Type A, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 42 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Botulinum Toxin Type A 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.