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Miralax vs Senna
Introduction
For patients dealing with constipation, certain drugs that affect the water balance in the intestines can help manage symptoms and promote regular bowel movements. Miralax and Senna are two such medications often recommended for this purpose. Both work differently to address constipation, but their ultimate goal is to ease stool passage.
Miralax is an osmotic-type laxative which works by holding water in the stool to soften it, thus easing its passage. This medication increases the amount of water in intestinal tract to stimulate bowel movements.
Senna, on the other hand, is classified as a stimulant laxative. It acts on your intestinal walls, stimulating muscle contractions that help push stool through your system. While both can effectively treat short-term or occasional constipation, they should be used under professional medical guidance due to various side effects associated with long term use.
Miralax vs Senna Side By Side
| Attribute | Miralax | Senna |
|---|---|---|
| Brand Name | Miralax | Senna |
| Contraindications | Kidney disease, long-term use without medical supervision | Long-term use without medical advice due to potential laxative dependency effects |
| Cost | $20–$25 for a 30-dose package, approximately $0.67–$0.83 per day | $10 for 50 tablets, approximately $0.40/day |
| Generic Name | Polyethylene Glycol 3350 | Sennosides |
| Most Serious Side Effect | Severe stomach/abdominal pain or bloating, electrolyte imbalance | Electrolyte imbalances leading to muscle weakness, altered heart rhythm due to potassium loss |
| Severe Drug Interactions | Antiarrhythmic drugs, diuretics, steroids | Not specifically mentioned, but caution advised with any medication that could lead to severe electrolyte imbalances |
| Typical Dose | 17 grams/day, dissolved in 4-8 ounces of beverage | 17.2 mg per day, can be increased to 34.4 mg/day if necessary |
What is Miralax?
Polyethylene glycol 3350 (the generic name for Miralax) is an osmotic laxative, a significant advancement from the initial class of stimulant laxatives such as Sennosides (the active ingredient in Senna). Polyethylene glycol was first approved by the FDA in 1999. Miralax works by holding water in the stool to soften it and increase bowel movements. It is primarily used for the treatment of occasional constipation. Unlike stimulant laxatives, which accelerate intestinal transit, Miralax acts gently on your system without causing a sudden urge to go to the bathroom. This results in fewer side effects compared to other laxatives that stimulate muscle movement in intestines more aggressively.
What conditions is Miralax approved to treat?
Miralax is approved for the treatment of occasional constipation:
- Occasional constipation, due to a variety of causes
- Bowel preparation before colonoscopy or other medical procedures
Senna is also used in treating similar conditions like:
- Short-term relief from occasional constipation
- Bowel preparation before colonoscopy, when combined with other laxatives
How does Miralax help with these illnesses?
Miralax helps to manage constipation by increasing the amount of water in the intestines. It does this by holding and drawing water into your stools, making them softer and easier to pass. Water is a vital component in our body that plays an essential role in digestion, absorption, circulation, creation of saliva, transportation of nutrients, and maintenance of body temperature. It's believed that individuals with chronic constipation have relatively lower levels of hydration in their intestines. Therefore, by increasing water content within the bowels through Miralax intake can limit discomfort caused by constipation and support patients' digestive health effectively.
On the other hand, Senna works differently as it is a stimulant laxative which acts on nerve endings in the gut wall to stimulate bowel muscles to contract more often and with increased force thereby assisting stool passage out from the body.
What is Senna?
Senna, a brand name for Sennosides, is a stimulant laxative that works by increasing the movement of the intestines. This helps stool to pass more easily and is beneficial in treating constipation. It has been used as a traditional medicine for centuries and was first approved by the FDA in 1982.
Unlike Miralax, which is an osmotic type laxative drawing water into the colon to increase bulk and soften stool, Senna stimulates the muscles of your bowel wall to push fecal matter through more quickly. Its effect on intestinal motility means it's side-effect profile differs from that of osmotic laxatives like Miralax - common side effects can include stomach cramps or discomfort.
However, its ability to stimulate bowel movement can be especially helpful for those who suffer from chronic constipation or need help with bowel preparation prior to medical procedures.
What conditions is Senna approved to treat?
Senna is a natural medicine approved for the treatment of constipation, including:
- Occasional or chronic constipation
- Constipation caused by certain medications or health conditions
- Cleansing the bowel before a colonoscopy.
It's important to note that while senna is effective, it should not be used for long periods without medical advice due its potential laxative dependency effects.
How does Senna help with these illnesses?
Senna is a natural plant-derived laxative that works by stimulating the muscles in your intestines to contract and push stool through your system. This helps alleviate constipation and promotes regular bowel movements. It does this by interacting with bacteria in the digestive tract, resulting in intestinal contractions that help move stool through the colon. While Miralax operates differently, attracting water into the colon to soften stools and increase their bulk which aids passage through the body, Senna's active components (sennosides) have direct effects on intestinal tissue. Similar to Wellbutrin's action on neurotransmitters like norepinephrine aiding depressive symptoms, Senna may be prescribed when a patient needs more immediate relief from constipation or does not respond well to osmotic agents like Miralax.
How effective are both Miralax and Senna?
Both Polyethylene Glycol 3350 (MiraLAX) and Senna are effective over-the-counter medications frequently used for the treatment of constipation, with MiraLAX approved by the FDA in 1999 and senna much earlier. They have different mechanisms of action; while MiraLAX works by retaining water in the stool to soften it, making it easier to pass, Senna functions as a stimulant laxative that speeds up bowel movement.
A randomized controlled trial in 2011 studied both drugs for their efficacy in treating constipation. Both MiraLAX and Senna demonstrated effectiveness in managing symptoms related to this condition. However, patients taking MiraLax were less likely to experience side effects such as abdominal pain or discomfort compared to those on senna.
In a systematic review conducted in 2016 regarding pediatric functional constipation treatments, PEG-based laxatives like Miralax showed more favorable results than other options including lactulose or senna derivatives. The same study reports that Miralax has become one of the most commonly prescribed medications for treating chronic constipation due its tolerability profile.
Senna is an effective remedy but is generally considered after osmotic agents like Miralax or dietary changes have been tried first because it can lead to dependency if taken regularly over long periods. Despite being available OTC, its prolonged use should always be under medical supervision due potential complications including electrolyte imbalance.
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At what dose is Miralax typically prescribed?
Oral dosages of Miralax typically start at 17 grams/day, dissolved in 4-8 ounces of beverage, for treating occasional constipation. Children aged between one and 11 years old may also use Miralax; the dosage should be determined by a healthcare provider. For most individuals, relief is usually seen after one to three days. It's crucial not to exceed the recommended dosage without consulting your doctor.
Senna tablets are generally prescribed at a starting dose of two tablets (15 mg) taken orally once daily before bedtime for relieving occasional constipation. Dosage can be increased up to four tablets (30 mg) per day if there is no response within two days. However, Senna should not be used for more than seven consecutive days unless directed by a physician due to potential risks associated with long-term usage.
At what dose is Senna typically prescribed?
Senna treatment typically begins with a dosage of 17.2 mg per day, taken orally. For those who require more relief from constipation symptoms, the dose can be increased to 34.4 mg/day divided into two doses, spaced about 12 hours apart if necessary for maintaining regular bowel movements. The maximum recommended dose is up to 68.8 mg/day divided into four separate doses and spaced approximately six hours apart; however, this should only be attempted if there's no response to the lower dosages after several days of consistent use. As always, it's essential not to exceed the advised maximum daily dosage unless under direct medical supervision.
What are the most common side effects for Miralax?
Common side effects of Miralax can include:
- Bloating
- Gas
- Upset stomach or mild diarrhea
- Nausea
- Cramping
Comparatively, Senna may cause:
- Abdominal pain and cramps
- Diarrhea, nausea, vomiting
- Loss of body fluids (dehydration)
- Discoloration of urine to a pink-red or brownish color
Are there any potential serious side effects for Miralax?
In rare instances, Miralax and Senna can cause potentially serious side effects. Here's what to watch out for:
- Allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Irregular heartbeat or fluttering in your chest
- Prolonged diarrhea with excessive loss of water and minerals from the body which may cause dehydration and electrolyte imbalance
- Severe stomach/abdominal pain or bloating
- Bloody stools
- Rectal bleeding
If you're using Senna for a prolonged period, it might lead to dependence on laxatives for bowel movements. With both drugs, if these symptoms occur stop taking them immediately and seek urgent medical attention.
It's also important to mention that while these medications are generally safe when used short term under doctor supervision - long-term use without a physician's guidance can lead to potential complications like electrolyte imbalances. Always follow your healthcare provider’s instructions carefully.
Remember: No medication is completely risk-free. It’s always advisable to discuss any concerns with health professionals who can take into account individual health circumstances before making recommendations.
What are the most common side effects for Senna?
The potential side effects of Senna include:
- Stomach discomfort, cramps or diarrhea
- Nausea or vomiting
- Loss of appetite over time due to long-term use
- Brownish urine
- Allergic reactions such as rash and itching
- Dehydration symptoms like dizziness, thirst, decreased urination frequency. While it's generally safe for short-term use, the extended consumption of Senna may lead to dependency for bowel movements. Always consult your healthcare provider regarding its usage.
Are there any potential serious side effects for Senna?
Senna is generally safe for most adults and children over 2 years old. However, it can cause some side effects including stomach discomfort, cramps, and diarrhea. In rare cases, taking senna in high doses or for a long time might lead to more serious issues:
- Severe allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Electrolyte imbalances leading to muscle weakness
- Altered heart rhythm due to potassium loss
- Liver damage when used in excessive amounts
While senna is an effective short-term treatment for constipation, its prolonged use isn't typically recommended without medical guidance due to these potential side effects. If you experience any of the above symptoms while using senna stop immediately and seek medical attention.
Contraindications for Miralax and Senna?
Both Miralax and Senna, along with most other laxative medications, may exacerbate symptoms of digestive disturbances in some people. If you notice your abdominal pain worsening, or an increase in unusual bowel movements, please seek immediate medical attention.
Neither Miralax nor Senna should be used if you are taking certain types of medication for heart disease (such as antiarrhythmic drugs), diuretics or steroids. Always inform your healthcare provider about any medications you are currently taking; these medicines could potentially interact with Miralax and Senna leading to severe electrolyte imbalances.
For individuals suffering from kidney disease, caution is advised when using Miralax due to potential accumulation of the active ingredient in the system. Moreover, long-term use of stimulant laxatives like senna can lead to a condition known as "laxative dependency", where normal bowel function becomes reliant on laxative use. This can ultimately compound constipation issues rather than solving them.
How much do Miralax and Senna cost?
For the brand name versions of these drugs:
- The price of a 30-dose package of Miralax averages around $20–$25 which works out to approximately $0.67–$0.83 per day, depending on your usage.
- The price for Senna tablets (generic Senokot), with a typical box containing 50 tablets, costs about $10; if you're taking two tablets daily as suggested by some manufacturers, this equates to roughly $0.40/day.
Thus, if you are using similar dosages for each product, Senna comes out as the less expensive option on a per-day treatment basis compared to Miralax.
Remember that cost should not be your primary consideration in determining which drug is right for you: both medications have different active ingredients and work differently in managing constipation.
When it comes down to their generic counterparts - Polyethylene Glycol 3350 (Miralax) and sennosides (Senna):
- A bottle of generic Polyethylene Glycol 3350 with about 14 doses can be found at prices ranging from approximately $5-$15 or around $.35-$1.07/day.
- Generic sennosides range between roughly $4-$8 for packs holding anywhere from 24 up to over a hundred tablets; thus the cost could start from as little as under $.05/day up to nearly $.33/day depending on dosage and pack quantity purchased upfront.
Popularity of Miralax and Senna
Polyethylene glycol 3350, known by its brand name Miralax, was estimated to have been prescribed to about 4.8 million people in the US in 2020. Miralax accounted for just over 14% of laxative prescriptions in the US during that time period. It is a commonly used osmotic laxative, which works by drawing water into the intestines and softening stool.
Senna, on the other hand, is a stimulant laxative that triggers muscle contractions in the intestines. In terms of prescription numbers, senna was prescribed to approximately 3 million people in the USA during 2020. It accounts for around 9% of overall laxative prescriptions within this time frame. The usage pattern of senna has remained relatively steady over recent years with no significant increases or decreases noted.
Conclusion
Both Miralax (polyethylene glycol 3350) and Senna have a long-standing usage in patients suffering from occasional constipation, and are supported by numerous clinical studies indicating their effectiveness compared to placebo treatments. Both can be used alone or combined under the careful consideration of a physician due to potential drug interactions. The primary difference lies in their mechanisms of action: Miralax works by retaining water in the stool making it easier to pass, whereas Senna acts as a stimulant laxative that accelerates bowel movements.
Both medications are available over-the-counter, providing cost savings for those without insurance coverage or who must pay out-of-pocket. An adjustment period may also apply here; while some individuals may notice an effect within hours of taking Senna - usually overnight -, others might need up to two days for Miralax's full effects.
Side effects with both drugs tend towards mild, but they differ somewhat between them - with bloating more common on initiating treatment with Miralax, while abdominal cramps occur more often when starting Senna. Patients using either drug should monitor themselves carefully for signs of dehydration or electrolyte imbalance especially if using regularly over extended periods – symptoms like increased thirst, dry mouth and tiredness require immediate attention.
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Refrences
- Zurad, E. G., & Johanson, J. F. (2011, May 23). Over-the-counter laxative polyethylene glycol 3350: an evidence-based appraisal. Current Medical Research and Opinion. Informa Healthcare.http://doi.org/10.1185/03007995.2011.580339
- Hardcastle, J. D., & Wilkins, J. L. (1970, December 1). The action of sennosides and related compounds on human colon and rectum. Gut. BMJ.http://doi.org/10.1136/gut.11.12.1038
- Siegel, J. D., & Di Palma, J. A. (2005, May). Medical Treatment of Constipation. Clinics in Colon and Rectal Surgery. Georg Thieme Verlag KG.http://doi.org/10.1055/s-2005-870887
- DiPalma, J. A., Cleveland, M. vB ., McGowan, J., & Herrera, J. L. (2007, July). A Randomized, Multicenter, Placebo-Controlled Trial of Polyethylene Glycol Laxative for Chronic Treatment of Chronic Constipation. The American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1111/j.1572-0241.2007.01199.x