UK Clinical Pharmacy Association

Linaclotide

Issues for surgery

Exacerbation of irritable bowel syndrome and constipation if omitted.

Advice in the perioperative period

Elective and emergency surgery 

Continue.

Consider checking U&E’s pre-operatively if patient reports severe diarrhoea.

Post-operative advice

Restart post-operatively once enteral intake resumed.

Review if patient develops reduced gastrointestinal motility (e.g. ileus) post-operatively.

Patients undergoing colorectal surgery

Review the need for linaclotide post-operatively.

Interactions with common anaesthetic agents

None.

Interactions with other common medicines used in the perioperative period

No pharmacokinetic interactions are anticipated; however, concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) or proton pump inhibitors (PPIs) with linaclotide may increase the risk of diarrhoea. Caution is advised in patients who are also prescribed oral medications with a narrow therapeutic range as absorption may be affected.

Further information

None relevant.

References

Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 4th March 2021]

Summary of Product Characteristics – Constella® (linaclotide) 290micrograms hard capsules. Allergan Ltd. Accessed via www.medicines.org.uk 04/03/2021 [date of revision of the text September 2020]

Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 4th March 2021]