Linzess side effects and how to avoid them

Linzess side effects | Serious side effects | How long do side effects last? | Warnings | Interactions | How to avoid side effects

Linzess is the brand name of a generic medication called linaclotide. It’s a prescription medication that’s used to treat chronic constipation, and it works by increasing the secretion of two chemical compounds called chloride and bicarbonate in the intestines. This causes the release of more intestinal fluid, which helps ease the passage of stools. Linzess also works by decreasing the amount of time it takes for food to travel through the digestive tract.

Linzess can treat two types of chronic constipation called irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC). In both of these conditions, constipation persists for three months or longer. Let’s take a look at the common side effects, warnings, and drug interactions of Linzess to better understand the drug and how it works.

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Common side effects of Linzess

Linzess can cause side effects just like any other medication can, and for many people with IBS-C or CIC, the benefits of taking it will outweigh any side effects they may experience. Here are the most common side effects of Linzess:

  • Abdominal pain
  • Diarrhea
  • Flatulence (passing gas)
  • Headaches
  • Gastroenteritis (inflammation of the intestines)
  • Abdominal distension (bloating)

Because Linzess works by decreasing gastrointestinal transit time, diarrhea is the most common side effect. Experiencing one or more of these side effects while taking Linzess is normal, and although they may be uncomfortable, many people will begin to feel relief from their chronic constipation soon after starting Linzess.

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Serious side effects of Linzess

In rare cases, Linzess can cause more serious side effects that may require medical attention:

Severe diarrhea

If you’re taking Linzess and start to have diarrhea that worsens or won’t go away, especially if you have bloody or black stools, then you should stop taking Linzess and contact your doctor to see if continuing the medication is right for you. Your doctor can provide medical advice on what to do. In rare cases, severe diarrhea can lead to dizziness or fainting, and hospitalization may be necessary in order to replace lost electrolytes from dehydration.


Anaphylaxis is a severe allergic reaction to a medication, food, or venom. It’s very rare for someone to have an allergic reaction to Linzess, but it is possible, and anaphylaxis can be life-threatening if it isn’t treated right away. If you start to experience difficulty breathing, swelling of the throat, nausea, vomiting, shock, and/or hives after taking Linzess, then you should seek medical attention right away.

Weight loss

Some people who take Linzess for chronic constipation may experience weight loss. This may be because the medication can cause diarrhea and the loss of water and electrolytes from the body, which can lead to weight loss if it isn’t treated right away. Diarrhea often begins within the first two weeks of taking Linzess, and in placebo-controlled trials, about 20% of people with IBS-C experienced diarrhea in comparison to placebo groups that did not receive the medication. Some mild diarrhea is common, but if you experience severe diarrhea while taking Linzess, you should stop taking it and call your doctor right away. This is especially important for older adults who may be more prone to dehydration.


There is very little research to suggest that Linzess causes depression, but there may be a link between depression, anxiety, and IBS-C. This is because the gut is partly controlled by the nervous system, which sends signals to the brain. It’s estimated that about 50% of people who have IBS-C will also have anxiety and depression symptoms. Someone who’s taking Linzess for IBS-C and feeling anxious or depressed may be feeling that way because they have anxiety or depression, not because of the medication.

If you’re taking Linzess and start to feel depressed, it’s best to speak with a doctor or healthcare professional about what might be causing you to feel the way you do. Your doctor will be able to help you figure out if Linzess is worsening your feelings of anxiety and depression.

Additionally, if you start to have suicidal thoughts or behaviors, you should seek medical attention right away. You can also call the National Suicide Prevention Lifeline for free at 1-800-273-8255 if you need someone to talk to. The Lifeline is available 24 hours per day.

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Hair loss

Among people with digestive disorders, there could be many causes of hair loss such as stress, gut inflammation, or not absorbing enough nutrients from food. Many medications are also known to cause hair loss, but there’s not enough evidence to suggest that Linzess does. Hair loss isn’t listed as a side effect of Linzess. It’s certainly possible for someone to experience side effects from a drug that other people don’t, and if this happens to you, you should let your healthcare provider know. You can also report side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088.

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How long do Linzess side effects last?

For the average person taking Linzess, diarrhea is the most common side effect and usually appears in the first two weeks of treatment. In clinical trials, diarrhea resolved in a week for about 33% of people. Although many side effects will resolve in the short term, it’s possible to have longer-lasting side effects. Some people will have diarrhea that lasts up to a month, so it really depends on the individual and how their body processes Linzess. If you’ve been taking Linzess for more than two weeks and your side effects aren’t going away, it may be a good idea to contact your doctor to make sure that what you’re experiencing is okay.

Note: Linzess is not a laxative and does not start working immediately. Most people will begin to feel relief from their chronic constipation symptoms about a week after starting Linzess, and IBS-C patients typically see improvements in their medical condition over the course of 12 weeks.

Linzess contraindications & warnings

Abuse and dependence

Linzess belongs to a group of medications called guanylate cyclase-C agonists, which work by increasing intestinal fluid secretion. There’s no evidence to suggest that these types of medications are habit-forming.

Linzess should be taken only as directed by a physician. Taking more than your recommended daily dose of Linzess in an attempt to make it work faster isn’t safe and won’t work. Taking a medication in a way you’re not prescribed can be harmful to your health.

If someone with IBS-C or CIC has to stop taking Linzess for any reason, they may experience some mild withdrawal symptoms such as changes to their bowel movements. Many people will see their chronic constipation symptoms return within a week of stopping Linzess.


The maximum dose of Linzess per day is 290 mcg unless otherwise recommended by a doctor. Overdosing on Linzess isn’t likely to be life-threatening, but it can cause some symptoms like diarrhea.


Even though Linzess is an effective treatment for IBS-C and CIC, it shouldn’t be taken by everyone who’s experiencing long-term constipation.

Linzess shouldn’t be taken by pediatric patients younger than 18 years of age because its safety and efficacy for this age group hasn’t been properly established. For children younger than the age of 6, Linzess shouldn’t be used at all because it can cause severe dehydration.

Linzess also shouldn’t be taken by people with known or suspected mechanical gastrointestinal obstruction (bowel blockage).

Linzess should be avoided during pregnancy or while breastfeeding unless its use is approved by a doctor. Linzess has not been adequately studied in pregnant women. There is no human data available to suggest that Linzess causes fetal harm or would be harmful to infants if it passes into breast milk, but it should not be used unless the benefits outweigh the risks.

Elderly patients over the age of 65 should be carefully monitored while taking Linzess. The effects of Linzess have not been specifically studied in this population. No dose adjustment is required, but elderly patients may have higher rates of liver and kidney problems that require more caution while taking this medication.

Linzess interactions

Laxatives such as sodium phosphate, magnesium citrate, and polyethylene glycol should be avoided when starting Linzess because they may increase the likelihood of diarrhea. If you take certain medications while taking Linzess you may increase your risk of getting dehydrated, so it’s best to give your healthcare provider a list of all the medications (including prescription drugs, over-the-counter medicine, and supplements) you’re taking so he or she can tell you if there’s anything you shouldn’t take.

How to avoid Linzess side effects

While completely avoiding Linzess side effects may not be possible, there are some things you can do to reduce their severity:

1. Take the recommended dosage

The daily recommended dose of Linzess for IBS-C is 290 mcg taken on an empty stomach at least 30 minutes before the first meal of the day. The daily recommended dose of Linzess for CIC is 145 mcg taken at least 30 minutes before the first meal of the day. A dosage of 72 mcg taken once per day may also be used for patients with CIC who have a low tolerability for Linzess.

Being consistent with how and when you take your medication is very important because consistency will help your body process Linzess better and reduce your chances of experiencing side effects. Taking your prescribed dose every morning 30 minutes before your first meal of the day will make a big difference in how well Linzess works for you.

If you miss a dose of Linzess, skip the dose you missed and take the next dose the following day before your first meal. Refer to the medication guide for more drug information.

Linzess should not be crushed or chewed. If you have difficulty swallowing pills, you can open your Linzess capsule and sprinkle the medicine into 1 teaspoonful of applesauce or 30 mL of water.

2. Store Linzess properly

Knowing how to properly store your medication is important to make sure it remains as effective as possible. Taking expired or improperly stored medication could result in the medication not working properly and may even cause unwanted side effects. Linzess should be stored at room temperature in a dry place in its original container. It’s also important to leave the drying agent that comes in the bottle inside of the bottle to prevent excess moisture from affecting the medication, and the bottle should be closed tightly.

3. Share your medical history with your doctor

Sharing your complete medical history with your doctor is important to help your doctor understand how well Linzess will work for you. Giving a complete list of all the medications and supplements you’re taking to your doctor will allow them to see if anything you’re already taking will interfere with Linzess and cause possible side effects. Your doctor will adjust your dose if needed or switch you to a different medication, like Amitiza, if side effects persist.

4. Listen to your body

Listening to your body while taking Linzess is important. If you start to experience any side effects of Linzess, it’s best to let your doctor know as soon as possible so that they can help you reduce the severity of those side effects. Many people will be able to safely take Linzess long-term with minimal side effects if they take it properly, but others may react to it differently.

According to the FDA, in long-term trials where 2,147 people with IBS-C received 290 mcg of Linzess daily for up to 18 months, 29% of patients had their dose reduced or suspended because of the incidence of adverse reactions such as diarrhea. These possible side effects should be carefully monitored by listening to how your body is feeling while you’re taking Linzess and keeping in close contact with your healthcare provider.