Drug & supplement interaction

Senna + Tadalafil

Tadalafil brand names: Cialis, Tadliq.

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 Tadalafil 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 Tadalafil

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 Tadalafil 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 Tadalafil and Senna? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Tadalafil

Interactions in our licensed database are recorded against drug classes, not just single drug names. Tadalafil is filed under 5 classifications — including phosphodiesterase-5 inhibitors, vasodilators, cytochrome p450 3a4 (cyp3a4) 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 Tadalafil’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 — Tadalafil 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. Tadalafil)

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 Tadalafil May Share a Side Effect

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.

Stomach pain 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

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
Tadalafil

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

Reported for Senna but not commonly for Tadalafil: a severe skin reaction, sun sensitivity, a skin rash and constipation.

Effects for Tadalafil 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 98,103 voluntary FDA FAERS reports for Tadalafil 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 Tadalafil

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 Tadalafil, 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 Tadalafil

This page covers Senna only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tadalafil page lists 144 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Mistletoe (major), Grapefruit (major), Hawthorn (major) and St. John's Wort (major).

By severity: 5 major · 98 moderate · 41 minor.

From our pharmacist’s overview on the Tadalafil page

“Grapefruit juice is the first thing to know about if you take tadalafil (Cialis, Tadliq). It blocks CYP3A4, the enzyme that clears the drug, so blood levels climb and side effects like a steep drop in blood pressure become more likely.”

Reviewed by 2 · Jul 18, 2026

Open the Tadalafil 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 Tadalafil, 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 Tadalafil 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 Tadalafil

Top 1%

#16 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 Tadalafil 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 Tadalafil

What Is Tadalafil Used For?

Brand names: Cialis, Tadliq

Tadalafil tablets (including Cialis and generic tadalafil) are used to treat erectile dysfunction (ED), the symptoms of benign prostatic hyperplasia (BPH — an enlarged prostate), or both conditions together. When used with the drug finasteride to start BPH treatment, this combination is recommended for up to 26 weeks.

Adcirca, Alyq (tablets), and Tadliq (oral suspension) are indicated specifically for pulmonary arterial hypertension (PAH — high blood pressure in the lungs), to improve the ability to exercise.

Most-Reported Side Effects for Tadalafil

From FAERS, the FDA’s public side-effect reporting system (99,210 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Dyspnea 11,917 reports

Headache 10,982 reports

Diarrhea 8,020 reports

Nausea 6,697 reports

Fatigue 6,080 reports

See full Tadalafil 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 Tadalafil, 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 Tadalafil Together: Common Questions

Is it safe to take Senna with Tadalafil?

We do not list a known interaction between Senna and Tadalafil. 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 Tadalafil have any of the same side effects?

Yes — our sources link each of them separately to one 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 Tadalafil combination checked?

Interactions in our licensed database are recorded against drug classes. Tadalafil is filed under 5 classifications, and Senna has documented interactions with 5 drug classes — none of Tadalafil'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 — Tadalafil 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 Tadalafil interact with any supplements?

Yes. Tadalafil has documented interactions with 144 supplements in our database — Senna is not one of them. The Tadalafil interaction page linked on this page lists every one, ranked by severity.

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 Tadalafil drug information The full plain-English guide to this medication Tadalafil supplement interactions Every supplement checked against Tadalafil, 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 Tadalafil 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.