Linaclotide

Aka: Linaclotide, Linzess, Constella

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II. Indications

  1. Constipation Dominant Irritable Bowel Syndrome
  2. Chronic Constipation

III. Contraindications

  1. Mechanical Bowel Obstruction
  2. Children (esp. age <6 years)

IV. 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)

V. 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

VI. Efficacy

  1. May improve stool frequency, consistency and straining in Irritable Bowel Syndrome
  2. Marginal efficacy (NNT 5-8) for decreased Abdominal Pain

VII. Adverse Effects

  1. Abdominal Pain
  2. Abdominal Distention
  3. Flatulence
  4. Diarrhea
    1. Hold Linaclotide for severe Diarrhea

VIII. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

IX. Drug Interactions

  1. No known Drug Interactions

X. Resources

  1. Linaclotide (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=09beda19-56d6-4a56-afdc-9a77b70b2ef3

XI. 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

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Related Studies

Cost: Medications

linzess (on 1/14/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LINZESS 145 MCG CAPSULE $15.71 each
LINZESS 290 MCG CAPSULE $15.69 each
LINZESS 72 MCG CAPSULE $15.70 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

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