Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist or qualified healthcare practitioner has told you.

• Keep this leaflet. You may need to read it again.
• Ask your pharmacist if you need more information or advice.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
• You must talk to a doctor if you do not feel better or if you feel worse after 3 days.

1. What Boots Senna 7.5mg Tablets 12 Years Plus are and what they are used for
2. What you need to know before you take this medicine
3. How to take this medicine
4. Possible side effects
5. How to store this medicine
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.

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

Stimulant laxatives (including Boots Senna 7.5mg 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.

Talk to your doctor, pharmacist or qualified healthcare practitioner before taking this medicine:

• If you suffer from kidney disorder
• If you are taking medicines for a heart condition (e.g. cardiac glycosides, antiarrhythmic medicines e.g. quinidine), medicines inducing QT prolongation, diuretics, adrenocorticosteroids or liquorice root preparations.

When administering this product to incontinent adults, pads should be changed more frequently to prevent extended skin contact with faeces.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines including those listed above and any medicines obtained without a prescription.

Do not take Boots Senna 7.5mg Tablets 12 Years Plus if you are pregnant or breast-feeding because there is no evidence that it is safe to do so.

Not to be used for more than one week.

Usually it is sufficient to take this medicine up to two to three times a week.

Consult your doctor, pharmacist or qualified healthcare practitioner after taking this medicine:

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

Do not take more than the leaflet tells you.

Overuse can be harmful.

If you take more tablets than you should, stop taking the medicine and consult your doctor and take this leaflet with you, even if you do not experience any symptoms.

It may be harmful to take too much of this medicine or take it for too long. This is because it may lead to:

• A '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 muscles such as those in the bowel. It can also affect the salts in the blood.
• Low levels of potassium in the blood (called 'hypokalaemia'). This can make you tired, dizzy, make your muscles weak and cause uneven heartbeat.
• Dehydration, making you thirsty, feel faint and giving you headaches. It can also mean you cannot pass enough urine.

If you miss a dose, take your next dose at the usual time. Do not take or give a double dose to make up for a forgotten dose, just carry on with the recommended dose.

If you get any side effects, talk to your doctor, pharmacist or qualified healthcare practitioner. 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. By reporting side effects you can help provide more information on the safety of this medicine.

Each tablet contains the active substance Alexandrian Senna fruit (Cassia senna L. (C. acutifolia Delile) fruit) corresponding to 7.5 mg hydroxyanthracene glycosides, calculated as Sennoside B.

The other ingredients are magnesium stearate, fennel seed, croscarmellose sodium, calcium hydrogen phosphate dihydrate, microcrystalline cellulose, and colloidal anhydrous silica.

Boots Senna 7.5mg Tablets 12 Years Plus are uncoated biconvex greenish tablets available in blister packs of 12, 20, 24, 50, 60 and 100 tablets. Not all pack sizes may be marketed.