Drug & supplement interaction

Senna + Hydrochlorothiazide, Triamterene

Hydrochlorothiazide, Triamterene brand names: Maxzide, Dyazide, Maxzide-25, Triamzide, Triazide.

Moderate Interaction
The bottom line Moderate

Senna has a moderate interaction with Hydrochlorothiazide, Triamterene. 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 Hydrochlorothiazide, Triamterene

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

Moderate

DIURETIC DRUGS

Why this applies to Hydrochlorothiazide, Triamterene

Hydrochlorothiazide, Triamterene 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 something worth knowing about your Maxzide or Dyazide. This pill is actually a combination: hydrochlorothiazide tends to flush potassium out of your body, while triamterene works to hold potassium in. They balance each other, so your potassium usually stays in a reasonable range. Senna, when overused, pulls potassium out through your gut, so in theory it could tip that balance toward low potassium (hypokalemia).

To be fair, this is a theoretical concern based on how these work, not something proven to happen often. Occasional, short-term senna use is unlikely to cause trouble. The real risk comes from leaning on senna for weeks at a time. Watch for muscle cramps, weakness, or an irregular heartbeat, and check with your pharmacist before using senna regularly.

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 Hydrochlorothiazide, Triamterene 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 Hydrochlorothiazide, Triamterene

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 Hydrochlorothiazide, Triamterene, 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 Hydrochlorothiazide, Triamterene

This page covers Senna only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide, Triamterene page lists 235 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 · 199 moderate · 26 minor.

From our pharmacist’s overview on the Hydrochlorothiazide, Triamterene page

“Hydrochlorothiazide with triamterene (Dyazide, Maxzide) does two delicate jobs at once, pulling fluid off the body while holding on to potassium, and that is exactly where most of these supplements press. The great majority either add to its blood-pressure-lowering and diuretic effects, tipping people toward dizziness and unbalanced po…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide, Triamterene 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 Hydrochlorothiazide, Triamterene 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 Hydrochlorothiazide, Triamterene 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 Hydrochlorothiazide, Triamterene
Top half

#1,199 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
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

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Pharmacist Counseling Corner

Taking Senna and Hydrochlorothiazide, Triamterene Together: Common Questions

Can you take Senna with Hydrochlorothiazide, Triamterene?
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 Hydrochlorothiazide, Triamterene 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 Hydrochlorothiazide, Triamterene 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.