- Linzess can interact with anticholinergic medications, such as oxybutynin (Ditropan XL), and antidiarrheal medications, such as loperamide (Imodium). Using these agents together with Linzess may reduce Linzess’s effectiveness.
- Although there are no established interactions between Linzess and alcohol, consuming alcohol while on Linzess might raise the likelihood of certain adverse effects, including headache and dehydration.
Linzess (linaclotide) is a prescription medication indicated for certain types of constipation in adults. Specifically, it is approved to treat adults with:
- chronic idiopathic constipation
- irritable bowel syndrome with constipation
Linzess is also indicated for functional constipation in children aged 6 years and older.
Like all medications, Linzess can have interactions.
Some interactions occur when one substance alters the effect of another. For instance, alcohol, another drug, or a supplement may change how a medication behaves in your body. Interactions may also arise from specific medical conditions.
Continue reading to learn about possible interactions with Linzess and who should avoid it. For more on Linzess, see this article.
When should I avoid Linzess?
Certain medical conditions or other factors could increase the risk of harm if you take Linzess. In those cases, your clinician may decide not to prescribe Linzess. These situations are called contraindications. The list below outlines Linzess contraindications.
If your child is under 2 years old. Linzess should not be given to children younger than 2 years. The drug carries a boxed warning for this reason. Animal studies have shown an increased risk of severe diarrhea that can lead to profound dehydration. In some cases, this dehydration can be life threatening.
Because Linzess hasn’t been studied in humans younger than 2 years and due to the potential dangers, it’s not recommended for that age group. Also note that Linzess is primarily used in adults.
Blockage in the stomach or intestines. Do not take Linzess if you have a known or suspected intestinal or gastric obstruction. Linzess promotes movement through the digestive tract. If a blockage exists, taking Linzess might worsen the obstruction.
Because of this risk, doctors generally will not prescribe Linzess to people with an intestinal or stomach blockage. Discuss alternative treatments with your provider.
If you’ve experienced an allergic reaction. If you’ve had an allergic response to Linzess or any ingredient in the product, your provider will likely avoid prescribing Linzess due to the potential for another allergic reaction. Ask your clinician about alternative therapies.
Before starting Linzess, tell your doctor if any of the above apply to you. They can evaluate whether Linzess is safe for your situation.
Does Linzess interact with alcohol?
No specific interactions between alcohol and Linzess have been identified. However, alcohol might heighten the risk of side effects that both alcohol and Linzess can cause, such as headache or dehydration.
If you consume alcohol, consult your clinician about how much, if any, alcohol is safe while you’re taking Linzess.
Does Linzess interact with other drugs?
Before you begin Linzess, inform your doctor and pharmacist about all prescription, over-the-counter, and other medications you use. Sharing this information helps reduce the chance of potential interactions. (To learn whether Linzess interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Linzess?” section below.)
If you have concerns about drug interactions that may affect you, speak with your clinician or pharmacist.
The table below lists medications that may interact with Linzess. Keep in mind this table doesn’t include every possible interacting drug. For further details on some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| anticholinergic drugs | • scopolamine (Transderm Scop)• benztropine• oxybutynin (Ditropan XL) | may reduce Linzess’s effectiveness |
| antidiarrheal drugs | • loperamide (Imodium)• bismuth subsalicylate (Pepto-Bismol)• atropine/diphenoxylate (Lomotil) | can make both Linzess and antidiarrheals less effective |
Drug interactions explained
More details on specific drug interactions that may occur with Linzess are provided below.
Interaction with anticholinergic drugs
If you’re taking anticholinergic medications, consult your clinician before beginning Linzess. Anticholinergics are prescribed for several conditions, including urinary incontinence and chronic obstructive pulmonary disease (COPD), among others.
Examples of anticholinergics include:
- scopolamine (Transderm Scop)
- benztropine
- oxybutynin (Ditropan XL)
What could happen
Anticholinergic drugs can cause constipation as a side effect. Since Linzess is used to treat constipation, using anticholinergics may make Linzess less effective.
What you can do
Before starting Linzess, review all your current medications with your clinician. They can identify whether any are anticholinergics and advise whether they’re safe to use alongside Linzess.
Interaction with antidiarrheal drugs
If you use antidiarrheal medications to relieve diarrhea, inform your clinician before starting Linzess.
Examples of antidiarrheals include:
- loperamide (Imodium)
- bismuth subsalicylate (Pepto-Bismol)
- atropine/diphenoxylate (Lomotil)
What could happen
Antidiarrheals slow intestinal transit and can lead to constipation. Linzess accelerates intestinal transit to treat constipation. Taking both types of medications can therefore blunt each drug’s effect.
What you can do
If you’re on any diarrhea treatments, notify your clinician before using Linzess. If you develop diarrhea while taking Linzess, discuss appropriate management with your clinician. They may reduce your Linzess dose or advise temporarily stopping it until the diarrhea resolves. Do not take over-the-counter anti-diarrheal medicines while on Linzess without consulting your clinician or pharmacist first.
Are there other interactions with Linzess?
Linzess may also interact with supplements, foods, vaccines, or laboratory tests. The information below does not include every potential interaction.
Does Linzess interact with supplements?
Before you start Linzess, tell your clinician and pharmacist about any supplements, herbs, or vitamins you use. Sharing this information helps avoid potential interactions.
If you’re unsure about interactions that might affect you, ask your clinician or pharmacist.
Linzess and herbs
There are no current reports of interactions between Linzess and herbal products. However, that doesn’t guarantee future interactions won’t be identified.
Therefore, always consult your clinician or pharmacist before combining herbs with Linzess.
Linzess and vitamins
There are no current reports of interactions between Linzess and vitamins. Still, it’s possible interactions could be discovered later.
So check with your clinician or pharmacist before taking vitamins while on Linzess.
Does Linzess interact with food?
Take Linzess on an empty stomach at least 30 minutes before your first meal of the day. Taking it with a high-fat meal may increase the risk of side effects, such as diarrhea.
For more on potential Linzess side effects, see this article.
Does Linzess interact with vaccines?
No interactions between Linzess and vaccines are currently known. If you have concerns about receiving vaccines while on Linzess, consult your clinician or pharmacist.
Does Linzess interact with lab tests?
No laboratory tests are known to be affected by Linzess. If you need lab work while taking Linzess, inform the person performing the test so they can ensure no interactions will interfere with results.
Does Linzess interact with cannabis or CBD?There are currently no documented reports of interactions between Linzess and cannabis (marijuana) or cannabis-derived products like cannabidiol (CBD). As with any medication or supplement, discuss using cannabis with Linzess with your clinician.Note: Cannabis remains illegal federally but is legal in many states to varying extents.
Does my health history affect whether I should take Linzess?
Certain medical conditions or health factors may increase the risk of interactions with Linzess. Discuss your medical history with your clinician before starting Linzess so they can decide if it’s appropriate for you.
Health conditions or factors that may be relevant include:
Blockage in the stomach or intestines. Avoid Linzess if you have a known or suspected obstruction in your stomach or intestines. Because Linzess speeds movement through the digestive tract, it could worsen an existing blockage. For this reason, clinicians usually won’t prescribe Linzess in this situation. Ask your provider about other options.
Pregnancy. It’s unknown whether Linzess is safe during pregnancy. If you are pregnant or planning to become pregnant, consult your clinician before using Linzess.
Breastfeeding. It’s unclear whether Linzess is safe while breastfeeding. If you are breastfeeding or plan to breastfeed, speak with your clinician before starting Linzess.
Allergic reaction. If you’ve experienced an allergic response to Linzess or any of its ingredients, your clinician will likely avoid prescribing it due to the risk of another allergic reaction. Ask about alternate treatments.
Common questions about Linzess and interactions
Answers to frequently asked questions about Linzess and interactions are below.
Can I take MiraLAX or dulcolax with Linzess?
Yes — in certain cases your clinician may recommend Linzess with polyethylene glycol (MiraLAX) or bisacodyl (Dulcolax). Because these medications all treat constipation, using them together can increase the risk of diarrhea and dehydration. If you combine MiraLAX or Dulcolax with Linzess, your clinician may monitor you more closely for dehydration symptoms.
Does Linzess interact with Cymbalta?
No known interactions exist between Linzess and duloxetine (Cymbalta). Cymbalta treats depression and anxiety.
Keep in mind that Cymbalta can cause constipation. Because Linzess treats constipation, Cymbalta’s constipating effects could make Linzess less effective.
If you have questions about taking Linzess with Cymbalta, speak with your clinician for personalized advice.
Are there interactions between levothyroxine and Linzess?
No known interactions have been reported between levothyroxine (Synthroid) and Linzess, so they are likely safe to use together. Levothyroxine is used for hypothyroidism and certain thyroid conditions.
Both levothyroxine and Linzess can cause diarrhea, so using them together may increase that risk. If you have concerns, consult your clinician or pharmacist.
Is it safe to take Linzess with gabapentin?
Generally, taking Linzess with gabapentin (Neurontin) is considered acceptable; no known interactions have been reported. Gabapentin is used to treat seizures and nerve pain.
Gabapentin can cause constipation or diarrhea. Because Linzess treats constipation, gabapentin’s effects could reduce Linzess’s benefit. Conversely, if gabapentin causes diarrhea, Linzess might worsen it. Your clinician will monitor for side effects if you take both.
Is tramadol safe to take with Linzess?
Tramadol (Ultram) can likely be used with Linzess; no known interactions are reported. Tramadol is prescribed for certain types of pain.
Tramadol may cause constipation, and Linzess treats constipation, so tramadol could lessen Linzess’s effectiveness.
If you have concerns about using tramadol with Linzess, discuss them with your clinician or pharmacist.
How can I prevent interactions?
Taking these steps can help you avoid interactions with Linzess. Before beginning treatment, talk with your clinician and pharmacist. Topics to cover include:
- Whether you drink alcohol or use cannabis.
- All other medications you take, including vitamins, supplements, and herbs. Your clinician or pharmacist can help you complete a medication list.
- What steps to take if you begin a new medication while using Linzess.
Also read Linzess’s label and accompanying materials. Colored stickers on the label may highlight interactions, and the patient information (package insert) can include additional details. If you didn’t receive paperwork with your Linzess, request a copy from your pharmacist. If you need help interpreting this material, ask your clinician or pharmacist.
Taking Linzess exactly as prescribed helps reduce the risk of interactions.
Disclaimer: Every effort has been made to ensure the information here is accurate, comprehensive, and up to date. This content should not replace the advice of a licensed healthcare professional. Always consult your doctor or another qualified healthcare provider before starting any medication. Drug information is subject to change and doesn’t cover all possible uses, directions, precautions, warnings, interactions, allergic reactions, or adverse effects. The absence of warnings does not mean a drug or drug combination is safe, effective, or appropriate for every patient or use.
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