Hermes No. 8

In the U.S.

• Correctol Herbal Tea Laxative
• Dr. Caldwell Senna Laxative
• Fletcher's Castoria
• Innerclean
• Rite Aid Senna
• Senexon
• Senokot
• Swiss Kriss
• Uni-Cenna
• X-Prep

In Canada

• Hermes No. 8
• Pharaon Tea
• Senokot Syrup

Available Dosage Forms:

• Tablet
• Powder for Suspension
• Liquid
• Capsule, Liquid Filled
• Syrup
• Granule
• Flake
• Suspension

Therapeutic Class: Laxative, Stimulant

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of senna in children. However, safety and efficacy of senna chewable tablets have not been established in children younger than 6 years of age, or senna oral liquid and tablets in children younger than 2 years of age.

Geriatric

No information is available on the relationship of age to the effects of senna in geriatric patients.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Licorice

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Stomach or bowel problems (including abdominal or stomach pain, nausea, vomiting, or a sudden change in bowel habits lasting for more than 2 weeks)—Use with caution. May make these conditions worse.

This section provides information on the proper use of a number of products that contain senna. It may not be specific to Hermes No. 8. Please read with care.

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

Follow the instructions on the medicine label if you are using this medicine without a prescription.

Take this medicine preferably at bedtime, or as directed by your doctor.

Shake the oral liquid before use. Measure the dose correctly using the marked measuring spoon that comes with the package. Rinse the dosing spoon with water after each use.

If you are taking other medicines, take senna 2 or more hours after these medicines.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For relief of constipation:
  • For oral dosage form (chewable tablets):
    • Adults and children 12 years of age and older—2 tablets one or two times a day.
    • Children 6 to 11 years of age—1 tablet one or two times a day.
    • Children younger than 6 years of age—Use and dose must be determined by a doctor.
  • For oral dosage form (oral liquid):
    • Adults and children 12 years of age and older—At first, 2 to 3 teaspoonfuls once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 3 teaspoonfuls two times a day.
    • Children 6 to 11 years of age—At first, 1 to 1 1/2 teaspoonfuls once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 1 1/2 teaspoonfuls two times a day.
    • Children 2 to 6 years of age—At first, 1/2 to 3/4 teaspoonfuls once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 3/4 teaspoonfuls once a day.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.
  • For oral dosage form (oral powder):
    • Adults and children 12 years of age and older—1/2 to 1 teaspoonful once or two times a day.
    • Children 6 to 11 years of age—1/4 to 1/2 teaspoonful once or two times a day.
    • Children younger than 6 years of age—1/4 to 1/2 teaspoonful once or two times a day.
  • For oral dosage form (tablets):
    • Adults and children 12 years of age and older—At first, 2 tablets once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 4 tablets two times a day.
    • Children 6 to 11 years of age—At first, 1 tablet once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 2 tablets two times a day.
    • Children 2 to 5 years of age—At first, 1/2 tablet once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 1 tablet two times a day.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you or your child should continue to use it.

Tell your doctor if you or your child had already used a laxative for more than 1 week.

Call your doctor right away if you or your child has rectal bleeding, no bowel movement within 30 minutes of enema use, or has symptoms of dehydration (eg, confusion, decreased urination, feeling thirsty, vomiting). These maybe symptoms of a serious condition.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Black, tarry stools
• blood in the stools
• nausea or vomiting
• stomach pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.