Stimulant + bulk-forming laxative combination
Senna with ispaghula husk
Brand names: Manevac
Adult dose
Dose: 5–10mL PO ON or BD with plenty of water
Route: PO
Frequency: OD-BD
Clinical pearls
- Chronic constipation, opioid-induced constipation
- Take with full glass of water
Contraindications
- Bowel obstruction
- Faecal impaction (need disimpaction first)
- Inadequate fluid intake (impaction risk)
Side effects
- Abdominal cramps
- Flatulence
- Faecal impaction (if inadequate fluid)
- Hypersensitivity
Interactions
- Other oral medicines (separate by ≥1h — bulking)
Reference: BNF; NICE CG99; https://bnf.nice.org.uk/drugs/senna-with-ispaghula-husk/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021