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(lin-a-kloe-tide) ,


(trade name)


Therapeutic: anti irritable bowel syndrome agents
Pharmacologic: guanylate cyclase c agonists
Pregnancy Category: C


Treatment of irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC).


Locally increases levels of cyclic guanosine monophosphate (cGMP); accelerates transit time, increases intestinal fluid and decreases pain sensation.

Therapeutic effects

Increased frequency of bowel movements with decreased pain associated with IBS-C or CIC.


Absorption: Minimally absorbed, action is primarily local.
Distribution: Stays within the GI tract with minimal distribution.
Metabolism and Excretion: Converted to its principal active metabolite within the GI tract; subsequently locally degraded to smaller peptides and amino acids; 3–5% found in stool, mostly as the active metabolite.
Half-life: Unknown.

Time/action profile (improvement in GI IBS-C or ICI symptoms)

POunknown6–9 wk1 wk†
†Following discontinuation.


Contraindicated in: Known/suspected mechanical GI obstruction; Pediatric: Children <17 yr.
Use Cautiously in: Lactation: Use cautiously in nursing women; Obstetric: Use during pregnancy only if potential maternal benefit justifies potential risk to the fetus.

Adverse Reactions/Side Effects

Central nervous system

  • fatigue


  • diarrhea (most frequent)
  • abdominal distention
  • abdominal pain
  • flatulence
  • gastrointestinal reflux
  • vomiting


Drug-Drug interaction

None noted.


Oral (Adults) IBS-C—290 mcg once daily; CIC—145 mcg once daily.


Capsules: 145 mcg, 290 mcg

Nursing implications

Nursing assessment

  • Assess patient for symptoms of IBS (abdominal pain or discomfort, bloating, constipation).

Potential Nursing Diagnoses

Constipation (Indications)
Diarrhea (Adverse Reactions)


  • Oral: Administer once daily on an empty stomach 30 minutes before eating first meal of the day. Swallow capsules whole; do not open, break, dissolve, or chew.

Patient/Family Teaching

  • Instruct patient to take as directed. Keep capsules in original bottle with desiccant packet to help keep medication dry; keep bottle tightly closed.
  • Inform patient that diarrhea often begins within first 2 wks of therapy. Stop taking and notify health care professional if severe diarrhea occurs. Contact health care professional and go to nearest hospital emergency room immediately if bright red, bloody stools or black stools that look like tar occur.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
  • Advise patient to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.

Evaluation/Desired Outcomes

  • Increased frequency of bowel movements with decreased pain associated with IBS-C or CIC.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
* Linzess by Allergan plc (NYSE:AGN) & Ironwood Pharmaceuticals, Inc.
Under the terms of the agreement, Ironwood will provide AHP disease education to gastroenterologists and other healthcare practitioners that Ironwood currently calls on for Linzess (linaclotide).
Allergan has a few growing marketed products, including gastrointestinal drug Linzess and antipsychotic treatment Vraylar.
To diversify their peptide based gastrointestinal disorders therapeutics offerings sos as to address chronic ailments such as irritable bowel disorders, Ironwood Pharmaceuticals, Inc., is poised to commercialize its linaclotide based peptide drug under the brand, Linzess. Ironwood in collaboration with its long standing ally AstraZeneca envisions to adequately promote and commercialize Linzess across China in 2019.
M2 EQUITYBITES-January 4, 2019-Ironwood Pharmaceuticals and Allergan reach agreement to resolve Mylan LINZESS patent litigation
(IBS with constipation as a primary symptom is called IBS-c, IBS with diarrhea is called IBS-d, and some patients have alternating bouts of both.) Linaclotide (Linzess) is a drug that treats IBS-c; a medical food, EnteraGam, may be used to treat IBS-d; and a gut-only antibiotic, called rifaximin (Xifaxan), may help relieve symptoms of IBS-d.
Eleven pharmaceutical agents or classes of drugs are used to treat IBS: linaclotide (Linzess), lubipro-stone (Amitiza), eluxadoline (Viberzi), polyethylene glycol laxatives (Miralax, Glycolax), rifaximin (Xifaxan), alosetron (Lotronex), loperamide (Imodium), tricyclic antidepressants (Elavil), selective serotonin reuptake inhibitors (Prozac, Zoloft) and antispasmodics (Atropine, Bentyl), and plecanatide (Trulance), approved in January 2017.
and has also reacquired rights to Linzess (linaclotide) in Mexico from Almirall, the company said.
Several newer medications, including Amitiza (lubiprostone) and Linzess (linaclotide), can help relieve chronic constipation.