Indications
Linaclotide is used in adults to treat irritable bowel syndrome with constipation (IBS-C), a long-term gut condition causing tummy pain, bloating and hard or infrequent stools. It is also used for chronic idiopathic constipation, which means long-lasting constipation without a known cause.
How It Works
Linaclotide acts inside the gut and is hardly absorbed into the blood. It switches on a receptor called guanylate cyclase-C on the lining of the intestine. This increases the release of fluid and salts into the bowel, which softens stools and helps them move more easily. It also reduces the activity of pain nerves in the gut, easing tummy pain.
Dosage and Administration
Usual adult doses: for IBS-C, 290 micrograms once daily; for chronic idiopathic constipation, 145 micrograms once daily (some people need 72 micrograms). Take the capsule on an empty stomach at least 30 minutes before the first meal of the day. Swallow it whole. If you cannot swallow capsules, ask your pharmacist how to open and mix it. If you miss a dose, skip it and take the next dose at the usual time.
Interactions
Linaclotide has few interactions because very little reaches the blood. However, severe diarrhoea can reduce the absorption of other medicines, including oral contraceptives; use extra contraception if diarrhoea is severe. Laxatives, proton pump inhibitors and NSAIDs may increase the risk of diarrhoea.
Contraindications
Do not use in children under 2 years of age, or if you have a known or suspected bowel blockage, or are allergic to Linaclotide. It is generally not recommended for anyone under 18.
Side Effects
The most common side effect is diarrhoea, usually in the first two weeks. Others include tummy pain, bloating, wind, nausea and headache. Severe diarrhoea can lead to dehydration and dizziness.
Get urgent medical help if you have severe or persistent diarrhoea with dizziness or fainting, bloody or black stools, or severe tummy pain that does not go away.
Pregnancy and Lactation
There is little information on use in pregnancy, so it is best avoided unless your doctor advises. Very little is absorbed, and it is not expected to reach breast milk in meaningful amounts, but ask your doctor before using it while breastfeeding.
Precautions and Warnings
Stop taking it and contact your doctor if severe diarrhoea develops. Older people and those with other bowel conditions should be monitored closely. See a doctor if you notice weight loss, bleeding or a change in bowel habits after age 50, as these need checking.
Overdose
Overdose may cause diarrhoea and related fluid loss. Drink fluids and seek medical advice if symptoms are severe.
Therapeutic Class
Guanylate cyclase-C agonist (drug for constipation and IBS-C).
Storage
Store below 25°C in the original bottle with the desiccant, tightly closed to protect from moisture, and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.