Linzess (Linaclotide) - Oral

What Is Linzess?

Linzess (linaclotide) belongs to a new class of drugs called guanylate cyclase-C (GC-C) agonists. It is a prescription-only medicine used in adults to treat irritable bowel syndrome with constipation (IBS-C; a condition causing stomach pain, bloating, and difficult passage of stools) and chronic idiopathic constipation (CIC; infrequent passage of stools or constipation of unknown cause).

Linaclotide binds to GC-C receptors in the digestive tract and activates GC-C, which has a localized effect on the surface of the intestinal epithelium. It increases the intra- and extracellular cyclic guanosine monophosphate concentrations. This stimulates the chloride and bicarbonate secretion in the intestine, accelerating the release of intestinal fluid and reducing the sensitivity of pain-sensing nerves. The increased fluid release helps speed up the movement of food through the gut and reduce pain.

Linaclotide is available in the oral dosage form as capsules.

Drug Facts

Generic Name: Linaclotide

Brand Name(s): Linzess

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Gastrointestinal agent

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Linaclotide

Dosage Form(s): Capsule

What Is Linzess Used For?

Linzess is prescribed to treat specific bowel problems such as IBS and CIC. It also improves stool texture and lessens symptoms such as:

Linzess is not approved for use in children and should not be used in children younger than 2, as it can cause severe dehydration in this age group.

Linzess (Linaclotide) Drug Information: A person with their stomach and intestines

Verywell / Dennis Madamba

How to Take Linzess

Take Linzess as prescribed by your healthcare provider. Always follow the directions on the prescription and the guidelines given by your pharmacist.

When taking Linzess:

  • Take one capsule by mouth on an empty stomach at least 30 minutes before the day's first meal.
  • Take at the same time each day.
  • Swallow the capsules whole.
  • Do not chew, open, or break the capsules.

Do not stop taking your medication without consulting your healthcare provider.

For people who have trouble swallowing pills, there are other ways to take Linzess:

  • Mixing with applesauce: You can open the capsule and mix the medicine in a teaspoonful of applesauce. Swallow this mixture immediately, without chewing it. Never save the mixture for later use. Wait for 30 minutes before taking the meal.
  • Mixing with water: You can also empty the capsule's contents into an ounce (30 milliliters) of water. Swirl the mixture well for at least 10 seconds and drink without chewing the beads.
  • Nasogastric or gastronomy feeding tube: The water mixture may also be given through a tube into the stomach. If you are giving this linaclotide mixture through a tube, ask your healthcare provider for detailed instructions on how to administer it.

Storage

Store in a tightly-closed container at room temperature, away from light, heat, and moisture. To help protect them from water, keep the pills in the container with the desiccant if provided. Do not store it in the bathroom. Keep medicines out of reach of children.

Do not discard the unwanted or expired medicines into a drain or toilet unless instructed. Discard the product when it is expired or no longer needed by consulting your pharmacist through a drug take-back program.

How Long Does Linzess Take to Work?

Linzess may take up to two weeks to improve the symptoms of constipation. Keep using the medicine as directed and consult your healthcare provider if the symptoms do not improve or worsen.

What Are the Side Effects of Linzess?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some common side effects of Linzess are:

  • Diarrhea 
  • Gas
  • Bloating or feeling of a full stomach
  • Stomach (abdominal) pain and discomfort

These side effects are not very dangerous, but contact your healthcare provider or pharmacist if any side effects continue or worsen.

Severe Side Effects

Stop using Linzess right away and call your healthcare provider if you have any of these severe side effects:

  • Severe or ongoing diarrhea
  • Diarrhea with dizziness or a light-headed feeling

Call 911 for immediate help if you have any life-threatening symptoms. A severe allergic reaction to Linzess is unlikely but possible. Signs of an allergic reaction can include:

  • Hives
  • Difficulty in breathing
  • Swelling of your face, lips, tongue, or throat

Report Side Effects

Linzess may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much of Linzess Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For chronic idiopathic constipation:
      • Adults—145 micrograms (mcg) once a day. Some patients may need 72 mcg once a day.
      • Children 2 years of age and older—Use and dose must be determined by your doctor.
      • Children younger than 2 years of age—Use is not recommended.
    • For irritable bowel syndrome with constipation:
      • Adults—290 micrograms (mcg) once a day.
      • Children 2 years of age and older—Use and dose must be determined by your doctor.
      • Children younger than 2 years of age—Use is not recommended.

Modifications

The whole capsule should be taken by mouth. However, if you have difficulty taking the capsule as a whole, you can open the capsule and mix the contents with a spoonful of applesauce or 30 milliliters of water. If mixing with water, dissolve the capsule's contents in 30 milliliters of water, mix well for at least 10 seconds, and drink the beads. Take another 30 milliliters of water, swirl again, and drink to ensure you get any leftover beads.

Linzess can also be given through a feeding tube (nasogastric or gastronomy tube). Ask your healthcare provider for instructions on how to administer it this way.

Talk to your healthcare provider if:

  • You are pregnant or planning to have a child. Linzess should be used in pregnant people only if needed. Your healthcare provider will monitor your risk factors. 
  • You are breastfeeding or planning to breastfeed. There is no data available on whether linaclotide is released in breast milk.

Missed Dose

If you missed a dose of Linzess, skip the missed dose and take the next one at a regular time. Never take a double dose to make up for the missed one.

Overdose: What Happens If I Take Too Much Linzess?

No life-threatening reactions have been reported in people taking high doses of Linzess. If you take more than prescribed, you may experience diarrhea or other side effects.

What Happens If I Overdose on Linzess?

If you think you or someone else may have overdosed on Linzess, call a healthcare provider or the Poison Control Center (800-222-1222).

If the person has seizures, trouble breathing, or a feeling of passing out after taking Linzess, call 911 right away.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

Call your doctor right away if you have severe diarrhea with feeling of lightheadedness, dizziness, or fainting.

What Are Reasons I Shouldn’t Take Linzess?

Linzess should not be used:

  • If you are allergic to any of the ingredients in linaclotide capsules. Ask a healthcare provider for a list of the ingredients.
  • If you have any stomach or intestinal blockage and inflammatory bowel disease history. Consult your healthcare provider first.
  • In children under age 6 due to the risk of severe side effects.
  • In children ages 6 to 17. Linzess is not approved for this use.

What Other Medications Interact With Linzess?

No drug interaction studies have been conducted with Linzess. However, you should still tell your healthcare provider about your medication history before starting Linzess. Keep a list of all the drugs you take, including prescription and over-the-counter drugs, supplements, and herbal products.

Do not start, stop, or change the dose of any medicines without your healthcare provider's approval.

What Medications Are Similar?

Linzess is the first approved drug belonging to the class of guanylate cyclase-C agonists. Trulance (plecanatide) is another GC-C agonist used to treat CIC and IBS-C in adults.

Either of these medications may be prescribed to treat the targeted condition(s). It is not recommended to take these drugs together. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Linzess used for?

    Linzess is used to treat Irritable bowel syndrome and chronic idiopathic constipation. It helps to relieve pain and overall bowel symptoms.

  • How does Linzess work?

    Linzess works by increasing fluid in the intestines and helps to speed up the movement of food through the gut.

  • How long does it take for Linzess to work?

    Linzess is not a laxative drug and does not start working instantly. After starting the medicine, it may take a week to feel relief from chronic constipation symptoms.

  • What are the side effects of Linzess?

    Common side effects of Linzess are diarrhea, abdominal pain, bloating, and gas.

  • How do I stop taking Linzess?

    Do not stop taking Linzess at once on your own. It may relapse your symptoms. Always consult your healthcare provider before you stop taking medicine.

How Can I Stay Healthy While Taking Linzess?

Linzess is a well-tolerated treatment option for adults with IBS–C or CIC. The medicine improves bowel symptoms and reduces abdominal pain and discomfort. Always follow the guidelines regarding medication use and ask your healthcare provider about anything you do not understand.

Dealing with constipation can be frustrating and uncomfortable if you have IBS-C or CIC. In addition to medication, you can also try to manage your symptoms through lifestyle modifications, such as dietary changes. Increasing your fiber intake, for example, can help soften stools and make them easier to pass. Upping how much fluids you drink, especially water, can also help.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Warning:

Linzess should not be used in children younger than 2 as it can cause severe dehydration.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Linzess label.

  2. Thomas RH, Allmond K. Linaclotide (Linzess) for irritable bowel syndrome with constipation and for chronic idiopathic constipation. P T. 2013;38(3):154-160.

  3. Corsetti M, Tack J. Linaclotide: a new drug for the treatment of chronic constipation and irritable bowel syndrome with constipation. United European Gastroenterol J. 2013;1(1):7-20. doi:10.1177/2050640612474446

  4. Lee N, Wald A. Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation. Core Evid. 2012;7:39-47. doi:10.2147/CE.S25240

  5. Yu SW, Rao SS. Advances in the management of constipation-predominant irritable bowel syndrome: the role of linaclotide. Therap Adv Gastroenterol. 2014;7(5):193-205. doi:10.1177/1756283X14537882

Ayesha

By Ayesha Gulzar, PharmD
Ayesha Gulzar is a clinical pharmacist interested in medical research, pharmacy practice, and medication therapy management. Dr. Gulzar has been working in medical communications, writing medical and clinical research for patients and health professionals in the United Kingdom.