Linzess (Linaclotide) Administration Instructions
Dosing
Take Linzess on an empty stomach at least 30 minutes before the first meal of the day, at approximately the same time each day. 1
Recommended Doses by Indication
- Chronic Idiopathic Constipation (CIC) in adults: 145 mcg once daily (or 72 mcg once daily based on individual tolerability) 1
- Irritable Bowel Syndrome with Constipation (IBS-C) in adults: 290 mcg once daily 1
- Functional Constipation in pediatric patients (6-17 years): 72 mcg once daily 1
Standard Administration
- Swallow the capsule whole - do not crush or chew the capsule or its contents 1
- If a dose is missed: Skip the missed dose and take the next dose at the regular time; never take 2 doses at the same time 1
- Timing is critical: Must be taken at least 30 minutes before eating to ensure proper absorption and efficacy 2, 1
Alternative Administration Methods (For Patients Unable to Swallow Capsules)
Option 1: With Applesauce
- Place 1 teaspoon of room-temperature applesauce in a clean container 1
- Open the capsule and sprinkle the entire contents (beads) on the applesauce 1
- Consume immediately without chewing the beads 1
- Do not store the mixture for later use 1
Option 2: With Water (Oral)
- Pour approximately 30 mL of room-temperature bottled water into a clean cup 1
- Open the capsule and sprinkle the entire contents (beads) into the water 1
- Gently swirl beads and water for at least 20 seconds 1
- Swallow the entire mixture immediately 1
- Add another 30 mL of water to any remaining beads, swirl for 20 seconds, and swallow immediately 1
- Note: The drug coating dissolves off the beads into water; the beads remain visible and do not dissolve, so consuming all beads is not necessary to deliver the complete dose 1
Option 3: Via Nasogastric or Gastrostomy Tube
- Open the capsule and empty beads into a clean container with 30 mL of room-temperature bottled water 1
- Mix by gently swirling beads for at least 20 seconds 1
- Draw up the mixture into an appropriately sized catheter-tipped syringe 1
- Apply rapid and steady pressure (10 mL/10 seconds) to dispense into the tube 1
- Add another 30 mL of water to any remaining beads and repeat 1
- Flush the tube with a minimum of 10 mL of water after administration 1
Storage and Handling
- Keep in the original container - do not subdivide or repackage 1
- Protect from moisture - do not remove the desiccant from the container 1
- Keep bottles tightly closed in a dry place 1
- Store securely out of reach of children, especially those under 2 years of age, as accidental ingestion can cause severe diarrhea and dehydration 1
Critical Safety Warnings
- Contraindicated in children under 2 years of age due to risk of fatal dehydration 1
- Contraindicated in patients with known or suspected mechanical gastrointestinal obstruction 2, 1
- Stop medication and contact healthcare provider if experiencing severe abdominal pain and/or severe diarrhea, especially with blood in stool 1
Common Pitfalls to Avoid
- Do not take with food - this significantly reduces efficacy; the 30-minute window before meals is essential 2, 1
- Do not sprinkle beads on foods other than applesauce or in liquids other than water - these combinations have not been tested 1
- Do not store prepared mixtures - all bead-applesauce or bead-water mixtures must be consumed immediately 1
- Do not double up on doses if one is missed 1