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Linaclotide (Linzess)

Indicated in adults for the treatment of both irritable bowel syndrome with constipation and chronic idiopathic constipation.

A peptide agonist of guanylate cyclase 2C that is for use in treating abdominal pain in patients with irritable bowel syndrome (IBS) accompanied by constipation.

A peptide consisting of 14 amino acids.

Oral agent

Trade name Linzess

May be efficacious for the treatment of gastroparesis, ulcerative colitis, chronic intestinal pseudo-obstruction (CIPO), and colon inertia.

In a study of 800 patients over 12 weeks given linaclotide or a placebo in a randomized double-blind trial: 34% of those receiving linaclotide experienced relief of pain and constipation, compared to 21% of patients who had taken the placebo, 50% of those saw a significant reduction in pain, versus 37% with the placebo.

Diarrhea, the most commonly reported side effect (Ironwood et al).

Acts locally in the intestine to increase cGMP.

Decreases pain sensing nerve activity in the bowel, and increases fluid secretions and transit.

Administered as an oral capsule once daily, and taken on an empty stomach 30 minutes before the first meal of the day.

Contraindicated in pediatric patients.

Contraindicated in patients with known or suspected mechanical gastrointestinal obstruction.

Associated with diarrhea, abdominal pain and flatulence.

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