Can you take Linzess while pregnant?

In this article:

• Linzess and pregnancy
• Potential risks
• Alternatives
• Natural remedies

In this article

• Linzess and pregnancy
• Potential risks
• Alternatives
• Natural remedies

Linzess is a medication prescribed for the treatment of medical conditions such as irritable bowel syndrome with constipation (IBS-C), chronic idiopathic constipation, and functional constipation in children ages six to 12. “Linzess works by increasing intestinal fluid secretion and accelerating intestinal transit,” explains Kecia Gaither, MD, FACOG, board-certified OB-GYN and Director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx. That means it will make a bowel movement happen more quickly. It is the brand name of the medication linaclotide and is considered a guanylate cyclase-c agonist. It is currently unknown if Linzess is safe during pregnancy, as no clinical trials have been conducted at this time.

Can you take Linzess while pregnant?

“Linzess should only be used during pregnancy if the benefits outweigh the possible risks,” explains Tamara Hughes, Pharm.D., assistant professor of clinical sciences at High Point University’s Fred Wilson School of Pharmacy. That’s because, so far, only animal studies have been conducted to determine whether it is safe to take Linzess during pregnancy, she explains. 

In animal studies conducted on rats and rabbits receiving linaclotide, no harmful effects were observed on developing fetuses and embryos unless the prescription drug was administered at doses that were also toxic to the mother. Additionally, in humans, linaclotide is minimally absorbed into the bloodstream after an oral dose.

But there is not enough research in humans to determine the risk of losing a pregnancy or of congenital disorders. “There is limited data on whether the medication crosses the placenta or its effects on the fetus,” says Dr. Gaither. “Due to its classification and the lack of established safety, caution is advised. It’s crucial for pregnant women to consult their providers before taking any medication.”

What are the risks of taking Linzess while pregnant?

As human studies for taking Linzess while pregnant are lacking, it is hard to say what specific risks may exist. “In mice, very high doses caused severe toxicity in the mother, including death, lower pregnancy and fetal weights, and changes in fetal development,” Dr. Hughes says. “These doses were much higher than what humans take. And while Linzess isn’t well absorbed into the body—making exposure to the baby unlikely—it still can’t be completely ruled out.”

Diarrhea is the most common side effect, usually occurring within the first two weeks of starting the medication. Sometimes, the diarrhea can be severe, making it a more serious side effect, as diarrhea carries the risk of serious dehydration. Other risks and possible side effects of Linzess include:

• Gas
• Abdominal pain
• Swelling or a feeling of fullness or pressure in the stomach

Linzess should never be prescribed to a person with a known or suspected intestinal blockage, as the medication could make a blockage worse.

Like most drugs taken during pregnancy, a small amount is likely to cross the placenta. Because of a lack of studies on pregnant human beings, it’s unknown what risks this might carry. Taking Linzess while breastfeeding is also not very well-studied, though linaclotide is not expected to enter breast milk because it is minimally absorbed in the body. However, the safety of taking this medication has not been adequately studied in lactating women.

Can Linzess cause miscarriage?

“So far, there’s no clear evidence that Linzess causes birth defects or miscarriage in pregnant women, but the risk of these outcomes is still unknown,” says Dr. Hughes. “The systemic absorption of Linzess (linaclotide) and its active metabolite is negligible after oral dosing, so it’s not expected to reach the baby.” However, both Dr. Hughes and Dr. Gaither cite the lack of data on women who take Linzess during pregnancy, so the risk of miscarriage or harm to the baby cannot be completely ruled out.

What can I take instead of Linzess during pregnancy?

Because the safety of Linzess for pregnant women is unknown, it’s not the first line of treatment during pregnancy. Instead, a healthcare professional may recommend the following pregnancy-safe Linzess alternatives:

• Colace (docusate sodium)
• Constulose (lactulose)
• Metamucil (psyllium)

While many of these medications are available over the counter, always discuss treatment with an OB-GYN before taking any new medications.

Natural remedies for constipation during pregnancy

According to both Dr. Gaither and Dr. Hughes, there are a number of more natural ways to address uncomfortable constipation during pregnancy, including:

• Eating more fiber: Increase fiber intake gradually to avoid bloating or gas.
• Avoiding foods that cause gas, such as beans or cabbage.
• Incorporating probiotic-rich foods: These may improve bowel function. “Foods like yogurt and fermented vegetables are good sources,” says Dr. Gaither.
• Eating smaller meals and eating food more slowly.
• Drinking plenty of water: This can soften stool and make it easier to have a bowel movement.
• Getting regular physical activity, such as walking, to improve digestion and reduce stress. “Regular exercise can stimulate bowel movements,” Dr. Hughes explains.
• Managing triggers: “Learn what triggers your constipation and discuss it with your healthcare provider so they can provide tips,” suggests Dr. Hughes. For example, stress is a known cause of constipation, so a pregnant person looking to treat constipation naturally should try to remain as stress-free as possible. “Managing stress through things like deep breathing, stretching, or talking to someone can also make a big difference,” says Dr. Hughes.

“In addition to the alternatives mentioned, creating a regular bathroom routine and not ignoring the urge to go can help with constipation,” Dr. Hughes says. No matter what method you try, be sure to seek medical advice from your healthcare provider before trying any new remedy or supplement for constipation or IBS while pregnant, to discuss potential risks.