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Linzess side effects and how to avoid them

While Linzess is effective for IBS-C and CIC, it can cause side effects, including severe diarrhea and dehydration.
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By | Updated on Mar. 10, 2025 Medically reviewed by Irene Xue, Pharm.D. & Gerardo Sison, Pharm.D.
Prescription pad with pill bottle: Common side effects of Linzess and now to avoid them

Key takeaways

  • Linzess relieves chronic constipation by drawing more fluid into the intestines, making bowel movements easier.

  • Common side effects include diarrhea, stomach pain, bloating, gas, and headaches, which may improve over time.

  • Severe diarrhea, allergic reactions, or dehydration can be dangerous and may require medical attention.

  • Linzess is not recommended for young children, people with bowel blockages, or some pregnant or breastfeeding women.

In this article:

Linzess is a prescription medication that contains linaclotide and is used to treat chronic constipation, particularly in conditions like irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC). It works by increasing fluid in the intestines, making it easier to pass stools. If you’re considering this medication or have just started treatment, it’s important to know about its common side effects, drug interactions, and other safety information. 

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Is Linzess dangerous?

Linzess is generally considered safe and effective in adults and children aged 6 and older. However, like all medications, it may cause side effects, some of which can be serious. In studies comparing Linzess to a placebo in IBS-C patients, 9% of patients taking Linzess stopped taking the medication early due to side effects, compared to 3% of patients taking the placebo. In longer studies lasting up to 18 months, 29% of patients had their dose of Linzess reduced or temporarily stopped due to side effects.

While Linzess is not considered dangerous when used as directed, it may not be the best choice for everyone. It’s important to be aware of the potential side effects and consult a healthcare provider for any severe or long-lasting symptoms.

Common side effects of Linzess

For many adults with IBS-C or CIC and children with functional constipation, the benefits of taking it often outweigh the potential side effects. Here are the most common side effects of Linzess: 

  • Diarrhea: Diarrhea is the most common side effect of Linzess and is characterized by loose, watery stools that occur more frequently than usual. Often, diarrhea starts within the first two weeks of taking Linzess. 
  • Stomach-area pain: While taking Linzess, some people may feel pain or discomfort in their stomach area. This pain might feel like cramping or aching in your belly. 
  • Gas: Linzess can cause gas to build up in your digestive system. This might make you pass gas or burp more often than usual, which can be uncomfortable. 
  • Bloating: Bloating is characterized by a feeling of fullness, tightness, or swelling in the abdomen. This can happen when gas builds up in your digestive system.
  • Viral inflammation of the intestines (gastroenteritis): Sometimes, people taking Linzess may get a viral infection that causes inflammation in their stomach and intestines. This condition is called gastroenteritis, and it can cause symptoms like diarrhea, vomiting, and stomach pain. 
  • Headache: Some people who take Linzess may get headaches. These headaches can be mild or severe and may be caused by different things related to the medication.

The severity of these side effects can vary from person to person. While some people may experience mild symptoms, others might face more adverse effects. It’s important to consult a healthcare provider to discuss any concerns and determine the best course of action if side effects worsen. 

Serious side effects of Linzess

In rare cases, Linzess can cause serious side effects that may require medical attention.

Severe diarrhea

If you’re taking Linzess and start to have diarrhea that worsens or won’t go away, especially if you have bloody or black stools, then you should stop taking Linzess and contact your doctor to see if continuing the medication is right for you. Your healthcare provider can provide medical advice on what to do. In rare cases, severe diarrhea can lead to dizziness or fainting, and hospitalization may be necessary to replace lost electrolytes from dehydration. 

Allergic reactions

Severe allergic reactions to Linzess are rare but possible. Anaphylaxis, in particular, is a serious reaction that can be life-threatening if not treated quickly. Symptoms may include trouble breathing, swelling in the throat, hives, or a rash. If you find yourself dizzy or unable to breathe after taking Linzess, it’s important to get medical help immediately. 

Weight loss

Weight changes are not a side effect reported in placebo-controlled trials with Linzess. However, because the medication can cause diarrhea, some people may experience weight loss. Diarrhea can lead to a loss of water and electrolytes from the body, which may contribute to weight loss if it isn’t treated right away. If you experience severe diarrhea while taking Linzess, you should stop taking it and call your doctor right away. This is especially important for older adults who may be more prone to dehydration.  

How long do Linzess side effects last?

How long side effects last depends on the individual and how their body processes the medication. For the average person taking Linzess, diarrhea is a common but temporary side effect. In clinical trials, around one-third of participants who experienced diarrhea during the first week of treatment saw their symptoms resolve within a week. 

Although many side effects will resolve in the short term, it’s possible to have longer-lasting side effects. For example, some people might have diarrhea that lasts up to a month. If you’ve been taking Linzess for more than two weeks and your side effects aren’t going away, it may be a good idea to contact your doctor to make sure that what you’re experiencing is okay.  

Note: Linzess is not a laxative and does not start working immediately. Most people will start to feel relief from their chronic constipation symptoms about a week after starting Linzess. The manufacturer suggests IBS-C patients typically see improvements in their medical condition over 12 weeks.   

Linzess contraindications & warnings

Contraindications and warnings are important factors to consider when using medications like Linzess. They help determine who should not take the drug because it could cause harmful side effects or not work as intended. 

Children under 2 years old 

Although Linzess is approved in children aged 6 to 17 years old with functional constipation, it’s not approved for all children. Linzess shouldn’t be taken by pediatric patients younger than 2 years of age because its safety and efficacy for this age group haven’t been established. Linzess may cause severe dehydration in young children. 

People with bowel blockage

People with known or suspected mechanical gastrointestinal obstruction (bowel blockage) should not take Linzess. This is because the medication works by increasing fluid in the intestines to help with bowel movements, which can worsen the blockage and lead to serious health problems.

Women who are pregnant or breastfeeding

Linzess should be avoided during pregnancy or while breastfeeding unless its use is approved by a doctor. Animal studies suggest Linzess may harm an unborn baby. However, Linzess has not been adequately studied in pregnant women. Although there is no human data available to suggest that Linzess causes fetal harm or is harmful to infants if it passes into breast milk, it should not be used unless the benefits outweigh the risks. 

Older adults

Older adults over 65 should be carefully monitored while taking Linzess. The effects of Linzess have not been specifically studied in this population. No dose adjustment is required, but elderly patients may have higher rates of liver and kidney problems that require more caution while taking this medication.

Linzess interactions 

There are no known drug interactions with Linzess indicated on the drug label. However, caution may be recommended while taking certain medications that may amplify the side effects of Linzess.

Laxatives such as sodium phosphate, magnesium citrate, and polyethylene glycol should be avoided when starting Linzess because they can increase the risk of diarrhea and dehydration. Other medications like diuretics can also increase the risk of dehydration. Therefore, it’s best to consult your healthcare provider about all your medications, including prescription drugs, over-the-counter medicine, and supplements.

How to avoid Linzess side effects

While completely avoiding Linzess side effects may not be possible, there are some things you can do to reduce their severity.

The daily recommended dose of Linzess for IBS-C is 290 mcg taken on an empty stomach at least 30 minutes before the first meal of the day. The recommended daily dose of Linzess for CIC is 145 mcg, which is taken at least 30 minutes before the first meal of the day. A dosage of 72 mcg taken once per day may also be used for patients with CIC who have a low tolerability for Linzess.  Taking your medication at the same time each day helps your body get used to it and can reduce the severity of side effects.

2. Store Linzess properly

Knowing how to properly store your medication is important to make sure it remains as effective as possible. Taking expired or improperly stored medication could result in the medication not working properly and may even cause unwanted side effects. Linzess should be stored in its original container at room temperature in a dry place. It’s also important to leave the drying agent that comes in the bottle inside of the bottle to prevent excess moisture from affecting the medication.

3. Share your medical history with your doctor

Sharing your complete medical history with your healthcare provider can help them review your potential risk of side effects with Linzess. For example, by sharing a list of all medications and supplements you are currently taking, your doctor can identify any possible interactions that may lead to side effects. If necessary, your doctor can adjust your dosage or consider an alternative medication if side effects continue.

4. Listen to your body

It’s important to listen to your body when taking Linzess. If you start to experience any side effects, let your doctor know right away so they can help you manage them. Many people can take Linzess for a long time without serious issues if they follow the instructions, but everyone can react differently to the medication.