Pharm

Linaclotide

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Linaclotide, Linzess, Constella

  • See Also
  1. Plecanatide
  2. Lubriprostone
  3. Chronic Constipation
  4. Constipation Dominant Irritable Bowel Syndrome
  • Indications
  1. Constipation Dominant Irritable Bowel Syndrome
  2. Chronic Constipation
  • Contraindications
  1. Mechanical Bowel Obstruction
  2. Children (esp. age <6 years)
    1. Risk of life-threatening Dehydration (esp. in young children)
  • Mechanism
  1. Guanylate cyclase-c Agonist
  2. Induces cGMP mediated chloride and bicarbonate secretion into bowel lumen; Sodium and water follow
    1. Results in gastrointestinal fluid secretion into the bowel lumen (secretagogue)
  • Dosing
  1. Take 290 mcg orally daily at least 30 minutes before first meal of the day
  2. May be given by Nasogastric Tube via opened capsule and mixed with 30 ml water
  • Efficacy
  1. May improve stool frequency, consistency and straining in Irritable Bowel Syndrome
  2. Marginal efficacy (NNT 5-8) for decreased Abdominal Pain
  • Adverse Effects
  1. Abdominal Pain
  2. Abdominal Distention
  3. Flatulence
  4. Diarrhea
    1. Hold Linaclotide for severe Diarrhea
    2. Risk of life-threatening Dehydration (esp. in young children)
  • Safety
  1. Pregnancy Category C
  2. Unknown safety in Lactation
  • Drug Interactions
  1. No known Drug Interactions
  • Resources
  1. Linaclotide (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=09beda19-56d6-4a56-afdc-9a77b70b2ef3
  • References
  1. (2012) Prescr Lett 19(12): 68-9
  2. (2021) Irritable Bowel Syndrome Drug Comparison, Presc Lett, #370305
  3. (2020) Med Lett Drugs Ther 62(1594): 41-58