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Linzess is a prescription medication used to treat irritable bowel syndrome with constipation (IBS-C). Linzess is approved for adults and is administered with one capsule a day, which should be taken at least 30 minutes prior to the first meal of the day.1

Linzess is not a laxative, although both laxatives and medications like Linzess work to relieve constipation. Linzess is a guanylate cyclase-C (GC-C) agonist. Guanylate cyclase is an enzyme found in the lining of the intestines, and Linzess binds to this enzyme to stimulate a response.2 As a GC-C agonist, Linzess is thought to bind to the receptor sites in the intestines, which creates two effects: reducing the amount of pain felt by helping calm the pain-sensing nerves, and accelerating bowel movements by increasing the fluid in the intestinal space.1,2

In clinical trials, Linzess showed significant reduction in abdominal pain and in easing constipation among patients with IBS-C. Patients taking Linzess were more likely to experience more frequent and complete bowel movements compared to patients on a placebo.1

Possible side effects with Linzess

The most common side effect with Linzess is diarrhea, which can sometimes be severe. Diarrhea often begins within the first two weeks of taking Linzess, and patients who experience severe diarrhea should stop taking Linzess and call their doctor.1

Other common side effects experienced with Linzess treatment are:

  • Gas
  • Abdominal pain
  • Swelling
  • Feeling of fullness or pressure in the abdomen

Rarely, severe abdominal pain or bloody or black stools may be experienced with Linzess. Patients are advised to go to the emergency room or call their doctor if they experience these adverse effects.1 These aren’t an exhaustive list of side effects and patients should consult their doctor if they experience anything unusual while taking Linzess.

Taking Linzess

Linzess was studied and found to be effective when taken daily, generally at the same time of day, 30 minutes prior to the first meal. When taken daily, Linzess may help manage the symptoms of IBS-C. If a dose is missed, patients should skip that dose and continue with the next dose at the regular time the next day. Patients should not take two doses at the same time.1

It may be helpful to put it in a place where it is visible as a reminder to take it daily, however, patients are instructed to keep Linzess out of the reach of children. In addition, Linzess should be kept in its original bottle and stored at room temperature.1

Who shouldn’t take Linzess

Linzess should not be used in children younger than 18 years of age as it may harm them. Linzess is also not to be used in patients who have a bowel blockage. It is unknown if Linzess is safe to take while pregnant or breastfeeding. Women who are pregnant or breastfeeding should talk to their doctor before using Linzess.1

Additional Treatment Options for IBS

No one remedy works for all patients, and patients with IBS often find they must try a variety of treatment options to manage their symptoms. Most patients find a combination of approaches work best. In addition to medication, other treatment strategies include diet changes, probiotics, stress management, exercise and alternative therapies.

Written by: Emily Downward | Last reviewed: July 2019
  1. Linzess product website, Allergan, Ironwood Pharmaceuticals, Inc. Accessed online on 3/8/16 at
  2. Hanning G, Tchernychev B, Kurtz CB, Bryant AP, Currie MG, Silos-Santiago I. Guanylate cyclase-C-cGMP: an emerging pathway in the regulation of visceral pain. Front. Mol. Neurosci., 16 April 2014. Accessed online on 3/8/16 at
  3. FDA approves Linzess to treat certain cases of irritable bowel syndrome and constipation. Food and Drug Administration. Accessed online on 3/9/16 at