Key takeaways

Linzess (linaclotide) is a prescription drug that treats constipation (both chronic idiopathic constipation and IBS with constipation). The generic form isn’t available yet.
Generic and brand-name drugs are similar in many ways; however, the brand-name version may be more effective or cause fewer side effects.
Switching from Linzess to the generic (when it becomes available) is easy; no tapering is needed.
Constipation management can also utilize other treatment options, such as drinking more water, eating a high-fiber diet, trying herbal products, and over-the-counter medicines, such as laxatives.

In this article:

Is there a generic for Linzess?
How much is Linzess?
What are the off-label uses for Linzess?
Long-term use of Linzess

In this article

Is there a generic for Linzess?
How much is Linzess?
What are the off-label uses for Linzess?
Long-term use of Linzess

Linzess is FDA approved for chronic idiopathic constipation. People may also take it if they have IBS-C, irritable bowel syndrome with constipation. According to a 2017 Ironwood press release containing forward-looking statements, about 1.5 million people in the U.S. take this medication.

“My patients have seen a lot of success on Linzess,” says Dr. Asma Khapra, MD, a gastroenterologist at Gastro Health who specializes in women’s digestive health and inflammatory bowel disease. “It has become a mainstay of treatment for constipation in many people.”

Currently, there’s no generic version of Linzess available.

Is there a generic for Linzess?

As mentioned, the generic form of Linzess isn’t available—yet—so you’ll have to stick with the brand name. That shouldn’t create a problem, doctors say.

“Linzess has been very available to my patients, [in terms of insurance coverage]” Dr. Khapra says.

More good news: The generic version may be coming.

“According to my research, pursuant to the terms of a settlement, Ironwood and Allergan will grant Teva a license to market its 145 mcg and 290 mcg version of Linzess in the United States beginning March 31, 2029,” says Dr. David Clarke, MD, a doctor who’s board-certified in internal medicine and gastroenterology and the president of the Association for Treatment of Neuroplastic Symptoms.

Essentially, Linzess (and Constella) are the intellectual property and trademarks of Ironwood Pharmaceuticals, so their “permission” is needed to make a generic version.

The generic may be referred to by Linzess’s active ingredient: linaclotide. Linzess contains linaclotide-coated beads in hard gelatin capsules. It belongs to the guanylate cyclase-C agonist (GC-C) drug class. This class of medications is known for—you guessed it—treating constipation.

What are the differences between brand name and generic Linzess?

The brand-name version (and eventual generic version) of this prescription drug are largely the same, so you’d experience similar therapeutic effects.

However, it’s worth noting that brand-name drugs—while more expensive—may at times lead to more positive results than generic drugs, according to some studies. That’s one reason people may opt for the brand name even when the generic comes out.

Research backs up the benefits of brand-name medications. A 2020 study in the International Journal of Neuropsychopharmacology found that brand-name antidepressants outperform their generic counterparts, at least when it comes to preventing hospitalization.

In addition, a 2017 study in Circulation: Cardiovascular Quality and Outcomes found that patients who took generic versions of blood pressure medications experienced increased rates of side effects.

Whether that goes for any given drug is unclear, but per usual, the best bet is to talk through options with a prescribing doctor.

Linzess is taken via oral administration; it comes in capsules that are white, cream, or grayish. As far as dosage, Linzess comes in a 72 mcg capsule, 145 mcg capsule, or 290 mcg capsule, depending on the patient’s age and condition (more details in the chart below), once daily.

	Linzess (linaclotide)
Uses	Treating health conditions such as irritable bowel syndrome (IBS) with constipation (IBS-C) and chronic idiopathic constipation (CIC) in adult patients Treating functional constipation in pediatric patients aged 6 to 17 years old
Standard dosage	For IBS with constipation in adults: 290 mcg capsule taken once daily For chronic idiopathic constipation in adults: 145 mcg capsule taken once daily For functional constipation in children 6 years of age and older: 72 mcg capsule taken once daily
Common side effects of Linzess	Diarrhea (this is the most common side effect and can be a contributing factor to dehydration) Abdominal pain, or stomach-area pain Gas Bloating Viral inflammation of the intestines (gastroenteritis) Headache More serious side effects, such as severe dehydration, severe diarrhea, severe stomach pain, or allergic reactions (like itching or hives) require immediate medical attention at the nearest hospital emergency room. For a complete list of adverse reactions, see the medication’s FDA label.
Contraindications	Known or suspected bowel or stomach blockage Allergies to linaclotide or other ingredients in this medication Children younger than 2 years of age Note: Has no major drug interactions
Other considerations	Store it at room temperature

How much is Linzess?

Linzess prices
	Brand-name Linzess
Average cost without insurance	$733 for one, 30 capsule bottle of Linzess
SingleCare’s lowest price	$494 for one, 145 mcg, 30 capsule bottle of Linzess
Free coupons	Linzess coupons

What are the off-label uses for Linzess?

Chronic idiopathic constipation isn’t the only reason people may buy Linzess; the medicine has other possible uses. For example, while it’s typically given to patients who have IBS-C or functional constipation, Dr. Khapra says, healthcare providers may prescribe it to patients facing general symptoms of constipation, regardless of the cause of the constipation.

“Of course, you cannot use it if patients have an active obstruction,” she adds. (When there’s an intestinal obstruction in the GI tract, a constipation medication could worsen the issue.)

Some patients have also misused linaclotide—particularly, those who want to lose weight or have eating disorders—using the medication as a laxative. “However, this use is not recommended, and [Linzess] is considered contraindicated in patients with inflammatory bowel disease (IBD) or mechanical bowel obstruction (MBO),” Dr. Clarke says.

How to switch from Linzess to linaclotide

Linzess-treated patients may want to switch to the generic when it becomes available. Thankfully, it’s easy to do so safely. Patients don’t need to worry about tapering or withdrawal effects (though stopping it abruptly can lead to the return of constipation).

“When switching, there is no need to do anything different,” Dr. Khapra says. “You can stop Linzess one day and start the linaclotide the following day.”

That’s because the two medications are identical, Dr. Clarke says.

If you miss a dose, just skip it and take your next dose at the regular time.

Other good-to-know information from these gastroenterology doctors:

There isn’t usually a specific need or medical condition in which a provider would want a patient to take Linzess instead of linaclotide (aka, the brand name versus the generic). At the same time, a clinician may prefer prescribing Linzess over a generic because of its “established efficacy and safety profile documented in clinical trials,” as well as the fact that brand-name medications “often come with patient support programs,” according to Dr. Clarke.
If the prescription says “brand medically necessary,” the pharmacist must give the brand name. Otherwise, they can switch to the generic if the generic is available. It just depends on state laws and insurance policies.
If a patient doesn’t keep up with the daily dosage or there’s a shortage, they won’t experience any withdrawal symptoms, per se; however, constipation will quickly return. But again, that’s a resumption of previous symptoms, not “withdrawal.”

Long-term use of Linzess

Yes, Linzess can be taken long-term. “Linzess is designed for long-term use, provided it remains effective and well-tolerated by the patient,” Dr. Clarke says. “There is no evidence of diminished response over time, making it suitable for extended treatment.”

Some long-term side effects people may face, he adds, include diarrhea, bloating, and abdominal pain.

Dr. Khapra agrees the medication is safe long-term and that it’s meant to be taken as a maintenance medication.

Last but not least, it’s important to note that this health information is only for educational purposes; it doesn’t replace the individualized expertise of a licensed healthcare provider or doctor. Talking to a medical professional who knows your history is a paramount first step.