From the Guidelines
Linzess (linaclotide) should be taken at a dose of 72 mcg or 145 mcg once daily for chronic idiopathic constipation, and 290 mcg once daily for irritable bowel syndrome with constipation (IBS-C). The medication is available in three dosage strengths: 72 mcg, 145 mcg, and 290 mcg capsules, and should be taken on an empty stomach at least 30 minutes before the first meal of the day 1. According to the American Gastroenterological Association-American College of Gastroenterology clinical practice guideline, linaclotide is FDA-approved for the treatment of CIC at a dose of 72μg or 145μg daily, and the 290μg daily dose is approved for IBS-C 1.
The medication works by increasing intestinal fluid secretion and motility, which helps soften stool and increase bowel movements. Patients should swallow the capsule whole and not crush or chew it. Common side effects include diarrhea, abdominal pain, and gas. If severe diarrhea occurs, patients should stop taking Linzess and contact their healthcare provider. The medication is not recommended for children under 18 years of age due to safety concerns. Improvement in symptoms may be noticed within the first week of treatment, but individual responses vary. It is also important to note that linaclotide is contraindicated in individuals with known or suspected mechanical GI obstruction 1.
Key points to consider when prescribing Linzess include:
- The dose and indication for the medication
- The potential for diarrhea and other side effects
- The importance of taking the medication on an empty stomach
- The contraindication in individuals with mechanical GI obstruction
- The potential benefits of the medication in improving symptoms of CIC and IBS-C, as recommended by the AGA clinical practice guideline 1.
From the FDA Drug Label
2 DOSAGE AND ADMINISTRATION
- 1 Recommended Dosage Irritable Bowel Syndrome with Constipation (IBS-C) in adults The recommended dosage of LINZESS is 290 mcg orally once daily. Chronic Idiopathic Constipation (CIC) in adults The recommended dosage of LINZESS is 145 mcg orally once daily. A dosage of 72 mcg once daily may be used based on individual presentation or tolerability Functional Constipation (FC) in pediatric patients 6 to 17 years of age The recommended dosage of LINZESS is 72 mcg orally once daily.
The recommended dose of Linzess is:
- 290 mcg orally once daily for Irritable Bowel Syndrome with Constipation (IBS-C) in adults 2
- 145 mcg orally once daily for Chronic Idiopathic Constipation (CIC) in adults, or 72 mcg once daily based on individual presentation or tolerability 2
- 72 mcg orally once daily for Functional Constipation (FC) in pediatric patients 6 to 17 years of age 2
From the Research
Linaclotide Dosage
- The recommended dosage of linaclotide for the treatment of chronic constipation is 145 μg or 72 μg once daily 3.
- For the treatment of irritable bowel syndrome with constipation, the recommended dosage is 290 μg once daily 3, 4.
Efficacy and Safety
- Linaclotide has been shown to be effective in increasing the number of spontaneous bowel movements and stool consistency scores in patients with chronic constipation and irritable bowel syndrome with constipation 5, 6.
- The most common adverse event associated with linaclotide is diarrhea, which can lead to discontinuation rates of up to 5% 3, 4.
Clinical Recommendations
- Patients should be warned about the risk of diarrhea and given choices concerning how to deal with this possible side effect 7.
- Linaclotide can be taken continuously and not sporadically, and treatment can be maintained for long periods of time due to the absence of tachyphylaxis or potential risks 7.