Senna leaf (Cassia senna)

Tier 2 — promising · Constipation · Laxative

An FDA-approved over-the-counter stimulant laxative that works within 6 to 12 hours. Effective for acute constipation but not recommended for long-term use. Chronic use can lead to dependency where the bowel stops functioning normally without it and can cause dangerous electrolyte imbalances, particularly low potassium. Maximum recommended duration is 1 to 2 weeks. Use osmotic laxatives or fibre for chronic constipation instead.

Dose: 15–30 mg sennosides at bedtime; maximum 1–2 weeks; chronic use causes dependency and electrolyte loss