Linaclotide 145 mcg Capsule

Linaclotide 145mcg Capsule – Generic Linzess, Colozo 145 Standard Dose | GC-C Agonist for Chronic Idiopathic Constipation in Adults

Reviewed by a licensed gastroenterologist | Last updated: April 2026 Prescription required | Take on empty stomach 30 minutes before first meal of the day

What It Is

Linaclotide 145mcg Capsule contains Linaclotide — a guanylate cyclase-C (GC-C) agonist and the active molecule in branded Linzess® (AbbVie and Ironwood Pharmaceuticals, USA) and Constella® (AstraZeneca/Almirall, EU/UK).

Important note on 142mcg vs 145mcg: Some Indian generic manufacturers label this product as 142mcg rather than 145mcg. This is a manufacturing specification rounding variation — both refer to the same clinical dose, the same active substance, and are therapeutically equivalent. If you have been prescribed linaclotide 145mcg and see 142mcg listed, they are the same product.

The three linaclotide doses — which is which:

The 145mcg dose is the most commonly prescribed linaclotide strength. It is the standard first-line dose for adults with chronic idiopathic constipation. If you previously experienced diarrhoea on 145mcg, your doctor may step you down to 72mcg. If you have IBS-C with abdominal pain as the dominant symptom, your doctor may prescribe 290mcg instead.

How It Works

Linaclotide binds to GC-C receptors on the luminal surface of intestinal epithelial cells, activating them to produce cyclic GMP (cGMP). Elevated cGMP:

Increases intestinal fluid secretion — drives chloride and bicarbonate into the gut lumen, softening stool consistency and speeding intestinal transit.

Reduces visceral pain — cGMP activates pain-modulating pathways in intestinal sensory neurons, reducing the hypersensitivity that causes bloating and abdominal discomfort in CIC.

Works exclusively in the gut — linaclotide is metabolised entirely within the gastrointestinal tract. Plasma concentrations are not measurable at recommended doses. No systemic absorption means no systemic side effects and no drug interactions — a clinically important advantage.

What It Treats

Chronic Idiopathic Constipation (CIC) in adults — the primary indication at 145mcg. CIC is defined as chronic constipation without an identifiable cause: fewer than 3 spontaneous complete bowel movements per week, straining, hard stools, sensation of incomplete evacuation, and associated abdominal discomfort. It is distinct from IBS-C, which includes significant abdominal pain as a dominant feature.

The American Gastroenterological Association (AGA) recommends linaclotide for CIC — one of only a few treatments with a strong evidence base and guideline endorsement for this condition.

Also used for: Functional constipation in paediatric patients 6–17 years under paediatric gastroenterologist supervision (dose adjusted by weight and age).

Not for at 145mcg: IBS-C — that requires the 290mcg dose.

Dosage

Standard adult dose: 145mcg orally once daily on an empty stomach, at least 30 minutes before the first meal of the day.

Take at the same time every day. Swallow capsule whole or open and mix contents with a teaspoon of applesauce or room-temperature water if unable to swallow whole — do not crush or chew the capsule shell.

Missed dose: Skip — do not double-dose. Resume at the regular time the next day.

If diarrhoea is problematic at 145mcg: Your doctor may step the dose down to 72mcg once daily. Do not reduce dose yourself without medical guidance.

No dose adjustment for renal impairment, hepatic impairment, or elderly patients — linaclotide is not systemically absorbed.

Duration: CIC is a chronic condition. Linaclotide is typically used as ongoing therapy. Reassess clinical benefit with your gastroenterologist at regular intervals.

Side Effects

Very common: Diarrhoea — occurs in approximately 20% of patients at 145mcg. Usually mild to moderate. Taking on an empty stomach (not with food) minimises diarrhoea risk. If severe diarrhoea occurs, stop temporarily, rehydrate, and contact your doctor before resuming.

Common: Flatulence. Abdominal pain. Abdominal distension. Viral gastroenteritis.

No systemic side effects — headache, dizziness, fatigue, and drug interactions are not expected because linaclotide is not absorbed into the bloodstream.

Critical warning: Contraindicated in children under 2 years — risk of serious, potentially fatal dehydration from excessive fluid loss. Keep out of reach of young children.

FAQ

Is 142mcg the same as 145mcg linaclotide? Yes. Some Indian generic manufacturers list the dose as 142mcg due to manufacturing specification rounding. Both are the same clinical dose of linaclotide and are therapeutically equivalent to the branded 145mcg Linzess capsule.

What is the difference between 145mcg and 290mcg linaclotide? The 145mcg dose treats chronic idiopathic constipation (CIC) — where constipation is the main issue. The 290mcg dose treats IBS with constipation (IBS-C) — where abdominal pain is also a dominant symptom. Using 145mcg for IBS-C may provide insufficient pain relief. Always use the dose your gastroenterologist has prescribed for your specific diagnosis.

Why must I take linaclotide on an empty stomach? Taking with food significantly increases the rate and severity of diarrhoea. An empty stomach maintains the therapeutic effect while substantially reducing this side effect.

Can I take linaclotide with other medications? Linaclotide has no known drug interactions because it works exclusively in the gut and is not absorbed into the bloodstream. However, always inform your prescriber of all medications before starting any new treatment.

Do you ship linaclotide 145mcg internationally? Yes — to USA, UK, UAE, Canada, Russia, Japan, Thailand, Philippines, Malaysia, Australia, and India.

References

1. 1. LINZESS (Linaclotide) Prescribing Information — FDA, AbbVie/Ironwood (Updated November 2025) https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/202811s022lbl.pdf
   2. LINZESS Dosing and Administration — Linzess HCP Official Site https://www.linzesshcp.com/linzess-dosing
   3. Linzess Dosage Guide — GoodRx (Updated December 2025) https://www.goodrx.com/linzess/dosage
   4. AGA Recommendation — Linaclotide for CIC/IBS-C — Guideline Central (November 2025) https://www.guidelinecentral.com/insights/dec-2025-linzess-linaclotide-monograph/
   5. Linaclotide — Cleveland Clinic Drug Information (February 2026) https://my.clevelandclinic.org/health/drugs/19230-linaclotide-capsules