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Watson, PharmD on August 10, 2022 IntroductionLinzess (linaclotide) is a brand-name prescription drug used to treat the following:chronic idiopathic constipation, which refers to long-lasting constipation that does not have a known causeirritable bowel syndrome with constipation As with other medications, Linzess can interact with certain other drugs. However, the drug is not known to interact with alcohol or supplements. An interaction occurs when one substance causes another substance to have a different effect than expected. For more about the interactions of Linzess and who should not take the drug, keep reading. For additional information about Linzess, including details about its uses, see this article. When to avoid Linzess In some cases, factors or conditions could prevent your doctor from prescribing Linzess due to the risk of harm. These are known as contraindications. The contraindications of Linzess include: Having a blockage in the intestine Doctors typically will not prescribe Linzess if you have a blockage in your intestines. The drug can make food move through the intestines more quickly than usual. This process could worsen a blockage in the intestines. If you have a blockage in your intestines, talk with your doctor. They can recommend treatment options other than Linzess. Being younger than age 2 years Linzess has a boxed warning about the risk of serious dehydration in children younger than age 2 years. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. Due to this risk, doctors typically will not prescribe Linzess for children younger than age 2 years. For details, see the boxed warning at the top of this article. Note: Before you start treatment with Linzess, it’s important to tell your doctor if any of these contraindications apply. Your doctor can determine whether to prescribe Linzess. Linzess and alcohol There’s not a known interaction between Linzess and alcohol. However, drinking alcohol may cause constipation or diarrhea. Linzess is used to treat certain types of constipation. And diarrhea is the most common side effect of the drug. So consuming alcohol while taking Linzess could worsen your constipation or increase your risk of diarrhea. (For information about the side effects of Linzess, see this article.) If you drink alcohol, talk with your doctor about the amount, if any, you may be able to have while taking Linzess. Linzess interactions with other medications Before you start treatment with Linzess, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Here’s a chart of drugs that can interact with Linzess. Keep in mind that this chart does not include all drugs that may interact with Linzess. Some of these interactions are described in detail just below in “Drug interactions in depth.”Drug classDrug examplesInteraction result with Linzessantidiarrheal drugs• bismuth subsalicylate (Pepto Bismol)• loperamide (Imodium A-D)• atropine/diphenoxylate (Lomotil)can make both Linzess and antidiarrheals less effective than usualanticholinergic drugs• hyoscyamine (Hyosyne, Levsin, others)• oxybutynin (Ditropan XL, Oxytrol)• scopolamine (Transderm Scop)• dicyclomine (Bentyl)can make Linzess less effective than usual Drug interactions in depth Here’s a closer look at interactions between certain drugs and Linzess. Antidiarrheal drugs Antidiarrheal drugs are used to ease the symptoms of diarrhea. Interaction result. Taking Linzess with an antidiarrheal can make both drugs less effective than usual. Interaction explained. Because of the way each drug works in the body, Linzess and an antidiarrheal can mask each other’s effects. This could make it hard to tell if Linzess is working to treat your condition. Linzess eases the symptoms of constipation by increasing the amount of fluid in the intestine. Increased fluid helps food move quickly through the digestive tract, making bowel movements occur more often. Antidiarrheals ease the symptoms of diarrhea by reducing the amount of fluid in the intestine. Less fluid helps food move slowly through the digestive tract, making bowel movements occur less often. Examples of antidiarrheal drugs. Below are examples of antidiarrheal drugs that may interact with Linzess:bismuth subsalicylate (Pepto Bismol)loperamide (Imodium A-D)atropine/diphenoxylate (Lomotil) Steps you or your doctor may take. In most cases, your doctor may suggest you avoid taking an antidiarrheal with Linzess. Keep in mind that diarrhea is a common side effect of Linzess. If you have diarrhea with Linzess, you may be wondering about ways to ease your symptoms. Your doctor may have you pause Linzess treatment until your diarrhea eases. Then they may have you start taking Linzess treatment at a lower dosage. If you have questions about Linzess and antidiarrheal drugs, talk with your doctor. Anticholinergic drugs Anticholinergic drugs are used to treat a variety of conditions. Examples include irritable bowel syndrome, frequent urination, and bladder spasms. Interaction result. Taking Linzess with an anticholinergic can make Linzess less effective than usual. Interaction explained. Anticholinergic drugs can relax the muscles in the intestines. This causes food to move slowly through the digestive tract, which can worsen constipation. Linzess is used to treat certain types of constipation. So, taking these medications together could make it hard to tell if Linzess is working to treat your condition. Examples of anticholinergic drugs. Examples of anticholinergic drugs that may interact with Linzess include:hyoscyamine (Hyosyne, Levsin, others)oxybutynin (Ditropan XL, Oxytrol)scopolamine (Transderm Scop)dicyclomine (Bentyl) Steps you or your doctor may take. Before starting Linzess treatment, tell your doctor if you’re taking an anticholinergic drug. They can advise you on whether you may need a different medication for your condition. Linzess and other interactions Linzess may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Linzess. Linzess and supplements It’s possible for drugs to interact with supplements such as vitamins and herbs. Linzess and herbs There have been no specific reports of herbs interacting with Linzess. However, it’s possible that interactions with herbs could be recognized in the future. That’s why it’s important to check with your doctor or pharmacist before taking any of these products during Linzess treatment. Linzess and vitamins Linzess has not been reported to interact with vitamins. However, it’s possible that interactions with vitamins could be recognized in the future. This is why you should talk with your doctor or pharmacist before taking any vitamins with Linzess. Linzess interactions with food Keep in mind that you should take Linzess on an empty stomach, at least 30 minutes before your first meal of the day. Taking Linzess with food could increase the risk of diarrhea as a side effect of the drug. (For information about the side effects of Linzess, see this article.) Linzess and vaccines No vaccines have been reported to interact with Linzess. For more information about getting certain vaccines while you take Linzess, talk with your doctor. Linzess and lab tests Linzess and lab tests have not been reported to interact with each other. To learn more about having specific lab tests during Linzess treatment, talk with your doctor.Linzess and cannabis or CBD Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Linzess. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Linzess. The impact of cannabis may affect how well you stick to your Linzess treatment plan. Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees. Linzess and health-related interactions Certain medical conditions and other factors may increase the risk of interactions with Linzess. Before you take Linzess, be sure to talk with your doctor about your health history. Linzess may not be the right treatment option if you have certain medical conditions or other factors affecting your health. Health conditions or factors that might interact with Linzess include:Blockage in the intestines. Doctors typically will not prescribe Linzess if you have a blockage in your intestines. For details, see the “When to avoid Linzess” section above.Pregnancy. It’s not known whether Linzess is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Linzess treatment. For more information about taking Linzess while pregnant, see this article.Breastfeeding. Linzess is not thought to pass into breast milk or cause side effects in a breastfed child. If you’re breastfeeding or planning to breastfeed, talk with your doctor before starting Linzess treatment.Allergic reaction. If you’ve had an allergic reaction to Linzess or any of its ingredients, your doctor will likely not prescribe Linzess. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you. FAQs about Linzess and interactions Here are some frequently asked questions about Linzess and possible interactions. Can I take Linzess with laxatives such as MiraLAX Yes, in certain situations, your doctor may suggest you take Linzess in combination with a laxative. Examples of laxatives include:osmotic laxatives, such as polyethylene glycol (MiraLAX)bulk-forming laxatives, such as psyllium (Metamucil)stimulant laxatives, such as bisacodyl (Dulcolax) Both Linzess and laxatives are used to relieve constipation. Laxatives are often used for short-term relief, while Linzess may be taken long term for certain types of constipation. (For details about when Linzess is prescribed, see this article.) Linzess and laxatives are not known to interact with each other. However, Linzess and laxatives may cause diarrhea when used on their own. Therefore, taking Linzess in combination with a laxative may worsen this side effect. For this reason, your doctor will likely recommend that you do not take Linzess with a laxative. However, you may find that Linzess does not fully relieve your constipation. In this case, your doctor may suggest temporary treatment with a laxative. If your doctor suggests that you take Linzess with a laxative, they’ll recommend which one to take. Your doctor can also instruct you on how long to take the laxative. If you have additional questions about Linzess and laxatives, talk with your doctor. Is it safe to take Linzess with Cymbalta Yes, it should be safe to take Linzess with duloxetine (Cymbalta). There’s no known interaction between these two drugs. However, Cymbalta may cause constipation as a side effect. (For details about Cymbalta’s side effects, see this article.) Linzess is used to treat certain types of constipation. So, taking Cymbalta with Linzess could worsen constipation and make it hard for you to tell if Linzess is working. It’s important to talk with your doctor before taking Linzess with Cymbalta. They can recommend whether these medications are right for you. Does Linzess interact with levothyroxine The manufacturer of Linzess has not reported an interaction between levothyroxine (Euthyrox, Synthroid, others) and Linzess. Levothyroxine is used to treat hypothyroidism and thyroid cancer in certain situations. However, it’s possible that Linzess could keep your body from absorbing levothyroxine. This could reduce the level of levothyroxine in your body, making the drug less effective. For this reason, if you take Linzess with levothyroxine, your doctor may check your thyroid hormone levels more often than usual. Your doctor or pharmacist can help answer other questions about taking Linzess with levothyroxine. Can I take Linzess with gabapentin It should be safe to take Linzess with gabapentin (Horizant, Gralise, Neurontin). There’s no known interaction between these medications. Keep in mind that gabapentin may cause digestive side effects, including constipation and diarrhea. Linzess is used to treat certain types of constipation. And diarrhea is a common side effect of the drug. So, taking Linzess with gabapentin could worsen the condition Linzess is used to treat. It’s also possible that taking these drugs together could lead to severe diarrhea. Before taking Linzess with gabapentin, talk with your doctor. They can advise you on whether these medications are the right treatment options for you. Preventing interactions You can take certain steps to help prevent interactions with Linzess. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:Let them know if you drink alcohol.Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.Create a medication list, which your doctor and pharmacist can help you fill out. It’s also important to read the label of Linzess and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Linzess does not come with paperwork, you can ask your pharmacist to print a copy for you.) If this information is difficult to understand, ask your doctor or pharmacist to help explain it. You can also help prevent interactions with Linzess by taking it exactly as your doctor prescribes. Other resources Besides learning about interactions, you may want to find out more about Linzess. These resources might help:Overview of Linzess. For a general overview of Linzess, you can see this article.Side effects. If you’re interested in the side effects of Linzess, see this article. Another option is to refer to the Linzess prescribing information.Dosage specifics. To learn about the dosage of Linzess, see this article.Drug comparison. For information abouthow Linzess compares with Trulance, read this article.Facts about your condition. To learn more about irritable bowel syndrome (IBS), visit our IBS hub. For more information about constipation, you can refer to our list of related articles. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Last medically reviewed on August 10, 2022ConstipationIrritable Bowel SyndromePharmacy / PharmacistDrugsMedically reviewed by Damilola Omopariola, PharmD, BCACP — By Amber R. Watson, PharmD on August 10, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related Coverage13 home remedies for constipationMedically reviewed by Saurabh Sethi, M.D., MPH Foods, lifestyle choices, medications, and disease can all cause constipation. However, there are many remedies available. 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