Search for articles or Rx savings
Key takeaways
Amitiza and Linzess are both prescription treatments for chronic constipation conditions and are available as oral capsules.
The two drugs differ in their mechanism of action, generic availability, pricing, insurance coverage, and most common side effects.
Examining the differences can help one to actively participate in shared decision-making with their healthcare provider on whether to choose Amitiza or Linzess.
Amitiza and Linzess are two prescription medications used in the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Chronic idiopathic constipation is characterized by a period of six months or longer with three or fewer spontaneous bowel movements per week, hard stools, and straining. Irritable bowel syndrome is marked by the potential for different symptoms occurring together, including abdominal pain and changes in bowel movement, which can be diarrhea, constipation, or both. Amitiza (lubiprostone) and Linzess (linaclotide) are used specifically in IBS with constipation. We will discuss the similarities and differences between Amitiza and Linzess here.
Compare Amitiza vs. Linzess conditions treated |
||
|---|---|---|
| Condition | Amitiza | Linzess |
| Chronic idiopathic constipation | Yes | Yes |
| Irritable bowel syndrome with constipation | Yes | Yes |
| Opiate agonist-induced constipation (chronic, non-cancer pain) | Yes | No (off-label) |
Is Amitiza or Linzess more effective?
A systematic review of twenty-one randomized controlled clinical trials compared the active ingredients of Amitiza, Linzess, and other common constipation treatments. Other treatments included in this study were prucalopride, tegaserod, bisacodyl, and polyethylene glycol (PEG). This analysis concluded that all included drugs showed similar efficacy over placebo when evaluating an endpoint of having 3 or more spontaneous bowel movements per week. Bisacodyl, an over-the-counter stimulant laxative, was superior to both Amitiza and Linzess in terms of change in the number of bowel movements per week. However, stimulant laxatives, like bisacodyl, may cause electrolyte imbalances and are prone to the development of tolerance over time, whereas Amitiza and Linzess can be used indefinitely.
In a more recent review, the efficacy of Amitiza and Linzess in treating chronic constipation was also similar. Without effectiveness as a differentiating factor, a prescriber may need to consider factors such as adverse events, drug interactions, insurance coverage, and compliance with once- or twice-daily dosing when deciding which drug is best for a patient.
Amitiza vs. Linzess: Insurance coverage and cost comparison
Drug formularies vary widely among different insurance plans. Amitiza is often not covered by commercial or Medicare Part D drug plans, but generic lubiprostone is usually covered. Aetna’s 2025 Standard Plan and Humana’s 2025 Medicare Advantage Plan typify this coverage differentiation. The out-of-pocket price for Amitiza can be as high as $510 for 60, 24 mcg capsules, but a coupon from SingleCare can lower the price of generic lubiprostone to around $40 for this 30-day supply.
Linzess is typically covered by both commercial and Medicare Part D drug plans, though in some cases it may also require prior approval for coverage. Without any type of coverage, Linzess may cost almost $750 for 30, 145 mcg capsules. A Linzess coupon from SingleCare will help you save on Linzess, and you could pay as little as $500 for that same 30-day supply of brand-name capsules. Each individual should consult their plan’s formulary to determine coverage.
Compare Amitiza vs. Jardiance cost & coverage |
||
|---|---|---|
| Amitiza | Linzess | |
| Typically covered by insurance? | No, but generic lubiprostone is typically covered | Yes, sometimes with prior authorization required |
| Typically covered by Medicare Part D? | No, but generic lubiprostone is typically covered | Yes, sometimes with prior authorization required |
| Standard dosage | 60, 24 mcg capsules | 30, 145 mcg capsules |
| Typical Medicare copay | Varies depending on plan | Varies depending on plan |
| SingleCare cost | See latest prices | See latest prices |
Amitiza vs. Linzess side effects
Amitiza and Linzess have some common adverse events between them, but the relative risk of each differs between the two. Diarrhea is the most common reason for treatment discontinuation for Linzess, and it is the drug’s most common side effect. Common side effects for Linzess include:
- Diarrhea
- Abdominal pain
- Abdominal distension
- Flatulence
Although it can cause diarrhea, Amitiza is more likely to cause nausea, occurring in almost one in every three patients who take the drug. This is the most common side effect of the drug and the most common reason for drug discontinuation. Nausea appears to happen more often if it is taken on an empty stomach. Sometimes this nausea is severe and debilitating, keeping patients from normal daily activities. Amitiza’s common side effects include the following:
- Nausea
- Diarrhea
- Headache
- Abdominal pain
- Abdominal distension
- Flatulence
These are not intended to be comprehensive lists of adverse effects. For a complete list, people should consult with their healthcare provider or pharmacist.
Amitiza vs. Linzess interactions and warnings
Fortunately, Amitiza and Linzess do not have many drug interactions. Some medications could reduce the efficacy of either constipation drug. They should be used with caution in patients on prescription drugs with anticholinergic properties. Anticholinergic drugs may promote constipation and oppose the pharmacologic actions of Amitiza and Linzess. The opioid pain reliever methadone can reduce the effectiveness of Amitiza.
Patients who are on loop diuretics, such as furosemide (Lasix), could be at risk of losing too much potassium (hypokalemia) through the kidneys and intestines if they develop diarrhea from Amitiza or Linzess. Concurrent use of diuretics and drugs that treat constipation requires caution. This is not a complete list of potential drug interactions. For a complete list, please seek medical advice from your gastroenterology healthcare professional.
The Food and Drug Administration (FDA) highlights some specific warnings about each drug on its labels. Regarding Linzess, the risk of serious dehydration when used in children under the age of 2 is highlighted. However, the chance of dehydration leading to hypotension (low blood pressure), dizziness, and electrolyte abnormalities is present in any user.
Likewise, the FDA’s warnings about Amitiza center around diarrhea and dehydration consequences, like hypotension and passing out. The drug’s label mentions nausea risk and the potential for shortness of breath to develop shortly after a dose. Healthcare professionals are advised to check for bowel obstruction prior to starting Amitiza.
Weighing the risks and benefits of taking either drug requires the help of a healthcare professional. Certain situations may call for Amitiza and others for Linzess. The medical advice of your healthcare provider can guide you on which option makes the most sense for you.
- Comparison of efficacy of pharmacological treatments of chronic idiopathic constipation: A systematic review and network meta-analysis, ScholarWorks (2018)
- Comparative profiles of lubiprostone, linaclotide, and elobixibat for chronic constipation: A systematic literature review with meta-analysis and number needed to treat/harm, BMC Gastroenterology (2024)
- Aetna Standard Plan drug formulary, Aetna (2025)
- Humana Medicare Advantage drug formulary, Humana (2025)
- Amitiza drug label, NIH DailyMed (2025)
- Linzess drug label, NIH DailyMed (2023)