Medical drugs work great… until they’re used the wrong way. A bit too much or a bit too late can make a drug ineffective or increase the severity of side effects, respectively.
Similarly, some drugs are supposed to be taken at a specific time of the day under specific conditions (such as an empty stomach). But some patients find it difficult to stick to the right schedule and others may simply forget to take the drug at the right time.
This article aims to explain the correct usage of LINZESS, what happens when it’s used incorrectly, and whether it can be taken at night.
What is LINZESS?
LINZESS is a drug that treats constipation.
The chemical name of LINZESS is linaclotide, which works by activating a molecule called guanylate cyclase inside intestinal cells.
Activation of guanylate cyclase leads to opening of chloride and bicarbonate channels. As chloride and bicarbonate diffuse out of intestinal cells into the intestinal lumen, they take water with them.
This ultimately leads to increased water content inside the gut, which makes stool softer and increases intestinal contractions. Both of these help stool pass out of the body, treating constipation.
The two most common conditions that are treated with LINZESS are constipation-predominant irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC). Both conditions often lead to long-term, difficult to treat constipation and LINZESS is used when other drugs stop helping.
Sometimes, LINZESS is also used to treat constipation caused by opioids and ulcerative colitis, however it’s not approved for these conditions.
Can I take LINZESS at night?
No, LINZESS is not supposed to be taken at night.
Since it increases the water content of the gut, it might cause an immediate bowel movement or lead to diarrhea. This can disrupt sleep.
Taking LINZESS at night also means that you’ll probably take it on a full stomach. This can lead to uncomfortable GI symptoms like bloating and gas, which will again disrupt your sleep.
However, you should know that some patients have reported taking LINZESS at night. While this helps them have a bowel movement in the morning, many patients have reported difficulty in getting to their workplace in the morning due to unpredictable (and often heavy) morning diarrhea.
When should LINZESS be taken?
LINZESS is supposed to be taken on an empty stomach, 30 minutes before the first meal of the day. This means the best time to take LINZESS is before breakfast. The drug is usually prescribed once daily.
It’s recommended to take LINZESS with plain water only. The capsule is not supposed to be chewed or crushed.
If swallowing a capsule is difficult for you, you can open up the capsule and dissolve the powder into a tablespoon of applesauce or some plain water. Swirl the mixture thoroughly before drinking it and do not save it for future use.
It’s also important to drink plenty of water while taking LINZESS. That’s because it can sometimes lead to diarrhea, which can cause dehydration if you’re not drinking enough water.
Once you start taking LINZESS, you should expect to wait a week before its effects show. Remember, it’s not a laxative and it will not treat constipation immediately.
When should LINZESS not be used?
Many people believe that LINZESS is a weight loss drug. You should know that LINZESS has not been approved for weight loss and there’s no evidence that supports its use for losing weight.
If you’re looking to lose weight, lifestyle and dietary modifications as well as some medical drugs approved for weight loss may help.
It’s also important to note that the effect of LINZESS on weight is not clearly understood. There have been reports of both weight loss and weight gain with LINZESS, which is another reason not to use it for weight loss.
LINZESS is also not recommended for patients under 18 years of age. The drug’s effectiveness and safety has not been demonstrated in this population.
Then, LINZESS is contraindicated in patients under 6 years of age. This means the drug absolutely can’t be used in this population because it can cause severe diarrhea and life-threatening dehydration.
Also, patients with a history of intestinal obstruction should report it to their doctor before starting LINZESS. And since we’re not really sure how the drug affects pregnancy and breastfeeding, it’s a good idea to avoid it during pregnancy.
However, LINZESS can be used in pregnancy if absolutely required.
As a general rule, make sure you don’t use LINZESS for any reason other than long-term constipation that has failed to respond to other therapies.
Is LINZESS safe?
LINZESS is generally considered safe in patients above 18 years of age.
The most common side effect is diarrhea, which results due to increased gut water content. Some people may also experience:
- Bloating
- Tummy pain
- Allergic reaction
Taking LINZESS on a full stomach can make bloating, pain, and gas worse, which is why it’s not a good idea to use the drug at night.
A severe allergic reaction can rarely occur in response to LINZESS. It’s characterized by swelling (especially around the face), difficulty in breathing, itching, and dizziness. If you experience any of these symptoms after taking LINZESS, seek immediate medical attention.
Another rare side effect of LINZESS is severe diarrhea, which also requires immediate medical attention.
Finally, you should know that LINZESS interacts with a wide range of drugs. During a drug interaction, one drug alters the level of another drug in the body. This can make the other drug either ineffective or exacerbate its side effects.
Drugs that LINZESS has been shown to interact with include:
- Levothyroxine
- Magnesium hydroxide
- Proton pump inhibitors
- Some diabetes drugs
- Bisacodyl
Takeaway
LINZESS is a drug used to treat long-term constipation that does not respond to other drugs. It’s recommended to take LINZESS 30 minutes before the first meal of the day.
Although some people have tried taking LINZESS at night, it’s not recommended. That’s because doing so can increase its GI side effects and disrupt sleep.
Medically Reviewed by Onikepe Adegbola, MD PhD
