Drug & supplement interaction

Senna + Chlorothiazide

Chlorothiazide brand name: Diuril.

Moderate Interaction
The bottom line Moderate

Senna has a moderate interaction with Chlorothiazide. Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Senna and Chlorothiazide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DIURETIC DRUGS

Why this applies to Chlorothiazide

Chlorothiazide falls under DIURETIC DRUGS — the group Senna interacts with.

Theoretically, senna might increase the risk of hypokalemia when taken with diuretic drugs.
Overuse of senna might compound diuretic-induced potassium loss and increase the risk for hypokalemia.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep in mind: chlorothiazide (Diuril) is a water pill that makes your kidneys flush out salt and water, and it also tends to lower your potassium. Senna, when overused, pulls fluid and potassium out through your gut. So the worry is that doing both at once could stack up and drop your potassium too low, a state called hypokalemia.

If potassium dips low, you might feel muscle cramps, weakness, tiredness, or notice an irregular heartbeat. Honestly though, this is mostly a theoretical concern based on how these two work, and it really only becomes an issue with heavy or daily senna use. Using senna occasionally for a few days is far less likely to cause trouble. If you take senna often, mention it to your pharmacist or doctor so they can check your potassium.

References
  1. Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Senna Also Interacts With Other Medications

Senna has 139 moderate known drug interactions in our database — the Chlorothiazide one above is 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.

From our Q&A

Questions About Senna or Chlorothiazide

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 Chlorothiazide, 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 Chlorothiazide

This page covers Senna only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlorothiazide page lists 227 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 192 moderate · 25 minor.

Open the Chlorothiazide 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. Your product may carry other ingredients that interact with Chlorothiazide too, on top of Senna — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Senna and Chlorothiazide 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 Chlorothiazide
Top half

#1,253 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.

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.

Read the full Senna monograph & all interactions
Medication

About Chlorothiazide

What Is Chlorothiazide Used For?

Brand name: Diuril

Chlorothiazide is used to reduce fluid buildup (edema) linked to conditions such as heart failure, liver cirrhosis (hepatic cirrhosis), and certain kidney disorders — including nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. It is also used when edema is caused by corticosteroid or estrogen therapy.

The oral suspension (Diuril) is additionally approved to treat high blood pressure, either on its own or alongside other blood pressure medications. The intravenous forms — including Sodium Diuril, Chlorothiazide Sodium, and Chlorothiazide injection products — are reserved for treating edema in patients who cannot take oral medication or in emergency situations; these intravenous products are not approved for high blood pressure management.

See full Chlorothiazide 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
139Moderate
0Minor
2,690No known interaction
Moderate

139 interactions

Showing 60 of 139 moderate interactions — see all 139 on the Senna page.

No interaction 2,690 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

Keep exploring
Pharmacist Counseling Corner

Taking Senna and Chlorothiazide Together: Common Questions

Can you take Senna with Chlorothiazide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Senna and Chlorothiazide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Chlorothiazide 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.