Senokot Max Strength Tablets 12 year plus.

• Keep this leafet. You may need to read it again.
• Always take this medicine exactly as described in this leafet or as your doctor or pharmacist have told you.
• Ask your pharmacist if you need more information or advice.
• If any of the side effects get serious or if you notice any side effect not listed in this leafet, please tell your doctor or pharmacist.

1. What Senokot Max Strength Tablets 12 Years Plus is and what it is used for
2. What you need to know before you take Senokot Max Strength Tablets 12 Years Plus
3. How to take Senokot Max Strength Tablets 12 Years Plus
4. Possible side effects
5. How to store Senokot Max Strength Tablets 12 Years Plus
6. Contents of the pack and other information

Normal and regular bowel movement is important for most people. However, what is “normal and regular” varies from person to person. Some may have a bowel movement every day, others less often.

Whatever it is like for you, it is best that your bowel movement has a regular pattern. Constipation is an occasional problem for some people. For others, it may happen more often It happens when the normal muscle actions in the bowel (large intestine) slow down. This can mean that material is not easily eliminated from the body. The cause of constipation is often not known. It can be associated with:

• Sudden change of diet
• A diet with not enough fibre
• Not drinking enough fluids
• Loss of ‘tone’ of the bowel muscles in older people
• Pregnancy
• Medicines such as morphine or codeine
• Having to stay in bed for a long time
• Lack of exercise

Whatever the cause, constipation can be uncomfortable. It may make you feel bloated and heavy or generally “off colour”. Sometimes it causes headaches.

It is recommended to use changes in diet and bulk forming medicines to control constipation before using this medicine.

These healthy tips are recommended to try to prevent constipation happening:

• Eat a balanced diet including fresh fruit and vegetables
• Drink enough water so that you do not become dehydrated
• Keep up your exercise and stay fit
• Make time to empty your bowels when your body tells you

• are allergic to any of the ingredients (for a full list of ingredients, see section 6)
• have blockage or narrowing of the gastro-intestinal tract or bowel (ileus, intestinal obstruction or stenosis).
• have paralysis or a lack of muscle tone in the bowel (atony).
• have appendicitis, inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
• have severe dehydration.
• have persistent or undiagnosed abdominal complaints e.g pain, nausea, or vomiting.
• have faecal impaction or rectal bleeding for which you don't know the cause, or blood in your stools.
• have already taken a laxative and are still constipated.
• have had a sudden change in bowel habit that has lasted for more than 2 weeks.
• are pregnant or breast-feeding.
• have kidney or heart failure.
• are under 12 years of age.

Stimulant laxatives (Senokot Max Strength Tablets 12 Years Plus) do not help with weight loss.

They do not reduce the absorption of calories or nutrients. They can cause watery stools (diarrhoea), abdominal cramps and dehydration. Dehydration can seem like weight loss. Overuse of laxatives may damage your health by:

• Causing disturbances of electrolyte and mineral balances. Sodium, potassium, magnesium, and phosphorus are electrolytes and minerals that are present in very specific amounts necessary for proper functioning of the nerves and muscles, including those of the colon and heart. Upsetting this delicate balance can cause incorrect functioning of these vital organs.
• Severe dehydration may cause tremors, weakness, blurry vision, fainting, kidney damage, and, in extreme cases, death. Dehydration often requires medical treatment.
• Overuse of laxatives can cause the colon to stop reacting to usual doses of laxatives so that larger and larger amounts of laxatives may be needed to produce bowel movements.
• Laxative dependency occurs from overuse.

Tell your doctor, pharmacist or nurse if:

• you suffer from kidney disorders.
• you are taking medicines for a heart condition (e.g. cardiac glycosides, antiarrhythmic medicines e.g quinidine) medicines inducing QT elongation, diuretics, adrenocorticosteroids or liquorice root preparations.
• you have been told you have an intolerance to some sugars because this medicine also contains lactose monohydrate (31.64 mg/tablet).When administering this product to incontinent adults, pads should be changed more frequently to prevent extended skin contact with faeces. It is recommended to use changes in diet and bulk forming medicines to control constipation before using this medicine.

You should consult your doctor or pharmacist for advice if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Normally it is sufficient to take this medicinal product up to two to three times a week. Not to be used for more than one week.

Tell a doctor, pharmasist or nurse if:

• the symptoms worsen, or persist during the use of medicinal product.
• there is no bowel movement within 3 days of use.
• you need to take laxatives every day if abdominal pain persists.

Do not take more than the leaflet tells you. Overuse can be harmful.

Consult your doctor and take this leafet with you.

It may be harmful to take too much of this medicine or take it for too long.

This is because it may lead to:

• ‘lazy bowel’ where the muscle in the bowel becomes too relaxed. This means that bowel emptying happens less often. This can lead to long-term constipation.
• imbalance of fluids and salts in the body. This can affect the tightness of muscle such as those in the bowel. It can also affect the salts in the blood.
• low levels of potassium in the blood (called hypo-kalaemia). This can make you tired, dizzy, make your muscles weak and cause an uneven heart beat.
• dehydration making you thirsty, feel faint and giving you headaches. It can also mean that you cannot pass enough urine.

If you miss a dose, take your next dose at the usual time. Do not take two doses at the same time to make up for the missed dose. Always consult your doctor if you need further advice.

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Each tablet contains powdered Alexandrian Senna fruit (pods) (cassia senna L. (C. acutifolia Delile)) and Tinnevelly Senna fruit (pods) (Cassia angustifolia Vahl) equivalent to 15mg hydroxyanthracene glycosides, calculated as sennoside B.

Also contains: calcium phosphate, maize starch, magnesium stearate and lactose monohydrate.

Senokot Max Strength Tablets 12 years Plus are available in pack sizes of 24 or 48 tablets.

Not all pack sizes may be marketed.

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