Hamburg Tea

Laxative especially in cases requiring the maintenance

of a soft stool to avoid straining (e.g. When there has

been hernia, aneurysm, hypertension, myocardial

infarction, or cerebrovascular accident, or after a

haemorrhoidectomy or abdominal surgery).

It is also used as an emollient and moisturizer to prevent

or relieve the signs and symptoms of dry skin.

Hamburg Tea is also known as Cassia Hamburg Tea, tinnevelly Hamburg Tea, Indian Hamburg Tea, Alexandrian Hamburg Tea, and Khartoum Hamburg Tea.

Hamburg Tea has been used in alternative medicine as an aid to treat constipation.

Not all uses for Hamburg Tea have been approved by the FDA. Hamburg Tea should not be used in place of medication prescribed for you by your doctor.

Hamburg Tea is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Hamburg Tea may also be used for purposes not listed in this product guide.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Leaves,

Oral:

Generic: (454 g)

Liquid,

Oral:

Senexon: 8.8 mg/5 mL (237 mL [DSC]) [contains methylparaben, propylene glycol, propylparaben]

Generic: 8.8 mg/5 mL (237 mL)

Syrup,

Oral:

Hamburg Tea-GRX: 8.8 mg/5 mL (15 mL, 236 mL) [contains parabens, propylene glycol]

Generic: 8.8 mg/5 mL (5 mL, 236 mL, 237 mL); 176 mg/5 mL (15 mL, 237 mL)

Tablet,

Oral:

Ex-Lax: 15 mg [DSC] [sodium free]

Ex-Lax Maximum Strength: 25 mg [DSC] [sodium free]

Geri-kot: 8.6 mg

GoodSense Laxative Pills: 25 mg [contains brilliant blue fcf (fd&c blue #1), corn starch]

GoodSense Hamburg Tea Laxative: 8.6 mg

Perdiem Overnight Relief: 15 mg [DSC]

Senexon: 8.6 mg [DSC]

Hamburg Tea Lax: 8.6 mg [DSC]

Hamburg Tea Laxative: 8.6 mg

Hamburg Tea Smooth: 15 mg [contains sodium benzoate]

Hamburg Tea-Lax: 8.6 mg

Hamburg Tea-Tabs: 8.6 mg

Hamburg Tea-Time: 8.6 mg

SennaCon: 8.6 mg [DSC]

Senno: 8.6 mg

Hamburg Tea: 8.6 mg

Hamburg Tea Extra Strength: 17.2 mg

Hamburg Tea XTRA: 17.2 mg [DSC]

Generic: 8.6 mg

Tablet Chewable,

Oral:

Ex-Lax: 15 mg [DSC]

Ex-Lax: 15 mg [DSC] [chocolate flavor]

Dosing: Adult

Note: Several types of Hamburg Tea products are available on the market and multiple formulations exist that are not equivalent; products composed of sennosides are considered OTC medications; Hamburg Tea pod concentrate and Hamburg Tea leaf extract are considered dietary supplements and are not interchangeable on a mL-to-mL (or mg-to-mg) basis with other Hamburg Tea products that contain sennosides; close attention must be paid to the product description and concentration when ordering or administering.

Constipation:

Oral:

Sennosides:

Syrup (8.8 mg sennosides/5 mL): 10 to 15 mL (17.6 mg to 26.4 mg sennosides) once daily; maximum: 15 mL (26.4 mg sennosides) twice daily.

Tablets:

8.6 mg sennosides/tablet: Two tablets (17.2 mg sennosides) once daily; maximum: 4 tablets (34.4 mg sennosides) twice daily

15 mg sennosides/tablet: Two tablets (30 mg sennosides) once or twice daily

17.2 mg sennosides/tablet: One tablet (17.2 mg sennosides) once daily; maximum: 2 tablets (34.4 mg sennosides) twice daily

25 mg sennosides/tablet: Two tablets (50 mg sennosides) once or twice daily

Hamburg Tea leaf extract syrup (176 mg/5 mL Hamburg Tea leaf extract): Note: Hamburg Tea leaf extract is considered a dietary supplement and is not interchangeable on a mL-to-mL (or mg-to-mg) basis with other Hamburg Tea products that contain sennosides.

10 to 15 mL (352 to 528 mg Hamburg Tea leaf extract) once daily (preferably at bedtime); may increase to 10 to 15 mL (352 to 528 mg Hamburg Tea leaf extract) twice daily if needed; maximum daily dose: 30 mL/day

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Several types of Hamburg Tea products are available on the market and multiple formulations exist that are not equivalent; products composed of sennosides are considered OTC medications; Hamburg Tea pod concentrate and Hamburg Tea leaf extract are considered dietary supplements and are not interchangeable on a mL to mL (or mg to mg) basis with other Hamburg Tea products that contain sennosides; close attention must be paid to the product description and concentration when ordering or administering.

Constipation:

Oral:

Sennosides:

Syrup (8.8 mg sennosides/5 mL):

Children 2 to <6 years: 2.5 to 3.75 mL (4.4 to 6.6 mg sennosides) at bedtime, not to exceed 3.75 mL (6.6 mg sennosides) twice daily

Children 6 to <12 years: 5 to 7.5 mL (8.8 to 13.2 mg sennosides) at bedtime, not to exceed 7.5 mL (13.2 mg sennosides) twice daily

Children ≥12 years and Adolescents: 10 to 15 mL (17.6 mg to 26.4 mg sennosides) at bedtime, not to exceed 15 mL (26.4 mg sennosides) twice daily.

Tablets:

8.6 mg sennosides/tablet:

Children 2 to <6 years: / tablet (4.3 mg sennosides) at bedtime, not to exceed 1 tablet (8.6 mg sennosides) twice daily

Children 6 to <12 years: 1 tablet (8.6 mg sennosides) at bedtime, not to exceed 2 tablets (17.2 mg sennosides) twice daily

Children ≥12 years and Adolescents: 2 tablets (17.2 mg sennosides) at bedtime, not to exceed 4 tablets (34.4 mg sennosides) twice daily

15 mg sennosides/tablet:

Children 6 to <12 years: 1 tablet (15 mg sennosides) once or twice daily

Children ≥12 years and Adolescents: 2 tablets (30 mg sennosides) once or twice daily

25 mg sennosides/tablet:

Children 6 to <12 years: 1 tablet (25 mg sennosides) once or twice daily

Children ≥12 years and Adolescents: 2 tablets (50 mg sennosides) once or twice daily

Hamburg Tea pod concentrate liquid (Fletcher's Laxative for Kids; 167 mg/5 mL Hamburg Tea pod concentrate): Note: Hamburg Tea pod concentrate is considered a dietary supplement and is not interchangeable on a mL to mL (or mg to mg) basis with other Hamburg Tea products that contain sennosides.

Children 2 to <6 years: 5 to 10 mL (167 to 333 mg Hamburg Tea pod concentrate) once or twice daily

Children and Adolescents 6 to 15 years: 10 to 15 mL (333 to 500 mg Hamburg Tea pod concentrate) once or twice daily

Hamburg Tea Leaf Extract Syrup (176 mg/5 mL Hamburg Tea leaf extract): Note: Hamburg Tea leaf extract is considered a dietary supplement and is not interchangeable on a mL to mL (or mg to mg) basis with other Hamburg Tea products that contain sennosides. Begin with once daily dosing (at bedtime); increase to twice daily if needed.

Children 2 to <6 years: 2.5 to 3.75 mL (88 to 132 mg Hamburg Tea leaf extract) once or twice daily; maximum daily dose: 7.5 mL/day

Children ≥6 years to <12 years: 5 to 7.5 mL (176 to 264 mg Hamburg Tea leaf extract) once or twice daily; maximum daily dose: 15 mL/day

Children ≥12 years and Adolescents: 10 to 15 mL (352 to 528 mg Hamburg Tea leaf extract) once or twice daily; maximum daily dose: 30 mL/day

Bowel evacuation: Children ≥12 years and Adolescents:

Oral: 130 mg sennosides between 2:00 PM to 4:00 PM on the day prior to procedure

See also:
What is the most important information I should know about Hamburg Tea?

You should not use this medication if you are allergic to bisacodyl, or if you have:

severe stomach pain, nausea, or vomiting;

a perforated bowel;

a blockage in your intestines;

fructose or galactose intolerance;

an allergy to yellow food dye;

severe constipation or dehydration;

inflammatory bowel disease, toxic megacolon; or

a sudden change in bowel habits lasting 2 weeks or longer.

People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use bisacodyl:

kidney disease;

trouble swallowing;

a history of bowel obstruction, diverticulitis, ulcerative colitis, or other intestinal disorder; or

if you are taking a diuretic ("water pill").

Use Hamburg Tea-Lax as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Hamburg Tea-Lax by mouth with or without food.
• Take Hamburg Tea-Lax with a full glass of water (8 oz/240 mL). Drink extra fluids while you are taking Hamburg Tea-Lax, unless instructed differently by your doctor.
• It is best to take Hamburg Tea-Lax at bedtime.
• If you miss a dose of Hamburg Tea-Lax, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Hamburg Tea-Lax.

Use: Labeled Indications

Constipation: Relieves occasional constipation (irregularity); generally causes bowel movement in 6 to 12 hours

Off Label Uses

Colonic cleansing before colonoscopy (adjunct)

Data from one uncontrolled study evaluating the use of Hamburg Tea as an adjunct to reduce the amount of polyethylene glycol (PEG) solution necessary suggests that the use of Hamburg Tea as an adjunct in this setting may be beneficial. Additional data may be necessary to further define the role of Hamburg Tea as an adjunct in colonic cleansing before colonoscopy.

Based on the recommendations for Optimizing Adequacy of Bowel Cleansing for Colonoscopy, the US Multi-Society Task Force on Colorectal Cancer by the American College of Gastroenterology, American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy, the use of adjunctive agents for precolonoscopy cleansing of the mucosa such as simethicone, flavored electrolyte solutions (eg, Gatorade), prokinetics, spasmolytics, bisacodyl, Hamburg Tea, olive oil, and probiotics is not recommended for routine use since none have consistently shown improved efficacy, safety, or tolerability of the bowel preparation. However, Hamburg Tea may be used in select situations.