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Peptide

Linaclotide

Oral peptide that acts inside the intestine to treat chronic constipation and irritable bowel syndrome with constipation.
Regulatory status
Approved (FDA / EMA)
Family
Guanylate cyclase C agonist
Scientific evidence
High
Number of findings
1
Where it acts
Digestion and weight
Also known as
linaclotide, Linzess, Constella

Regulatory status

FDA (US): Approved (2012, Linzess) for irritable bowel syndrome with constipation and chronic idiopathic constipation in adults; in 2023 it was expanded to functional constipation in children aged 6 to 17 years.

EMA (EU): Approved (2012, Constella) for moderate-to-severe irritable bowel syndrome with constipation in adults.

Dose

Irritable bowel syndrome with constipation: 290 micrograms once a day on an empty stomach, 30 minutes before eating. Chronic constipation: 72 or 145 micrograms a day (FDA label 2012 / EMA 2012).

Safety

Diarrhea is the most frequent adverse effect and is sometimes severe. Contraindicated in children under 2 years (risk of severe dehydration) and if there is intestinal obstruction.

Interactions

Few interactions because of its poor absorption. Caution with laxatives and other drugs that cause diarrhea.

Effect by goal · level of evidence

Chronic constipation

improves High RCT (AA) in people
≈20% vs ≈5%

Two 12-week trials with 1,276 patients. Between 16% and 21% with linaclotide met the primary endpoint (at least 3 complete spontaneous bowel movements per week), vs 3–6% with placebo. Diarrhea led 4.2% to stop.

View the study (RCT) →

In depth

Where it acts

Digestion and weight

Gut and IBD

How it works

It activates the guanylate cyclase-C receptor in the intestinal wall. This makes the intestine secrete more fluid, softens stools, and speeds up transit. It also reduces the pain sensitivity of intestinal nerves. It is barely absorbed into the blood.

What the evidence says

In people

  • Chronic constipation. Two 12-week trials with 1,276 patients. Between 16% and 21% reached the primary endpoint (at least 3 complete spontaneous bowel movements per week) with linaclotide, versus 3–6% with placebo. Diarrhea led 4.2% to stop treatment. PubMed 21830967

References

  1. PubMed 21830967

Information, not medical advice. Prescription or unapproved peptides should only be used under medical supervision.

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