From the Guidelines
Linaclotide (Linzess) should be taken daily as prescribed, rather than as needed, to maintain its effectiveness in treating irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). The medication works by increasing intestinal fluid secretion and motility to relieve constipation, but it requires consistent use to maintain effectiveness 1. Unlike some laxatives that provide immediate relief, Linzess may take several days to a week to reach its full therapeutic effect. Stopping and starting the medication can disrupt this process and reduce its effectiveness.
Some key points to consider when taking Linzess include:
- It should be taken once daily on an empty stomach at least 30 minutes before the first meal of the day 1
- The recommended dosage for IBS-C is 290 mg once daily, while for CIC, the dosages are 72 mg and 145 mg once daily 1
- Irregular use may make it difficult to assess whether the medication is truly working for your condition
- If you're considering changing how you take Linzess, it's essential to discuss this with your healthcare provider first, as they might suggest alternative medications that are better suited for as-needed use or adjust your treatment plan based on your specific symptoms and needs 1.
The most recent and highest quality studies support the daily use of Linzess for the treatment of IBS-C and CIC, with the American Gastroenterological Association (AGA) recommending its use in patients with IBS-C 1. Similarly, the British Society of Gastroenterology guidelines suggest that Linaclotide is an efficacious second-line drug for IBS with constipation in secondary care 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION The recommended dosage in adults is: IBS-C: 290 mcg orally once daily. (2. 1) CIC: 145 mcg orally once daily or 72 mcg orally once daily based on individual presentation or tolerability. (2.1)
The FDA drug label does not provide information to support the use of Linzess as needed, it specifies a daily dosage.
- Key points:
- The label recommends a specific daily dosage for different conditions.
- There is no mention of using Linzess as needed.
- The dosage instructions are to take the medication at approximately the same time each day 2.
From the Research
Linaclotide Usage
- Linaclotide, also known as Linzess, is a medication used to treat chronic idiopathic constipation and constipation-predominant irritable bowel syndrome (IBS-C) 3, 4, 5, 6.
- The recommended usage of linaclotide is once daily, with doses of 145 μg for chronic constipation and 290 μg for IBS-C 5.
- It is recommended that patients take linaclotide continuously and not sporadically, as this can help maintain its efficacy and minimize potential side effects 7.
Efficacy and Safety
- Linaclotide has been shown to be effective in increasing weekly spontaneous bowel movements and complete spontaneous bowel movements, while reducing abdominal pain in patients with chronic constipation and IBS-C 3, 5.
- The most common adverse effect of linaclotide is diarrhea, which was reported in 16-20% of clinical trial participants 5.
- Linaclotide has been demonstrated to be safe and well-tolerated in patients with chronic constipation and IBS-C, with a low risk of serious adverse events 4.
Usage Guidelines
- Patients should be warned about the risk of diarrhea and given choices concerning how to deal with this possible side effect 7.
- The absence of tachyphylaxis or potential risks implies that linaclotide treatment can be maintained for long periods of time 7.
- There is no evidence to suggest that linaclotide should be used "as needed" rather than continuously, as this may affect its efficacy and increase the risk of side effects 7.