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Drug overview for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
Generic name: senna leaf/psyllium husk/cascara/L.acidophilus/herbal no.279
Drug class: Stimulant Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Cellulose derivatives (methylcellulose), malt soup extract, and psyllium The anthraquinone group of stimulant laxatives includes the plant-derived compounds aloe (preparations containing aloe are no longer commercially preparations are bulk-forming laxatives. available in the US), cascara sagrada (preparations containing cascara sagrada are no longer commercially available in the US), frangula, and senna.
No enhanced Uses information available for this drug.
Generic name: senna leaf/psyllium husk/cascara/L.acidophilus/herbal no.279
Drug class: Stimulant Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Cellulose derivatives (methylcellulose), malt soup extract, and psyllium The anthraquinone group of stimulant laxatives includes the plant-derived compounds aloe (preparations containing aloe are no longer commercially preparations are bulk-forming laxatives. available in the US), cascara sagrada (preparations containing cascara sagrada are no longer commercially available in the US), frangula, and senna.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279) have been approved by the FDA:
Indications:
None.
Professional Synonyms:
None.
Indications:
None.
Professional Synonyms:
None.
The following dosing information is available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
Bulk-forming laxatives are usually administered 1-3 times daily. To reduce the risk of esophageal obstruction in patients receiving large (e.g., the maximum daily dosage recommended by the manufacturer) dosages of bulk-forming laxatives, these laxatives should be administered in divided doses instead of a single daily dose. The usual dosages for the individual bulk-forming laxatives are below; for dosages in children younger than the ages listed, a physician should be consulted.
Anthraquinone laxatives are administered orally, usually in a single dose Bulk-forming laxatives are administered orally. Commercially available at bedtime. powders, flakes, granules, tablets, and liquids should be dissolved and/or diluted according to the instructions of the manufacturer.
In the treatment of constipation, at least one full glass (250 mL) of liquid should be administered with each laxative dose. When used to increase the bulk of stools in patients with chronic, watery diarrhea, one manufacturer suggests that one-third of a glass (80 mL) of liquid be administered with each dose.
In the treatment of constipation, at least one full glass (250 mL) of liquid should be administered with each laxative dose. When used to increase the bulk of stools in patients with chronic, watery diarrhea, one manufacturer suggests that one-third of a glass (80 mL) of liquid be administered with each dose.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
There are 0 contraindications.
There are 3 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Selected Bowel Preparations/Stimulant Laxatives SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Osmotic laxatives and stimulant laxatives may have additive adverse effects.(1) CLINICAL EFFECTS: Concurrent use of stimulant laxatives and Sutab tablets (sodium sulfate, magnesium sulfate, and potassium chloride) may increase the risk of mucosal ulceration, ischemic colitis, gastric ulcerations, or gastritis.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of Sutab tablets (sodium sulfate, magnesium sulfate and potassium chloride) recommends avoiding the use of stimulant laxatives while using this bowel preparation product.(1) DISCUSSION: Osmotic laxative products may produce colonic mucosal aphthous ulcerations which reports have shown can lead to ischemic colitis requiring hospitalization. Using stimulant laxatives in addition may increase this risk.(1) |
SUFLAVE, SUTAB |
| Trofinetide/Laxatives SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Trofinetide commonly causes diarrhea of mild to moderate severity. Laxatives may increase the incidence or severity of diarrhea.(1) CLINICAL EFFECTS: Concurrent use of laxatives with trofinetide may increase the risk of severe diarrhea.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients should stop laxatives before starting trofinetide. If diarrhea occurs, consider anti-diarrheal treatment and monitor hydration status. If severe diarrhea or dehydration occurs, interrupt, reduce dose, or discontinue trofinetide.(1) DISCUSSION: In clinical trials, 85% of patients on trofinetide developed diarrhea. Concurrent use of laxatives may increase this risk.(1) |
DAYBUE |
| Tenapanor/Laxatives; Stool Softeners SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Tenapanor commonly causes diarrhea of mild to moderate severity. Laxatives and stool softeners may increase the incidence or severity of diarrhea.(1) CLINICAL EFFECTS: Concurrent use of laxatives or stool softeners with tenapanor may increase the risk of severe diarrhea.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of tenapanor states that patients should be instructed to avoid stool softeners and laxatives with tenapanor. If severe diarrhea occurs, tenapanor should be discontinued.(1) DISCUSSION: In clinical trials, 43-53% of CKD patients on dialysis treated with tenapanor developed diarrhea. Diarrhea usually occurred soon after treatment initiation and was severe in 5% of patients.(1) |
XPHOZAH |
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Clozapine/Bulk Forming Laxatives SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Clozapine has potent anticholinergic properties and inhibits serotonin receptors, including 5-HT3.(1-4) Both of these properties may cause inhibition of gastrointestinal (GI) smooth muscle contraction, resulting in decreased peristalsis.(3,4) If fluid intake is inadequate, bulk forming laxatives can increase the risk of gastrointestinal obstruction.(1-6) CLINICAL EFFECTS: Concurrent use of clozapine and bulk forming laxatives with inadequate fluid intake may increase the risk of constipation (common) and serious bowel complications (uncommon), including complete bowel obstruction, fecal impaction, paralytic ileus and intestinal ischemia or infarction.(1-6) PREDISPOSING FACTORS: The risk for serious bowel complications is higher with increasing age, higher frequency of constipation, and in patients on higher doses of clozapine or multiple anticholinergic agents.(1,5) PATIENT MANAGEMENT: Concurrent use of bulk forming laxatives with clozapine may be used with caution in patients who can maintain adequate fluid intake. Evaluate the patient's bowel function regularly. If patient is unable to maintain adequate fluid intake and use bulk forming laxatives as prescribed, avoid the use of bulk forming laxatives with clozapine.(1-6) Monitor for symptoms of constipation and GI hypomotility, including having bowel movements less than three times weekly or less than usual, difficulty having a bowel movement or passing gas, nausea, vomiting, and abdominal pain or distention.(2) Consider a prophylactic laxative in those with a history of constipation or bowel obstruction.(2) Review patient medication list for anticholinergic agents which may have additive effects on decreased GI motility. When possible, decrease the dosage or number of prescribed anticholinergic agents, particularly in the elderly. Counsel the patient about the importance of maintaining adequate hydration. Encourage regular exercise and eating a high-fiber diet.(2) DISCUSSION: The concurrent use of clozapine and bulk forming laxatives has not been studied. Use of bulk forming laxatives with inadequate fluid intake has been associated with gastrointestinal obstruction. |
CLOZAPINE, CLOZAPINE ODT, CLOZARIL, VERSACLOZ |
The following contraindication information is available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 7 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Appendicitis |
| Esophageal obstruction |
| Gastrointestinal obstruction |
| Ileus |
| Lactation |
| Paralytic ileus |
| Pyloroduodenal obstruction |
There are 1 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Pregnancy |
There are 3 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Diarrhea |
| Fecal incontinence |
| Inflammatory bowel disease |
The following adverse reaction information is available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 17 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Allergic dermatitis Anaphylaxis Bronchospastic pulmonary disease Conjunctivitis Esophageal obstruction Gastrointestinal obstruction Hypocalcemia Hypokalemia Intestinal impaction Metabolic acidosis Metabolic alkalosis Proteinuria Pruritus of skin Rhinitis Skin rash Tetany Urticaria |
There are 18 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Abdominal pain with cramps Flatulence |
Diarrhea Eructation Nausea |
| Rare/Very Rare |
|---|
|
Allergic dermatitis Arthritis Cachexia Constipation Dyspepsia Hematuria Hypertriglyceridemia Melanosis of colon Osteomalacia Pruritus of skin Skin rash Urine discoloration Urticaria |
The following precautions are available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for NARCOSOFT (senna leaf/psyllium husk/cascara/l.acidophilus/herbal no.279)'s list of indications:
No ICD codes found for this drug.
No ICD codes found for this drug.
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