XPREP ® is a drug based on concentrated extracts of senna.
THERAPEUTIC GROUP: Laxatives - Contact laxative (stimulant).
Indications XPREP ® Concentrated extract of Senna
XPREP ® is indicated for the symptomatic treatment of occasional constipation.
Mechanism of action XPREP ® Concentrated extract of Senna
The active ingredient contained in the XPREP ® drug is represented by particular derivatives belonging to the family of anthraquinone glycosides (sennosoids), extracted directly from senna, a plant known for its important medicinal properties. Taken orally, sennosoids cross the alimentary canal and are only minimally absorbed by the duodenal mucosa, so much so that the metabolites found in the urine represent only 3.6% of the total; in large part, however, they are metabolized by the bacterial flora of the large intestine, with the production of a particularly active metabolite, known as reina. This derivative of sennosoids is able to exert a "direct action at the level of the intestinal mucosa, influencing the motility of the colon, increasing its peristalsis and thus ensuring an" acceleration of intestinal transit and a reduction in the absorption of liquids, keeping the stool hydrated. These processes are carried out with a fairly long timeframe, between 7 and 10 hours.
About 90% of sennosoids will be found in the faeces in the form of polymers, indicating the low degree of systemic absorption of the product.
Studies carried out and clinical efficacy
1. SENNA AND CONSTIPATION
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Dec; 29: 1119-22.
Clinical observation on treatment of functional constipation with compound plantain-senna granules
Zhang CX.
The administration of senna for limited time intervals has been shown to be effective and safe in the treatment of functional constipation, highlighting an increase in the frequency of bowel movements, an improvement in stool consistency and a reduction in pain associated with defecation.
2. SENNA EXTRACTS AND TOXICITY "
J Toxicol. 2009; 2009: 287247. Epub 2009 Sep 10.
Is senna laxative use associated to cathartic colon, genotoxicity, or carcinogenicity?
Morales MA, Hernández D, Bustamante S, Bachiller I, Rojas A.
Prolonged use of senna extracts for laxative purposes has been associated for some time with the development of histological and functional alterations of the intestinal mucosa. This study, conducted on animal models to which senna extracts could be administered for long periods, denied the aforementioned hypotheses, not highlighting any type of alteration and validating the good safety and tolerability profile of the product.
3. PREGNANT BREAST
Reprod Toxicol. 2009 Jul; 28: 100-4. Epub 2009 Feb 24.
Senna treatment in pregnant women and congenital abnormalities in their offspring - a population-based case-control study.
Acs N, Bánhidy F, Puhó EH, Czeizel AE.
Given the absence of clinical trials relating to the use of senna in pregnancy, and the related side effects, this backward study made it possible to evaluate the possible appearance of congenital anomalies in pregnant women suffering from constipation treated with senna derivatives. The study found no statistical difference in the development of newborns with congenital anomalies from pregnant women with or without senna therapy.
Method of use and dosage
XPREP ® powder and solvent for oral solution, 75 ml bottle containing 150 mg of sennosoids: the recommended dose is one or two coffee spoons, after having reconstituted the drug, to be taken preferably in the evening after a meal so that the laxative effect can be realized the next morning.
The treatment should be started with the minimum doses foreseen, and eventually the dosage should be increased within the foreseen therapeutic range, until the desired effect is obtained.
In case of reduced efficacy or prolonged administration of XPREP ®, medical advice is required.
Warnings XPREP ® Concentrated Senna Extract
The assumption of laxatives should be preceded by a period of healthy eating and a correct lifestyle, aimed at improving intestinal peristalsis. Therefore, one should resort to the use of stimulant laxatives only in case of acute episodes of constipation and in any case for periods of limited time; this recommendation is a must, given the presence of important side effects, on the health of the intestine and on the electrolyte picture, which can be observed following the prolonged intake of these drugs.
XPREP ® contains sugars, therefore it would be advisable to limit its consumption in case of endocrine-metabolic diseases such as diabetes, for which medical supervision is recommended.
Sennosoids do not interfere with the ability to drive cars or use machines.
PREGNANCY AND BREASTFEEDING
At the moment there are no exhaustive clinical trials and scientific studies that demonstrate the effects on the health of the fetus related to the intake of XPREP ® during pregnancy and lactation. In the light of these data, the drug should be used only and exclusively in in case of real need and under close medical supervision.
Of course XPREP ® is contraindicated in case of hypersensitivity to one of its components.
Interactions
The increase in intestinal transit speed induced by XPREP ® could reduce intestinal absorption of various active ingredients, altering their normal effectiveness. Therefore, laxative intake should take place at least two hours after taking other medications.
Potassium depletion, which could occur following prolonged intake of laxatives, could enhance the functionality of some drugs, including digitalis.
Contraindications XPREP ® Concentrated Senna Extract
XPREP ® should not be taken by children under the age of 10, by patients suffering from gastrointestinal diseases, both acute and chronic, intestinal obstruction or stenosis, or dehydration and altered electrolyte balance.
Undesirable Effects - Side Effects
The most commonly described side effects, following the intake of XPREP ® include abdominal colic and cramping pains, much more intense and frequent in patients suffering from chronic constipation.
Prolonged use of laxatives could instead lead to a gradual reduction in the effectiveness of the drug, accompanied by intestinal atony and constipation, possibly preceded by diarrhea, dehydration and hypokalemia.
Note
XPREP ® is an OTC drug, without a prescription, therefore freely salable.
The information on XPREP ® Concentrated Senna Extract published on this page may be out of date or incomplete. For a correct use of this information, see the Disclaimer and useful information page.
