Linzess Side Effects: A Comprehensive Guide

Linzess Side Effects: A Comprehensive Guide

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: October 9, 2023


LINZESS, also known as Linaclotide, can aid in increasing bowel movements and alleviating abdominal discomfort. It is prescribed for adults with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC), as well as children with functional constipation (FC).

LINZESS belongs to a class of drugs known as guanylate cyclase-C agonists, and it works by increasing the enzyme in the lining of the intestine, which then assists in speeding up transit through the intestine and reducing intestinal pain.

Understanding the benefits and potential drawbacks of taking LINZESS is crucial. In addition to its effectiveness, it’s important to know the severity and likelihood of any potential side effects. Fortunately, we’re here to provide a thorough guide to LINZESS side effects.

What is LINZESS used for?

If you’re struggling with Irritable Bowel Syndrome (IBS) and chronic constipation, you may find relief with LINZESS. This medication contains linaclotide and can help alleviate discomfort. To take LINZESS, it’s best to do so on an empty stomach,t 30 minutes before your first meal of the day. However, follow your healthcare provider’s instructions regarding when and how to take the medication.

How Does LINZESS Function as a Guanylate Cyclase-C Agonist?

LINZESS stimulates the GC-C (guanylate cyclase-C) receptor in the intestine’s surface, increasing cGMP levels (cyclic guanosine monophosphate). This process encourages fluid secretion into your intestine, and speeds up intestinal movement. Additionally, it eases abdominal pain by activating GC-C in the gut lining, which reduces pain signals.

LINZESS’s Role in Gastrointestinal Symptom Relief

LINZESS’s mechanism of action performs as an effective IBS-C relief (Irritable Bowel Syndrome with Constipation). Irritable bowel syndrome is a condition that causes the muscles in your intestine to contract either more or less often than what is considered normal. Since LINZESS speeds up bowel movement, the drug aids in reducing abdominal pain and alleviating constipation.

Common Side Effects of LINZESS

Before taking LINZESS, it’s important to know about its potential side effects. While it can be a highly effective drug, it’s essential to be aware of any risks. Some of the side effects of LINZESS are more common than others, so it’s worth noting the most frequently reported ones.

  • Bloating – A feeling that the stomach is stretched or over full;bloating occurs when the organs located in your digestive system are stretched.
  • Gas – This is one of the most common side effects of LINZESS. Some symptoms include bloating and abdominal cramps.
  • Diarrhea – A side effect you should look out for is LINZESS diarrhea. Diarrhea is irregular, watery, or loose stool; if you frequently pass stool, but it is a consistent frequency, then this is not considered diarrhea. Fear not, because we will inform you how to deal with LINZESS diarrhea.

These should be temporary, lasting only a few days or weeks. If the side effects persist and worry you, we recommend you speak to your healthcare provider.

LINZESS and Diarrhea: How to Manage It

We’ve established that diarrhea is a common side effect for many individuals taking LINZESS. The medication’s mechanism of action increases the amount of fluid in the intestine, which is beneficial for constipation but can lead to loose stools or diarrhea. In a study of individuals taking LINZESS, diarrhea mainly occurred in the first two weeks. However, it is important to note that severe diarrhea can occur in rare cases, along with symptoms like fever, bloody or dark stools, and severe abdominal pain. Most cases of LINZESS-induced diarrhea are mild, but individuals taking higher doses of the medication are at a greater risk of severe diarrhea.

If you are experiencing diarrhea, it is important to inform your doctor immediately. They can provide medical advice on the severity of your symptoms. For severe symptoms, your doctor may advise you to discontinue the use of medication or reduce the dosage. Additionally, it is essential to stay hydrated as dehydration can result from severe diarrhea.

For mild cases of diarrhea, hydration is key. You can achieve this by consuming plenty of fluids, such as water and electrolyte replacement drinks. Electrolytes are mineral substances that carry an electrical charge when dissolved in water, and they play a crucial role in maintaining fundamental bodily processes such as nerve communication, regulating pH levels, enabling muscle contractions, and ensuring proper hydration. Some examples of electrolyte replacement drinks include milk, smoothies, and coconut water.

Also, medications like Imodium A-D (loperamide) can help with diarrhea. As always, consult your doctor before taking this medication.

Abdominal Pain and How LINZESS Aids in its Reduction

LINZESS can also prove advantageous in alleviating abdominal discomfort, especially among those diagnosed with IBS-C. This relief is achieved by activating GC-C receptors in the intestinal lining, leading to enhanced fluid secretion and inhibiting nociceptors, nerve cells responsible for sensing pain.


Fatigue is a potential side effect of LINZESS (linaclotide). While fatigue is not as common as diarrhea, some individuals have reported feeling fatigued while taking linaclotide. While it is unlikely, if you are concerned that your fatigue may be severe or at least serious, consult your doctor immediately.

LINZESS Weight Loss & Gain

Weight changes are usually a concern for individuals considering taking a new medication.

Does LINZESS Cause Weight Gain?

Due to the bloating, a side effect of LINZESS, some weight gain may be experienced. This, however, is not a common thing.

While both LINZESS weight loss and gain are not common, there have been occurrences of patients mentioning they have experienced either. Some patients have said that LINZESS causes rapid weight gain. Others have mentioned there are fluctuations in their weight. At times, some people may gain weight, and at other times they may lose weight. It is best to keep track of your weight and see what happens. Likely, you will not lose or gain weight, but on the other hand, you can either gain or lose or both.

Less Common Side Effects of Linzess

Less common LINZESS side effects are adverse effects that do not frequently occur. While it is improbable that you will suffer from these side effects, knowing about them is still very important.

LINZESS and Hair Loss

One of these less frequent LINZESS side effects is hair loss. Some individuals who have taken LINZESS have reported experiencing hair loss. Some online tools found it is more common in females over 60 taking linaclotide for less than one month. Overall, hair loss is rare.

It is important to note that many factors can contribute to hair loss for individuals with digestive disorders. Factors include stress, gut inflammation, or not absorbing enough nutrients from food. There isn’t enough evidence to directly link taking linaclotide and hair loss. You can experience a LINZESS side effect that is not shared by others. So, while hair loss is unlikely, there is still a possibility, and you should speak to your healthcare provider if you experience any.

Available Studies

There has yet to be much research or studies done on the less common side effects of LINZESS. Most studies and clinical trials explored the effectiveness of the medication and the more common side effects of LINZESS.

As we mentioned before, while diarrhea is a common side effect, severe diarrhea is less common and, in placebo-controlled studies, it was reported to be around 2% of those who took LINZESS. In the same study, it was reported that fecal incontinence, defecation urgency, vomiting, and gastroesophageal reflux disease were some less common side effects of LINZESS and were reported in less than 2% of those who took the medicine.

Long-term Effects of Using LINZESS

LINZESS is not a laxative and won’t start working immediately, so you must take it for a while. Perhaps for a long time. Is this safe? Yes! LINZESS is safe for long-term use for individuals needing treatment with IBS-C. In the first week, there will be some relief from your chronic constipation symptoms. After 12 weeks, you will see more and more improvements.

What about the length of LINZESS side effects? Taking LINZESS long-term does not necessarily mean you will suffer long-lasting side effects. Some side effects will resolve quickly, but it is still possible to have side effects that last longer.

Addressing Concerns About Liver Damage

There isn’t enough information to suggest that LINZESS causes liver damage, so it shouldn’t be a significant concern for you. However, a few people experienced temporary liver enzyme level increases during prolonged use, affecting less than 1% of users. No severe liver injury was reported.

Please note that while LINZESS does not lead to direct liver damage, dehydration can cause liver damage in severe cases.

Is it bad to take LINZESS every day?

LINZESS has shown to be quite effective when taken once daily. When taking LINZESS as prescribed by your doctor, patients have seen effective management of their symptoms of IBS-C or CIC.

Linzess Dosage and Administration

The daily recommended dosage for chronic idiopathic constipation, CIC, is 145 mcg, taken at least 30 minutes before the day’s first meal. Taking only 72 mcg may be recommended for individuals with CIC who have a low tolerance to LINZESS. For irritable bowel syndrome with constipation, IBS-C, the dose is higher at 290 mcg once daily on an empty stomach at least 30 minutes before your first meal.

Deviating from your recommended dosage will result in either not feeling relief or an increased risk of side effects. If you take the medication consistently and precisely, you are most likely to experience the best results. Please follow their advice if your doctor recommends something different from the norm.

Comparative Analysis with Other IBS Medications

How does LINZESS compare to other IBS Medications? When comparing it to medications like laxatives, LINZESS has demonstrated superior effectiveness to some. While laxatives offer a more general stimulation of the bowel, Linzess’s targeted action provides a more predictable and efficient improvement in bowel habits for those suffering from IBS-C and chronic constipation. Laxatives are generally a more short-term treatment option, while LINZESS is more suited for the long term.

Antispasmodics aim to relax intestinal muscles and may help with abdominal pain; LINZESS offers a comprehensive approach by relieving pain and improving stool consistency and frequency. The antispasmodic Levsin and LINZESS have similar side effects, like bloating, vomiting, headache, and heartburn.

Trulance and LINZESS belong to the drug class guanylate cyclase-C agonists and treat chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). There are some similarities in side effects like diarrhea, bloating, and gas. Trulance and LINZESS are recommended as part of the treatment plan for adults. Another drug, Amitiza, is prescribed only to adult females. Amitiza and Linzess are available in capsule form, whereas Trulance is in tablet form. All these options require swallowing for administration.

Frequently Asked Questions (FAQ)

What is the most common side effect of LINZESS?

Diarrhea is the most common side effect of LINZESS and usually starts about two weeks after you begin taking the drug. It’s important to note that not everyone will experience this side effect, and its severity can vary from person to person.

When Can I Expect To Start Seeing My Symptoms Improve With LINZESS?

In the first week of taking LINZESS, there will be some relief from your chronic constipation symptoms. After 12 weeks, you will see more and more improvements.

Is LINZESS a Laxative?

No, LINZESS is not a laxative. While they both help relieve constipation, they operate differently. Laxatives loosen your stool, so you don’t strain when having a bowel movement, and they make bowel movements occur more frequently. LINZESS increases the amount of fluids in your intestine. Laxatives are more of a short-term treatment, while LINZESS is more for the long term.

Why Do I Need To Take LINZESS Daily?

Studies have shown that LINZESS is more effective when taken daily.

Does LINZESS Cause a Lot Of Gas?

Gas is one of the most common side effects of LINZESS, so you should expect it. Some symptoms include abdominal cramping and bloating. Contact your healthcare provider if your gas is becoming bothersome or too much.

What Must I Do If I Experience Any Severe Side Effects?

If your side effects are severe or you believe it is, contact your healthcare provider as soon as possible. Things like severe abdominal pain, bloody stools, or black stools are a cause for concern.

LINZESS is a great medicine that helps to relieve Irritable Bowel Syndrome with Constipation (IBS-C) and chronic constipation. Its mechanism of action, targeting guanylate cyclase-C (GC-C) receptors, offers a focused approach, effectively enhancing bowel movements and alleviating associated symptoms.

While the drug has proved effective at its job, it is essential to note that there are some side effects of LINZESS in adults. It causes diarrhea, bloating, and gas. Things like weight gain or loss are not common but can occur. Other side effects, like hair loss, are less common but have been reported in patients.

LINZESS is meant for long-term use, and is recommended daily use to ensure you are getting the most effective use of the medicine.

If you’re considering Linzess as a treatment option, discussing your situation with a healthcare professional is highly encouraged. They are best suited to provide personalized advice, recommend the appropriate dosage, and address any concerns you may have. Your healthcare provider remains your most valuable resource, so contact them if you doubt anything.

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