Linzess dosage, forms, and strengths

Linzess (linaclotide) is a prescription guanylate cyclase-C agonist used to treat irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC). It's prescribed in adult patients who have not responded to other treatments such as fiber supplements and laxatives. This medication works by increasing the secretion of chemical compounds that promote increased intestinal fluid, which helps lead to more frequent bowel movements. It's taken as a capsule and comes in several different strengths. Your doctor will determine your dosage based on your medical needs and how you respond to the treatment.

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Linzess forms and strengths

Linzess comes in capsule form and is taken by mouth. The capsules are available in a 72 mcg dose, 145 mcg dose, and 290 mcg dose. The capsules should never be crushed or chewed but can be opened and mixed with applesauce or water.

• Capsule: 72 mcg, 145 mcg, 290 mcg

Linzess dosage for adults

Linzess is approved by the U.S. Food and Drug Administration (FDA) for oral administration to treat adults with chronic idiopathic constipation or IBS-C. It's also used to treat adults who did not respond to other treatments for chronic constipation or IBS-C.

Linzess dosage for irritable bowel syndrome with constipation

Linzess may help reduce the symptoms of IBS-C, one of the three subtypes of irritable bowel syndrome. This subtype produces chronic constipation as well as abdominal pain, flatulence, and bloating. The recommended oral dose is a 290 mcg capsule taken by mouth daily, at least 30 minutes before your first meal. 

Linzess dosage for chronic idiopathic constipation

Linzess is also prescribed for chronic idiopathic constipation. This subtype of chronic constipation produces hard stools, belly pain, and straining. The standard dose is 145 mcg capsule once daily, at least 30 minutes before the first meal. A smaller dose of 72 mcg capsule given once daily may be used in patients with lower tolerability. Capsules should never be chewed or crushed. If the capsule can't be swallowed whole, it can be opened and sprinkled on 1 teaspoonful of room-temperature applesauce—if taken immediately. The contents of the capsule may also be mixed with 30 mL of water. Once mixed thoroughly, the entire mixture should be consumed immediately.

Linzess dosage for children

Linzess is contraindicated (should not be used) in pediatric patients less than 6 years of age. Non-clinical trials in neonatal mice given Linzess caused death due to dehydration within 24 hours of administration. The safety and effectiveness of Linzess in patients less than 18 years of age have not been established. Children less than 18 years old should avoid taking Linzess, due to the deaths seen in mice and the lack of data in pediatric patients. Store Linzess securely and out of the reach of children. Discard unused Linzess.

Linzess dosage restrictions

Linzess may not be the right medication to treat IBS-C or CIC in everyone. Always tell your doctor if you are taking other medications (prescription or over-the-counter) or vitamins or supplements. Make sure they are aware of all health conditions and allergies before taking this medication.

• Linzess should not be taken by patients who have had an allergic reaction to linaclotide or any of its components. The most common adverse reactions while taking this medication include diarrhea, abdominal pain, abdominal distension, flatulence, sinusitis, and headache. Allergic reactions to Linzess are rare. If you have symptoms of an allergic reaction such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, get emergency medical help right away.

• Linzess should not be taken by patients less than 18 years of age due to the risk of serious dehydration that could be potentially fatal. This medication has a black box warning contraindicating use in patients under 6 years old, and avoiding use in patients ages 6 years old to less than 18 years old.

• Patients with known or suspected mechanical gastrointestinal obstruction should not take Linzess.

• Linzess is not recommended in patients with severe diarrhea and vomiting due to the potential risk of complications associated with dehydration. If you experience these symptoms, you should immediately inform your doctor.

How to take Linzess

Linzess is taken by mouth, once daily. It should be taken at least 30 minutes before your first meal of the day. It’s important to follow the instructions provided by your doctor or on the prescription label. Do not take more than one dose in a day.

• Your doctor will tell you how much medicine to use. Do not use more than directed.

• Take Linzess on an empty stomach, at least 30 minutes before breakfast or the first meal of the day.

• Swallow the capsule whole. Do not crush, break, or chew it. For adults with difficulty swallowing, the contents of the capsule can be mixed with applesauce or water and consumed immediately. The Medication Guide has detailed instructions on preparing the dosage this way.

• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one. The Medication Guide contains important information about the drug, including side effects and warnings. Read the guide thoroughly each time you fill or refill your prescription, and consult your healthcare professional if you have any questions or concerns.

• Missed dose: Skip the missed dose and go back to your regular dosing schedule. Do not double doses.

• Store the medicine in a closed container at room temperature. Make sure it’s in a dry place, away from heat and direct light. Keep the medicine in the original bottle until you are ready to use it. The bottle contains a desiccant packet that helps protect the capsules from moisture. Do not remove the packet from the bottle. Do not swallow the desiccant packet.

• If you have trouble swallowing the capsule, you may mix the contents with applesauce or water. To mix with applesauce: Open the capsule and sprinkle the beads on 1 teaspoonful of room-temperature applesauce. Swallow the mixture immediately without chewing. Do not store it for later use. To mix with water: Open the capsule and sprinkle the beads into a clean cup with 30 mL (1 ounce) of water. Gently swirl for at least 20 seconds. Swallow the entire mixture immediately. Add another 30 mL (1 ounce) of water to the cup and swirl. Drink the water right away to make sure all of the medicine is taken. Do not store it for later use. The water mixture may also be used with a nasogastric or gastric feeding tube. After the mixture is given, flush the tube with at least 10 mL (2 teaspoons) of water.

Linzess dosage FAQs

How long does it take Linzess to work?

Linzess usually begins working within the first week of treatment. You should see improvements in your symptoms and normal bowel movement patterns within 4-12 weeks of taking Linzess as prescribed by your doctor. Improvements may be seen in symptoms such as constipation frequency, stool consistency, straining, abdominal discomfort, small bowel movements, and relief of bloating.

How long does Linzess stay in your system?

The active ingredient in Linzess is linaclotide. The medication acts locally in the intestine, where it relaxes the muscles of the intestines and increases peristaltic movement. Linzess is minimally absorbed. Studies show that taking Linzess once daily is effective for managing symptoms in IBS-C and CIC patients.

What happens if I miss a dose of Linzess?

If you forget to take a dose, do so as soon as possible after remembering. If it’s almost time for your next dose, skip the missed dose and continue taking your medication at the regular time. Do not double up on doses of Linzess. You should never take more than one capsule in a 24-hour period.

How long can you take Linzess?

There is no known limit to how long you can take Linzess. Once your doctor has prescribed the medication, he or she will decide how often it should be taken and for as long as it should be used. Long-term trials followed patients receiving 290 mcg of Linzess daily for up to 18 months. Your doctor may recommend Linzess as a long-term medication. 

How do I stop taking Linzess?

If you decide that you no longer want to take Linzess, talk with your doctor. He or she may suggest a diet, or medication similar to Linzess that will function in the same way and help with any future bowel issues. 

What is the maximum dosage for Linzess?

The maximum dosage of Linzess is 290 mcg per day. Overdosing on this medication could cause serious side effects including diarrhea that could lead to serious complications. If you accidentally take too much, call your healthcare provider immediately to avoid further complications.

Can you overdose on Linzess?

Overdosing on Linzess could lead to serious side effects. Symptoms include diarrhea that can cause dehydration, which could be fatal if not treated immediately. If you think you’ve taken too much of this medication, call your medical provider for help as soon as possible.

What interacts with Linzess?

Drug interactions are possible when taking Linzess. Tell your doctor about all the prescription drugs, over-the-counter medications, dietary supplements, and vitamins you’re taking.

• Saline laxatives: Bowel preps like sodium phosphate and magnesium citrate induce bowel movements, helping to prepare you for medical testing. Be sure to tell your doctor you are taking Linzess before taking any bowel prep products. This combination may increase your risk of severe dehydration and electrolyte abnormalities.

• Osmotic laxatives: Taking Linzess with polyethylene glycol will increase the risk for diarrhea and electrolyte imbalances.

What happens when you mix Linzess and alcohol?

The potential interactions of Linzess and alcohol are not well established. Drinking alcohol while taking this medication may increase the risk for adverse effects. Alcohol may also increase your symptoms of IBC-C and CIC. For these reasons, avoid drinking alcohol while taking Linzess.

Is it safe to take Linzess during pregnancy?

Because there is a lack of research on Linzess during pregnancy, you should talk with your doctor before taking this medication. It could be harmful to unborn babies. Pregnant women and breastfeeding mothers should talk to their doctor about prescribing an alternative medicine during this time.

Related resources for Linzess dosages:

• Linzess, Epocrates

• Linzess prescribing information, Allergan