Mechanism of Action in IBS-C | LINZESS® (linaclotide)

Not an actual patient.

LINZESS is not a laxative and works differently^1,2

LINZESS is a peptide that stimulates the guanylate cyclase (GC-C) receptor and is thought to work in 2 ways*:

LINZESS binds to the guanylate cyclase-C (GC-C) receptor and reduces visceral hypersensitivity as well as stimulates secretion of chloride and bicarbonate into the intestinal lumen, resulting in increased intestinal fluid and accelerated transit.

LINZESS acts locally within the GI tract and has negligible systemic availability¹

GI, gastrointestinal.

*Based on nonclinical studies. Exposure of drug and active metabolite is negligible following oral administration.¹

^†The clinical relevance of the effect on nerve fibers has not been established.¹

INDICATIONS AND USAGE

LINZESS^® (linaclotide) is indicated for the treatment of:

irritable bowel syndrome with constipation (IBS-C) in adults
chronic idiopathic constipation (CIC) in adults
functional constipation (FC) in pediatric patients 6 to 17 years of age

IMPORTANT SAFETY INFORMATION

WARNING:
RISK OF SERIOUS DEHYDRATION IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE LINZESS is contraindicated in patients less than 2 years of age; in nonclinical studies in neonatal mice, administration of a single, clinically relevant adult oral dose of linaclotide caused deaths due to dehydration.

Contraindications

LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.
LINZESS is contraindicated in patients with known or suspected mechanical gastrointestinal obstruction.

Warnings and Precautions
Risk of Serious Dehydration in Pediatric Patients Less Than 2 Years of Age

LINZESS is contraindicated in patients less than 2 years of age. In neonatal mice, linaclotide increased fluid secretion as a consequence of age-dependent elevated guanylate cyclase (GC-C) agonism, which was associated with increased mortality within the first 24 hours due to dehydration. There was no age-dependent trend in GC-C intestinal expression in a clinical study of children 2 to less than 18 years of age; however, there are insufficient data available on GC-C intestinal expression in children less than 2 years of age to assess the risk of developing diarrhea and its potentially serious consequences in these patients.

Diarrhea

In adults, diarrhea was the most common adverse reaction in LINZESS-treated patients in the pooled IBS-C and CIC double-blind placebo-controlled trials. The incidence of diarrhea was similar in the IBS-C and CIC populations. Severe diarrhea was reported in 2% of 145 mcg and 290 mcg LINZESS-treated patients and in <1% of 72 mcg LINZESS-treated CIC patients. In pediatric patients 6 to 17 years of age, diarrhea was the most common adverse reaction in 72 mcg LINZESS-treated patients in the FC double-blind placebo-controlled trial. Severe diarrhea was reported in one LINZESS-treated patient. If severe diarrhea occurs, dosing should be suspended and the patient rehydrated.

Common Adverse Reactions (incidence ≥2% and greater than placebo)

In IBS-C or CIC adult patients: diarrhea, abdominal pain, flatulence, and abdominal distension.
In FC pediatric patients: diarrhea.

Please see full Prescribing Information, including Boxed Warning, or visit https://www.rxabbvie.com/pdf/linzess_pi.pdf.

US-LIN-230215

References: 1. LINZESS [package insert]. North Chicago, IL: AbbVie Inc. 2. Feng B, Kiyatkin ME, La JH, et al. Activation of guanylate cyclase-C attenuates stretch responses and sensitization of mouse colorectal afferents. J Neurosci. 2013;33(23):9831-9839. doi:10.1523/JNEUROSCI.5114-12.2013 3. Eutamene H, Bradesi S, Larauche M, et al. Guanylate cyclase C-mediated antinociceptive effects of linaclotide in rodent models of visceral pain. Neurogastroenterol Motil. 2010;22(3):312-e84. doi:10.1111/j.1365-2982.2009.01385.x 7

Ironwood^® and its three-leaf design are registered trademarks of Ironwood Pharmaceuticals, Inc. LINZESS^® and its design are registered trademarks of Ironwood Pharmaceuticals, Inc. © 2025 AbbVie and Ironwood Pharmaceuticals, Inc. All rights reserved.

The information provided in this site is intended for U.S. healthcare professionals only. The products described on this site may have different product labeling in countries outside the United States.

US-LIN-240112

IMPORTANT SAFETY INFORMATION

WARNING:
RISK OF SERIOUS DEHYDRATION IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE LINZESS is contraindicated in patients less than 2 years of age; in nonclinical studies in neonatal mice, administration of a single, clinically relevant adult oral dose of linaclotide caused deaths due to dehydration.

Contraindications

LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.

IMPORTANT SAFETY INFORMATION

WARNING:
RISK OF SERIOUS DEHYDRATION IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE LINZESS is contraindicated in patients less than 2 years of age; in nonclinical studies in neonatal mice, administration of a single, clinically relevant adult oral dose of linaclotide caused deaths due to dehydration.

Contraindications

LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.

IMPORTANT SAFETY INFORMATION

WARNING:
RISK OF SERIOUS DEHYDRATION IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE LINZESS is contraindicated in patients less than 2 years of age; in nonclinical studies in neonatal mice, administration of a single, clinically relevant adult oral dose of linaclotide caused deaths due to dehydration.

Contraindications

LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.

IMPORTANT SAFETY INFORMATION

WARNING:
RISK OF SERIOUS DEHYDRATION IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE LINZESS is contraindicated in patients less than 2 years of age; in nonclinical studies in neonatal mice, administration of a single, clinically relevant adult oral dose of linaclotide caused deaths due to dehydration.

Contraindications

LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.

INDICATIONS AND USAGE

LINZESS^® (linaclotide) is indicated for the treatment of:

irritable bowel syndrome with constipation (IBS-C) in adults
chronic idiopathic constipation (CIC) in adults
functional constipation (FC) in pediatric patients 6 to 17 years of age

IMPORTANT SAFETY INFORMATION

WARNING:
RISK OF SERIOUS DEHYDRATION IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE LINZESS is contraindicated in patients less than 2 years of age; in nonclinical studies in neonatal mice, administration of a single, clinically relevant adult oral dose of linaclotide caused deaths due to dehydration.

Contraindications

LINZESS is contraindicated in patients less than 2 years of age due to the risk of serious dehydration.
LINZESS is contraindicated in patients with known or suspected mechanical gastrointestinal obstruction.

Warnings and Precautions
Risk of Serious Dehydration in Pediatric Patients Less Than 2 Years of Age

LINZESS is contraindicated in patients less than 2 years of age. In neonatal mice, linaclotide increased fluid secretion as a consequence of age-dependent elevated guanylate cyclase (GC-C) agonism, which was associated with increased mortality within the first 24 hours due to dehydration. There was no age-dependent trend in GC-C intestinal expression in a clinical study of children 2 to less than 18 years of age; however, there are insufficient data available on GC-C intestinal expression in children less than 2 years of age to assess the risk of developing diarrhea and its potentially serious consequences in these patients.

Diarrhea

In adults, diarrhea was the most common adverse reaction in LINZESS-treated patients in the pooled IBS-C and CIC double-blind placebo-controlled trials. The incidence of diarrhea was similar in the IBS-C and CIC populations. Severe diarrhea was reported in 2% of 145 mcg and 290 mcg LINZESS-treated patients and in <1% of 72 mcg LINZESS-treated CIC patients. In pediatric patients 6 to 17 years of age, diarrhea was the most common adverse reaction in 72 mcg LINZESS-treated patients in the FC double-blind placebo-controlled trial. Severe diarrhea was reported in one LINZESS-treated patient. If severe diarrhea occurs, dosing should be suspended and the patient rehydrated.

Common Adverse Reactions (incidence ≥2% and greater than placebo)

In IBS-C or CIC adult patients: diarrhea, abdominal pain, flatulence, and abdominal distension.
In FC pediatric patients: diarrhea.

Please see full Prescribing Information, including Boxed Warning, or visit https://www.rxabbvie.com/pdf/linzess_pi.pdf.

US-LIN-230215

IBS-C mechanism of action

INDICATIONS AND USAGE

LINZESS® (linaclotide) is indicated for the treatment of:

IMPORTANT SAFETY INFORMATION

Contraindications

Warnings and Precautions Risk of Serious Dehydration in Pediatric Patients Less Than 2 Years of Age

Diarrhea

Common Adverse Reactions (incidence ≥2% and greater than placebo)

IMPORTANT SAFETY INFORMATION

Contraindications

IMPORTANT SAFETY INFORMATION

Contraindications

IMPORTANT SAFETY INFORMATION

Contraindications

IMPORTANT SAFETY INFORMATION

Contraindications

INDICATIONS AND USAGE

LINZESS® (linaclotide) is indicated for the treatment of:

IMPORTANT SAFETY INFORMATION

Contraindications

Warnings and Precautions Risk of Serious Dehydration in Pediatric Patients Less Than 2 Years of Age

Diarrhea

Common Adverse Reactions (incidence ≥2% and greater than placebo)

LINZESS^® (linaclotide) is indicated for the treatment of:

Warnings and Precautions
Risk of Serious Dehydration in Pediatric Patients Less Than 2 Years of Age

LINZESS^® (linaclotide) is indicated for the treatment of:

Warnings and Precautions
Risk of Serious Dehydration in Pediatric Patients Less Than 2 Years of Age