Gut HealthWell-evidencedHuman trials

Linaclotide

Linaclotide

Overview

Linaclotide is a synthetic 14-amino-acid peptide agonist of guanylate cyclase-C (GC-C) receptors in the intestinal epithelium FDA-approved under the brand name Linzess for irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation. It represents one of the few gut peptides with full FDA approval and a robust clinical evidence base from multiple large Phase 3 trials. Linaclotide acts locally in the gut with minimal systemic absorption making it a highly targeted gastrointestinal therapeutic.

Mechanism of Action

Linaclotide mimics the heat-stable enterotoxins produced by E. coli binding to and activating guanylate cyclase-C receptors on intestinal epithelial cells. GC-C activation increases intracellular cGMP which activates CFTR chloride channels promoting chloride and bicarbonate secretion into the intestinal lumen. This osmotic effect increases luminal fluid content softening stool and accelerating intestinal transit. The elevated cGMP also has direct analgesic effects — it diffuses through the epithelium to afferent pain-sensing neurons reducing their sensitivity to colonic distension and explaining linaclotide's efficacy for abdominal pain in IBS-C beyond its laxative effects. Minimal systemic absorption means virtually no off-target effects.

Dosage Information

Typical Dose

72-290 mcg once daily (FDA-approved doses)

Frequency

Once daily on empty stomach 30 minutes before first meal

Administration

Oral capsule

Notes

FDA-approved for IBS-C (290 mcg) and chronic idiopathic constipation (72 mcg or 145 mcg). Must be taken on empty stomach. Keep away from children — dangerous if accidentally ingested.

Where does Linaclotide sit?

See how this peptide compares across all 111 peptides in our database.

Evidence Score

0.80

Clinical trials
1.0035%
Literature
1.0030%
Community
0.0020%
Completeness
1.0015%
11 RCTs3 clinical trials12 reviews

Compound Data

Linaclotide structure

Molecular Formula

C59H79N15O21S6

Molecular Weight

1526.80 g/mol

IUPAC Name

(2S)-2-[[(1R,4S,7S,13S,16R,21R,24R,27S,30S,33R,38R,44S)-21-amino-13-(2-amino-2-oxoethyl)-27-(2-carboxyethyl)-44-[(1R)-1-hydroxyethyl]-30-[(4-hydroxyphenyl)methyl]-4-methyl-3,6,12,15,22,25,28,31,40,43,46,51-dodecaoxo-18,19,35,36,48,49-hexathia-2,5,11,14,23,26,29,32,39,42,45,52-dodecazatetracyclo[22.22.4.216,33.07,11]dopentacontane-38-carbonyl]amino]-3-(4-hydroxyphenyl)propanoic acid

PubChem CID

16158208

Potential Side Effects

Diarrhea (very common — most frequent reason for discontinuation)Abdominal pain (common)Flatulence (common)Serious dehydration with severe diarrhea (uncommon but important to monitor)

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Quick Facts

Administration
Oral capsule
Typical Dose
72-290 mcg once daily (FDA-approved doses)
Frequency
Once daily on empty stomach 30 minutes before first meal
References
0 curated + 49 from PubMed
Clinical Trials
50 registered
Evidence Score
0.8 / 100