# Linaclotide

A peptide capsule that works inside the gut and is barely absorbed. It draws fluid into the bowel and dulls pain nerves there. It shows that an oral peptide can be an ordinary, approved medicine.

Also called: Linzess, Constella
Source page: https://peplogue.com/peptides/linaclotide/
Reviewed: 2026-10-12. Not medical advice.

## How it works

- Where it acts: Guanylate cyclase-C receptors on the lining of the gut.
- What it changes: More fluid released into the bowel, and calmer pain nerves in the gut wall.
- What people notice: Softer, more frequent stools within days. Diarrhoea is the main side effect.

## What the evidence shows

- **Irritable bowel syndrome with constipation**: Proven. Approved in the US and EU since 2012.
- **Chronic constipation**: Proven. Approved in the US, including for children from age 2 with functional constipation.

## Side effects and risks

- common: Diarrhea in 16% to 20% of users, severe in about 2%.
- serious: US boxed warning: not for children under 2, because of the risk of serious dehydration. Canada bars it under age 6, and the EU license is for adults only.

Who should avoid it: Children under 2, and anyone with a bowel blockage.

## How it is taken

One capsule a day on an empty stomach, at least 30 minutes before a meal, at about the same time each day. The adult dose is 290 micrograms for IBS and 145 micrograms for constipation.

## Legal status

- United States: undefined. Linzess.
- European Union: undefined. Constella, for adults with IBS with constipation.
- Spain: undefined. Constella 290 microgram capsules are authorised and marketed in Spain (CIMA), prescription only. SNS funding not verified.
- Germany: undefined. Constella (AbbVie) on sale, Rx only, one 112-capsule pack at about 260 EUR. GKV not obliged to pay; some insurers pay case by case.
- France: undefined. Constella is EU-authorised, so authorised in France. We could not verify French sale, price or reimbursement.
- Italy: undefined. Constella 290 mcg: classe C (you pay), repeatable prescription. Not every pack is marketed; current availability not confirmed.
- Netherlands: undefined. Constella capsules (AbbVie) are listed for IBS with constipation. Reimbursement was not confirmed. Linzess is the US name.
- United Kingdom: undefined. Constella.
- Canada: undefined. Constella.
- Australia: undefined

## Questions people ask

**How does Linzess work?**

Linaclotide works inside the gut and is barely absorbed. It draws fluid into the bowel and dulls pain nerves there, giving softer, more frequent stools within days.

**What are the side effects of Linzess?**

Diarrhea affects 16% to 20% of users and is severe in about 2%.

**Can children take linaclotide?**

In the US it is approved for children from age 2 with functional constipation, and a boxed warning bars it under 2 because of the risk of serious dehydration. Canada bars it under age 6, and the EU license is for adults only.

**Is Linzess the same as Constella?**

Yes. Both are linaclotide: Linzess in the US, Constella in the EU, UK and Canada.

**How do you take Linzess?**

One capsule a day on an empty stomach, at least 30 minutes before a meal, at about the same time each day.

## Sources

- Linzess US prescribing information (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=09beda19-56d6-4a56-afdc-9a77b70b2ef3
- EMA: Constella product page: https://www.ema.europa.eu/en/medicines/human/EPAR/constella