Pharmacology and toxicology
Anthraquinone derivatives with a laxative action occur in a number of plants: folia sennae, rhizoma rhei, cortex frangulae, and aloe. They have a laxative effect by directly stimulating colonic smooth muscles. Anthraquinone derivatives occur as glycosides. After the sugar portion is cleaved in the intestine, these agents are partially absorbed and excreted in the urine (colored!). Anthraquinone derivatives do not appear to be teratogenic. Reported experience is the most extensive with senna laxatives. No stimulating effect on uterine contractions or other side effects relevant to pregnancy were noted when senna laxatives were used in pregnancy (Anonymous 1992).
A stimulating effect on uterine muscles as well as the risk of meconium passage in utero as a result of the direct action of the aloe ingredient aloin have been discussed.
Recommendation. Anthraquinone derivatives should be avoided during pregnancy because some of them have a stimulating effect on uterine contractions. However, treatment with them does not necessitate either termination of the pregnancy or invasive diagnostic procedures.
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