• Robin D Rothstein and Frank K Friedenberg.
• Temple University School of Medicine, Division of Gastroenterology , 8th Floor Parkinson Bldg, 3401 N. Broad St, Philadelphia, PA 19140 , USA +1 215 707 4391 ; +1 215 707 2684 ; robin.rothstein@tuhs.temple.edu.
• Expert Opin Pharmacother. 2013 Oct 1; 14 (15): 2125-32.

IntroductionIrritable Bowel Syndrome with constipation (IBS-C) is associated with abdominal pain and infrequent spontaneous bowel movements. Patients with Chronic Idiopathic Constipation do not have abdominal pain as a predominant symptom. Linaclotide represents a new class of medication approved in the USA for both of these common conditions. Linaclotide is approved for IBS-C only in the EU. The only other medication approved at this time for IBS-C is lubiprostone.Areas CoveredThis review will cover the mechanism of action of linaclotide, and review the pivotal pre-clinical and clinical trials leading to its approval in 2012. The indications, common side effects, and black box warnings listed for linaclotide are reviewed.Expert OpinionLinaclotide is superior to placebo for the treatment of both IBS-C and Chronic Idiopathic Constipation. The drug has minimal systemic bioavailability and a favorable safety profile. For IBS-C, it is appropriate as a first-line prescription treatment. For Chronic Idiopathic Constipation, osmotic or stimulant laxatives should be tried prior to using linaclotide due to their considerable lower cost.

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