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Linzess
linaclotide
Black Box Warnings .
Pediatric Risk
contraindicated in pts <2 yo; deaths occurred due to dehydration w/in 24h in nonclinical studies in neonatal mice after admin. of a single clinically relevant adult oral dose
Adult Dosing .
Dosage forms: CAP: 72 mcg, 145 mcg, 290 mcg
IBS, constipation-predominant
- [290 mcg PO/NG/GT qd]
- Info: give >30min before meal; may open cap, but do not crush/chew contents
chronic idiopathic constipation
- [145 mcg PO/NG/GT qd]
- Info: give >30min before meal; may give 72 mcg PO/NG/GT qd if tolerability concern; may open cap, but do not crush/chew contents
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: CAP: 72 mcg
functional constipation
- [6-17 yo]
- Dose: 72 mcg PO/NG/GT qd; Info: give >30min before meal; may open cap, but do not crush/chew contents
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pts <2 yo
- GI obstruction
Drug Interactions .
Overview
linaclotide
guanylate cyclase-C agonist
-
None
No significant interactions known or found for this drug. Caution always advised with multiple medications.
Adverse Reactions .
Serious Reactions
- anaphylaxis
- diarrhea, severe
Common Reactions
- diarrhea
- abdominal pain
- flatulence
- URI
- gastroenteritis
- headache
- abdominal distension
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
linaCLOtide confused with: linaGLIPtin
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available, though risk of fetal harm not expected based on insignificant systemic absorption; possible risk of fetal malformation based on conflicting animal data
Lactation
Clinical Summary
may use while breastfeeding; inadequate human data available, though risk of infant harm and adverse effects on milk production not expected based on insignificant systemic absorption in breastfeeding pts
Pharmacology .
Metabolism: GI tract; CYP450: none; Info: active metabolite; no systemic absorption
Excretion: feces (none unchanged); Half-life: unknown
Subclass: Constipation: Guanylate Cyclase-C (GC-C) Agonists ; Irritable Bowel Syndrome (IBS)
Mechanism of Action
activates guanylate cyclase-C, stimulating cGMP production and increasing intestinal fluid secretion and motility
Formulary .
No Formulary Selected
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