Linaclotide (Oral)

Linaclotide capsules are given to people with irritable bowel syndrome, and constipation.

Overview

This medication works by increasing the amount of fluid in the intestines, which allows stools to pass more easily.

The medication is generally well-tolerated, but some people experience side-effects. The most common side effects include diarrhea and pain in the stomach or abdomen.

Patients with stomach or bowel blockages, or with a history of these conditions, should not use this medication.

This is a prescription-only medication that is normally sold under the brand name Linzess.

Conditions Treated

* Irritable bowel syndrome
* Chronic idiopathic constipation

Type Of Medicine

* Gastrointestinal drug
* Guanylate cyclase-C agonist

Side Effects

As well as the desired effect of the medication, linaclotide can also cause some undesired side effects.

Consult your doctor immediately if you experience any of the following side-effects:

More common

* Pain in the stomach or abdomen
* Severe diarrhea

Less common

* Bleeding from the rectum
* Black or tarry stools
* Bloody stools
* Changes to your heartbeat, such as a faster heartbeat
* Confusion, dizziness, or disorientation
* Coughing
* Difficulty swallowing
* Loss of bladder control
* Fainting, feeling faint, or lightheadedness
* Fatigue or weakness
* Heartburn or indigestion
* Increased thirst or dry mouth
* Nausea or vomiting
* Reduced appetite
* Reduced urine output
* Sunken eyes
* Tightness or pain in the chest area
* Wrinkling of the skin

Linaclotide may also trigger some other medications which may be unpleasant, but are not harmful. Sometimes these less serious side-effects disappear by themselves after you have been taking the medication for a while, but if they do not, there may be another medication you can take to remove them. Consult your doctor if you experience any of the side effects below, especially if they are bothersome or concerning:

More common

* Aches and pains in the muscles
* Changes to your voice, such as losing your voice
* Chills or a fever
* Congestion in the ear
* Excessive gas or flatulence
* Feeling bloated
* Headaches
* Nasal congestion
* Sneezing
* Soreness in the throat
* Runny nose

Less common

* Belching
* Indigestion
* Pain in the cheekbones, or around the eyes
* Pain, swelling or a feeling of pressure in the stomach
* Upset stomach

This is not a complete list of the side-effects that you might experience while you are taking linaclotide. If you notice any other side effects that are not listed here, consult your doctor for further advice.

Allergic reaction

Allergic reactions to this medication are rare, but they can occur in some people. It is also possible that you may be allergic to the non-active ingredients, such as the capsule, or filler ingredients. Seek emergency medical assistance if you experience any of the following symptoms:

Extreme drowsiness, dizziness, or fatigue

Itching

Problems with your breathing

Rash, redness or hives on the skin

Swelling particularly when located in the tongue, throat, face, or hands

Dosage

Your doctor will prescribe a dose of linaclotide that is unique to you, based on the type and severity of the symptoms that you are experiencing. Take the medication exactly as prescribed by your doctor. Do not take more or the medication than prescribed, and do not take it for longer than prescribed.

As a general guideline, here are the doses that are typically prescribed:

For chronic idiopathic constipation

* Adults: 145 micrograms once per day. This may be reduced to 72 micrograms depending on your response to the drug
* Children: this medication is not recommended for use in children

For irritable bowel syndrome

* Adults: 290 micrograms once per day
* Children: this medication is not recommended for use in children

If you find it difficult to swallow the capsule, you can try mixing the contents of the capsule into around 30 milliliters of water, and drinking the mixture. Then pour another 30 milliliters of water into the same container swirl it around to absorb any beads that remain, and swallow this also. The mixture can be used in a nasogastric or gastric feeding tube, but flush the tube with an extra 10 milliliters of water to ensure all of the medication has entered the stomach.

You can also pour the contents of the capsule onto a teaspoon of applesauce, taking care to make sure all of the medication ends up on the spoon. Then swallow the mixture whole, without chewing.

Ideally, you should take the medication on an empty stomach, around half an hour before your first meal of the day.

If you forget to take your dose, or if you are unable to take it for some reason, skip that dose and continue as normal the following day. Do not take a double dose the next day -- you will not receive any additional benefit from doing so, and you put yourself at greater risk of experiencing undesirable side effects.

Interactions

Before you take this medication, it is important to tell your doctor about any other medications, vitamins, or herbal supplements that you are currently taking. Linaclotide can interact with certain medications in ways that can produce negative side-effects. The medications listed below are of particular note:

* Desogestrel
* Dienogest
* Drospirenone
* Estradiol
* Ethinyl estradiol
* Ethynodiol
* Etonogestrel
* Folic acid
* Idelalisib
* Leuprolide
* Levomefolate calcium
* Levonorgestrel
* Levothyroxine
* Liotrix
* Mestranol
* Norelgestromin
* Norethindrone
* Norgestimate
* Norgestrel
* Thyroid desiccated

Using these medications does not usually mean that you will not be able to take linaclotide. However, your doctor may want to adjust your dose of one of the medications, or see you more frequently for check-ups to make sure that you are not experiencing and adverse reactions.

If you experience diarrhea while taking this medication, this may cause any other oral medications or supplements that you are taking to pass through your body more quickly that normal. This may mean that your body absorbs less of these other medications than you are supposed to be taking. If you experience any diarrhea, consult your doctor without delay. They may advise you to discontinue your use of the medication, and give you other medications to rehydrate you.

Warnings

Linaclotide is generally well-tolerated in adults and is considered to be safe if you take it as prescribed by your doctor. However there are certain people for whom this may not be an appropriate choice of medicine.

Linaclotide is normally not recommended for use in people with stomach or bowel blockages, or with a history of these conditions. If you have every suffered from either of these conditions, let your doctor know so that they can discuss alternative forms or treatment with you.

Do not take the medication with food. Take the medication at least 30 minutes before the first meal of your day. If you take the medication with food, you will be more likely to experience side-effects including diarrhea, stomach pain, and excess gas.

Your doctor may want to see you regularly while you are taking linaclotide. Make sure you keep these appointments, as your doctor will use them to check that the medication is working, and to ensure that no undesired side-effects are occurring.

Consult your doctor if you experience diarrhea while taking this medication. Severe diarrhea can cause dizziness, low blood pressure, dizziness, and electrolyte imbalances.

Research has not conclusively determined whether this medication is safe for pregnant or breastfeeding women to take. Studies in animals have shown that the drug can be harmful to the unborn fetus, however, this was at doses much higher than would be prescribed in humans, and no human studies have yet been conducted. It is also not known whether this medication passes into the breastmilk. If you are pregnant or breastfeeding, ask your doctor whether linaclotide is safe for you to take. If you become pregnant during the course of your treatment with linaclotide, tell your doctor immediately.

This medication may be toxic to children, and so it should not be taken by anyone under the age of 18.

Storage

Improper storage of your medication may damage it, making it less potent or even unsafe for you to take. Follow the guidelines below to safely store your medication:

Store at room temperature: Heat or cold can damage the medication. Do not store this medication near to heaters, radiators, or other sources of heat. Do not store it in the refrigerator or the freezer.

Avoid moisture: Linaclotide capsules are particularly sensitive to moisture, and can become damaged easily if they are exposed to moist or humid environments. Do not store the medication in the bathroom, as the moisture from the shower can damage the capsules. Your medication will come with a desiccant inside the bottle, which will help to absorb any moisture that may find its way into the bottle. Do not remove the desiccant, and ensure the lid of the bottle is tightly sealed. Do not repackage the capsules into another container.

Avoid sunlight: Do not store the medication in a place where it will be exposed to sunlight, such as near a window.

Keep away from children: Linaclotide can be very dangerous when consumed by children. Keep the medication out of the sight and reach of children, and ensure that it is stored in a child-proof container.

Disposal: If your medication has become damaged, for example, if the capsules are soft and stuck together, do not take them. You should also stop taking the medication if it has passed its expiry date. In these cases, do not throw the medication away in the trash. Ask your doctor or pharmacist for advice on how to dispose of this medication.

Summary

Linaclotide is a prescription-only drug used to treat irritable bowel syndrome and chronic idiopathic constipation. It works by causing the intestines to produce more fluid, which helps stools to pass through more easily.

Some people experience side-effects when taking this medication, the most common of which being stomach or abdominal pain, and diarrhea.

People who have stomach or intestinal blockages, and people who have previously suffered from these conditions, are usually advised not to take this medication.