Linzess (linaclotide) is a new prescription drug which can be used to treat both irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) in adults. It is the first treatment available in a new class of medications called GC-C agonists. It received FDA approval in the USA on 30 August 30 2012 and became available in pharmacies in December 2012. It is designed to relieve abdominal pain and constipation associated with IBS-C and constipation and hard stools associated with CIC.
How effective is Linzess in clinical trials?
A Phase I randomized, double-blind, placebo-controlled study described in January 2009 in the American Journal of Gastroenterology found that 42 patients with chronic constipation experienced relief with few side effects.
Conclusion: Linaclotide improved bowel habits and symptoms of patients with chronic constipation. Further randomized controlled trials are warranted. Pubmed article: Johnston JM, Kurtz CB, Drossman DA, Lembo AJ, Jeglinski BI, MacDougall JE, Antonelli SM, Currie MG.
A second study published in the American Journal of Gastroenterology looked at 804 patients over a period of 26 weeks. Statistically significant improvements in symptoms including abdominal pain, abdominal bloating and number of bowel movements were seen in patients taking linaclotide versus those given a placebo.
Conclusion: Linaclotide at a dosage of 290ug once per day significantly improved abdominal and bowel symptoms associated with IBS-C over 26 weeks of treatment. Pubmed article: Chey WD, Lembo AJ, Lavins BJ, Shiff SJ, Kurtz CB, Currie MG, MacDougall JE, Jia XD, Shao JZ, Fitch DA, Baird MJ, Schneier HA, Johnston JM.
REVIEWS OF LINZESS
Review by Sarah
I have been taking Linzess for over a year for IBS-C. It has been a never-ending game of guess work, even on an auto-immune IBS diet. I took the lower dosage of 145 for a while. It was too effective for a month with explosive, unpredictable bowel movements for hours in the morning. Then it become ineffective with time and regular use.
My gastroenterologist increased my dose to 290 and again it had too much effect. We decided it was too high a dose and I have been guessing each day whether to use the high or low dose depending on what I anticipated for a day. I can't travel while on the medication because you need constant access to a toilet.
I have noticed sensation changes in my fingers and my thyroid eye disease flares up about two hours after my dose is taken. Over time, I have been gaining weight. I started to look alcohol puffy and I am not joking as a colleague asked if I was all right.
This month I just gave up and quit. I have lost 10lbs of water weight in a week. My eyes are looking much improved. I literally look 10 years younger and healthier. The inflammatory reaction around my left eye has not occurred since I stopped taking Linzess.
I have been functioning with coffee enemas twice per day. It is more time-consuming in one way but the bowel movement is predictable and then I don't worry all day about where the bathroom is or whether it is gas I am going to pass or fecal matter. I just can't go back on it.
Review by CM
After reading several of the reviews of Linzess I can tell you that my experience on this new medication has been nothing short of amazing. I was diagnosed with IBS with constipation in November 2009 and following many excruciating trials of over-the-counter remedies I visited my gastroenterologist who prescribed Amitiza initially. Although I took a modified dose of the drug due to its rather harsh side effects it worked fairly effectively for the next four and a half years and then suddenly stopped working.
Thankfully Linzess was available and so I began taking it about six months ago, once per day approximately 30 minutes before breakfast (145mcg) and within 20 minutes following the morning meal it works like a charm. The only caveat is that I need to be close to a bathroom for up to 30 minutes as I continue to have episodes of diarrhea. The fact that I only have to take this medication once daily is a blessing...
Review by Julie
Four days ago my gynecologist gave me a boz of samples of Linzess to see if it might help my chronic constipation that I have had since I was a teenager (I'm now 60 years old). I'd been using Miralax for years but that didn't seem to be working as it's supposed to leaving me with hard stool constipation.
I've stopped using Linzess after the first four days because my lower abdomen was so bloated, causing sharp pains in the area of my colon and bowels. I had a colonoscopy just three months ago so I don't understand the reason I have such terrible constipation and bloating with the Linzess.
Review by Ron
I'm 65. I have suffered from IBS-C my entire adult life. In August I started experimenting with office samples of Linzess. I took it sporadically for a few months and then had the doctor prescribe it for me. At the same time I was taking the probiotic Align and I had just started on that as well.
It was when I got off the Align for about a week and tried dosing Linzess for 12 straight days that I had a savage attack of abdominal pain (trapped gas and splenic flexure syndrome). I had never taken Linzess for more than three or four days in a row prior to the 12-day stint. I got back on Align immediately, discontinued Linzess for a few days and in four or five days the trapped gas abated.
My conclusion is that Linzess is a very potent and effective laxative, perhaps to be taken every second or third day but not without the Align buffer. On its own, taken day after day, my experience suggests that Linzess may actually contribute to abdominal discomfort and bloating rather than alleviate it. I realize that this will vary from individual to individual, but I just wanted to share my own experience. Word of caution: you may experience thunderous diarrhea with Linzess, often after an initial somewhat firm stool. It's like milk of magnesia to the tenth power.
Review by Donna
I have suffered from IBS-C for 30+ years. I eat heathily and exercise regularly. I am not overweight. I could never understand why I have IBS-C. My gastroenterologist recommended Linzess and I took it as directed. Within 45 minutes I felt a warmth spread in my upper sternum, a definite pressure, a feeling of fullness, sweating and nausea. I also got a little short of breath but that may be due to the anxiety I was feeling because I thought I was having a cardiac event.
I called the gastroenterologist on call and he said he had been prescribing Linzess for about two months and none of his 17 patients reported experiencing any side effects. He instructed me to go to the ER if my symptoms did not resolve in the next hour just to rule out a cardiac event. I had had a complete physical with a cardiac work-up two months prior so that was ruled out. I began to feel better after 30 minutes when my discomfort peaked so I had a total of two hours of discomfort. I also take Prilosec so it was not GERD. I will never take this med again.
Review by Kristi
I have been on Linzess with amitriptyline for about a month and a half and I have noticed that I feel horrible from constipation, cramping and nausea if I don't take it at all. However if I take it as prescribed, before I eat first thing in the morning, I feel sick all day! It only took me two times of doing that before I figured out that it was the Linzess. So, as long as I take it at night before I go to bed, with the amitripyline, I am better.
I am so glad to have found your website and to read about the food side of IBS. My GI doc has said that there really is no definitive study to show that foods can trigger IBS. So I have thought that it is in my head that eating certain things - most things - actually makes me sicker. Thank you!
Review by Lynn
Yes, Zelnorm is off the market, but three months ago I was given this new drug that was approved by the FDA in the United States called Linzess. I was on Zelnorm for years (even after they took it off the market in the US) and it was a miracle pill. I have only 18 inches of colon left and I had suffered from horrible constipation. None of my doctors could figure out why I have constipation instead of diarrhea - they still can't figure it out and it is 12 years since my surgery.
Anyway, I had seen there was going to be a new drug out in place of Zelnorm. It was available three months ago and I have been on it since it became available. It works exactly like Zelnorm! You take it 30 to 60 minutes prior to eating. It is another miracle drug for me.
Do you suffer from IBS? Have you tried Linzess? Please contact Sophie to send in your review.