Linzess Side Effects: What They Are And How To Manage Them

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SubscribeLinzess Side Effects and Tips for Managing ThemMedically reviewed by Stan Saji, PharmD, MBA, RPhWritten by Rosanna Sutherby, PharmD Updated on August 27, 2025
  • More common side effects
  • Mild side effects
  • Serious side effects
  • Managing side effects
  • FAQ
  • Warnings
  • What to ask your doctor

Key takeaways

  • Linzess may cause side effects like diarrhea, which often starts within the first 2 weeks. Staying hydrated is important for mild diarrhea, but get medical help for severe cases.
  • Linzess doesn’t directly cause weight changes, fatigue, hair loss, or depression, but it may lead to bloating or diarrhea, affecting weight. Consult your doctor about mood changes or fatigue, as other medications might be responsible.
  • Linzess has a boxed warning for serious dehydration in children under age 2 years and should not be taken by this age group. Adults should discuss their medical history, including bowel blockage, with a doctor before starting the medication.

Linzess (linaclotide) — a prescription capsule used to treat certain types of digestive system problems — can cause mild to serious side effects. Examples include diarrhea, bloating, and abdominal pain.

Specifically, Linzess is used to treat:

  • irritable bowel syndrome with constipation (IBS-C) in adults
  • chronic idiopathic constipation (CIC) in adults
  • chronic functional constipation in some children

Keep reading to learn about the common, mild, and serious side effects Linzess can cause. To learn more about Linzess, including its uses, dosage, and cost, read this Linzess overview article.

More common side effects of Linzess

Linzess can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult to tolerate.

More commonly reported side effects of Linzess include:

  • diarrhea
  • abdominal pain
  • gas
  • bloating
  • nausea

Side effects can vary depending on which condition the drug is being used to treat.

For more information about some of these side effects, see the “Tips for managing side effects” section.

Mild side effects of Linzess

Examples of mild side effects that have been reported with Linzess include:

  • abdominal pain
  • bloating
  • gas
  • gastroesophageal reflux disease (GERD)
  • headache
  • mild diarrhea
  • upper respiratory infection

In most cases, these side effects should be temporary and some may be easily managed. But if you have any symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. Do not stop taking Linzess unless your doctor recommends it.

Linzess may cause mild side effects other than those listed here. See the drug’s prescribing information for details.

For more information about some of these side effects, see the “Tips for managing side effects” section.

Serious side effects of Linzess

Linzess may cause serious side effects, including severe diarrhea and severe allergic reaction.

If you develop serious side effects while taking Linzess, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Allergic reaction

For some people, Linzess can cause an allergic reaction. But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Linzess.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Linzess, they may have you switch to a different treatment.

Tips for managing side effects

There may be things you can do to help make certain side effects of Linzess more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other treatment options for your condition.

Diarrhea

Some people taking Linzess may experience diarrhea. This was the most common side effect reported in studies of people taking Linzess. In most cases, diarrhea began within the first 2 weeks of starting Linzess treatment.

Symptoms of diarrhea include:

  • loose or watery stools
  • abdominal cramping or pain
  • bloating

In some cases, diarrhea can be severe. Symptoms of severe diarrhea may include fever, severe abdominal pain, and bloody or dark stools. You have a higher risk of severe diarrhea from Linzess if you take higher doses.

Severe diarrhea may lead to dehydration. Tell your doctor right away if you think you might be dehydrated due to diarrhea. Severe dehydration is a serious condition requiring immediate medical attention.

Symptoms of dehydration include:

  • dizziness
  • dry mouth
  • fatigue (low energy)
  • headache
  • increased thirst
  • lightheadedness

Severe or long-lasting diarrhea from Linzess can sometimes cause low potassium levels, which may make you feel weak, dizzy, or have muscle cramps. Let your doctor know if you have these symptoms.

What might help

If you have symptoms of severe diarrhea, stop taking Linzess and call your doctor right away. They may adjust your Linzess dosage or have you switch to a different treatment.

If you have mild diarrhea while taking Linzess, staying hydrated is important. You can do this by drinking plenty of fluids, especially water and electrolyte replacement drinks.

Over-the-counter medications, such as Imodium A-D (loperamide), may help relieve your diarrhea. But be sure to first ask your doctor or pharmacist if Imodium A-D is safe for you to take.

Headache

Linzess may cause headache in some people. This was a common side effect reported in studies of people taking Linzess for irritable bowel syndrome with constipation (IBS-C).

Headache was not reported in people taking Linzess for chronic idiopathic constipation (CIC) or functional constipation (FC).

What might help

Because headache may be a symptom of dehydration, drink plenty of fluids while you’re taking Linzess. Let your doctor know if you also have diarrhea and symptoms of dehydration.

Certain over-the-counter (OTC) drugs may help relieve your headache. These include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve).

Before taking OTC medications, talk with your doctor or pharmacist to learn whether such medications interact with other drugs you take or conditions you have.

Bloating

Bloating can occur during Linzess treatment. This was a side effect in studies of Linzess. With bloating, your abdomen is typically larger than usual, and you may have a feeling of fullness.

Bloating may be caused by a buildup of gas in the stomach and intestines.

What might help

Exercise and movement can sometimes help move your bowels and get rid of gas. This may help relieve bloating.

Some OTC medications, such as simethicone (Gas-X, Mylicon, Phazyme), can also help relieve gas.

If your boating is bothersome or causes excessive pain, talk with your doctor.

Upper respiratory infection

Linzess may cause upper respiratory infection (such as the common cold) in some people. In studies of Linzess, this was a common side effect reported in people taking Linzess to treat CIC. Upper respiratory infection wasn’t reported in people taking Linzess for IBS-C or FC.

An upper respiratory infection may be caused by a virus or bacteria. Typically, it affects your nose, throat, sinuses, windpipe, or bronchi (the airways that connect your windpipe to your lungs).

Symptoms of an upper respiratory infection can include:

  • cough
  • headache
  • congestion or pressure in the nose
  • runny nose
  • sneezing
  • sore throat

What might help

Upper respiratory tract infections typically go away without antibiotics. But certain over-the-counter drugs may help relieve your symptoms.

For example, antihistamines such as diphenhydramine (Benadryl), loratadine (Claritin), or fexofenadine (Allegra) can help relieve runny nose and sneezing. Antihistamines can also help relieve coughing caused by nasal drainage into your throat.

Decongestants such as pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE) may help relieve sinus congestion and pressure.

Acetaminophen (Tylenol) or NSAIDs such as ibuprofen (Motrin, Advil) and naproxen (Aleve) may help relieve headache or sore throat.

Some of these medications come as combination products that treat multiple symptoms.

Before taking OTC medications, talk with your doctor or pharmacist. They can help make sure the OTC drugs are safe for you to take and won’t interact with your other medications.

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD) can occur with Linzess treatment. In studies, GERD was a rare side effect reported in people taking Linzess to treat IBS-C. GERD wasn’t reported in people taking Linzess to treat CIC or FC.

With GERD, the contents of your stomach go up into your esophagus (the tube that connects your throat to your stomach). GERD is considered a severe form of acid reflux.

What might help

GERD may cause a burning sensation or pain in your chest. Certain OTC medications may help relieve these symptoms.

Antacids such as Tums (calcium carbonate) or Maalox (aluminum hydroxide/magnesium hydroxide) can help relieve mild GERD symptoms. Acid reducers, such as Pepcid (famotidine) or Tagamet HB (cimetidine), may help decrease the amount of acid your stomach makes. And stronger medications, such as Prilosec (omeprazole), Nexium (esomeprazole), and Prevacid (lansoprazole), can block your stomach from making acid.

Before taking OTC medications to relieve GERD symptoms, discuss all medications you take with your doctor or pharmacist. They can help make sure the OTC medications don’t interact with other drugs you take.

Frequently asked questions about Linzess side effects

Here are answers to some frequently asked questions about side effects of Linzess.

Does Linzess cause weight gain or weight loss?

No, Linzess doesn’t cause weight gain or weight loss. But it can cause diarrhea, which in some cases may lead to weight loss. On the other hand, Linzess may cause bloating, which could lead to weight gain.

Some people who have irritable bowel syndrome with constipation (IBS-C) may experience weight gain or weight loss related to their condition.

For example, some people with IBS-C may have trouble digesting certain foods or absorbing nutrients. This may lead to weight loss.

If you’re concerned about changes in your weight while taking Linzess, talk with your doctor.

When do side effects from Linzess go away?

How long side effects of Linzess last may depend on several factors, including which side effect you have and how your body responds to Linzess.

Diarrhea is the most common side effect of Linzess. In one study, diarrhea lessened within 1 week for some people taking Linzess. But how long diarrhea or other side effects last for you can vary.

If you experience side effects from Linzess that are bothersome or don’t go away, talk with your doctor.

Does Linzess cause fatigue?

No, Linzess doesn’t cause fatigue. This wasn’t a side effect seen in studies of Linzess. But it’s possible that other medications used to treat IBS-C or chronic idiopathic constipation (CIC) may cause fatigue. Examples of these drugs include Amitiza (lubiprostone) and Motegrity (prucalopride).

If you experience fatigue while taking Linzess or other drugs for your condition, talk with your doctor.

Do side effects of Linzess vary depending on the strength (72 mcg, 145 mcg, or 290 mcg)?

In some cases, yes. For example, diarrhea was the most commonly reported side effect in studies of Linzess. The risk of having this side effect was higher in people who took 290 micrograms (mcg) of Linzess per day than in those who took lower doses.

Also, certain side effects, such as viral gut infections and headache, were only reported in people taking a daily dosage of 290 mcg.

If you have bothersome side effects from Linzess, talk with your doctor. They may be able to adjust your dosage to help relieve your side effects.

Does Linzess cause hair loss?

No, hair loss is not a side effect of Linzess. But some people may experience hair loss related to IBS-C, which Linzess treats.

If you’re concerned about hair loss, talk with your doctor.

Could I experience depression during my Linzess treatment?

No, Linzess isn’t known to cause depression. This wasn’t reported as a side effect in people taking Linzess in studies.

Other medications used to treat IBS-C or CIC may cause mood changes, including depression. Examples of these other drugs include Amitiza (lubiprostone) and Motegrity (prucalopride).

Also, it’s possible that IBS-C may raise your risk of developing depression, anxiety, and other mood-related conditions.

If you experience mood changes such as depression, talk with your doctor.

Keeping track of side effects

During your Linzess treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Linzess affects you. They can then use this information to adjust your treatment plan if needed.

Warnings for Linzess

Linzess comes with several warnings, including a boxed warning.

Boxed warning: Risk of serious dehydration in children younger than 2 years old

Linzess has a boxed warning for the risk of serious dehydration in children younger than 2 years old. This is a serious warning from the Food and Drug Administration (FDA).

Linzess was not tested in children younger than 2 years. But it was tested in animal studies. These studies showed that Linzess raised the risk of dehydration due to severe diarrhea in young mice. In some cases, severe dehydration was fatal in these animals.

Linzess should not be used in children younger than 2 years old. It’s important to note that Linzess is approved for use only in adults and children ages 6 years and older, depending on the condition being treated.

If you have questions about this warning, talk with your doctor.

Other warnings

Linzess may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Linzess is a good treatment option for you.

Talk with your doctor about your health history before starting Linzess. The list below includes factors to consider.

Bowel blockage. Linzess can make your digestive tract move more quickly than usual. This can worsen a bowel blockage. Due to this risk, doctors may not prescribe Linzess if you have a bowel blockage. They’ll discuss other treatment options that are right for you.

Allergic reaction. If you’ve had an allergic reaction to Linzess or any of its ingredients, your doctor will likely not prescribe Linzess. Ask them what other medications are better options for you.

Alcohol and Linzess

It may be safe to drink alcohol during your Linzess treatment. But keep in mind that Linzess can cause headaches and diarrhea. In some cases, diarrhea may lead to dehydration. And drinking alcohol can worsen these side effects.

If you drink alcohol and have questions about alcohol use with Linzess, talk with your doctor. They can help determine how much alcohol may be safe for you to drink while taking this medication.

Pregnancy and breastfeeding while taking Linzess

It’s not known whether it’s safe to take Linzess during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before starting Linzess treatment. They’ll let you know whether this drug is safe for you to take or discuss other treatment options with you.

It’s not known whether Linzess is safe to take while breastfeeding. Linzess isn’t thought to pass into breast milk. But it’s not known whether Linzess affects your body’s ability to produce breast milk.

If you’re breastfeeding or planning to breastfeed, talk with your doctor before taking Linzess.

What to ask your doctor

As with most drugs, Linzess may cause side effects in some people. Some of the most common side effects of Linzess are mild and can be managed with over-the-counter treatments. Others can be more serious. If you have questions about your risk of certain side effects from Linzess, talk with your doctor.

Here are a few examples of questions to ask your doctor:

  • Based on my medical history and other factors, is Linzess safe for me to take?
  • Are there any long-term side effects of Linzess?
  • What are my options if Linzess doesn’t work for me?

To learn more about Linzess, see these articles:

  • Linzess (linaclotide)
  • Linzess and Cost: What You Need to Know
  • Dosage for Linzess: What You Need to Know
  • Linzess Interactions: Alcohol, Medications, and Others
  • Trulance vs. Linzess: What You Should Know

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.

 

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
  • Food and Drug Administration. (2025). Orange Book: Approved drug products with therapeutic equivalence evaluations.https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
  • Hyland ME, et al. (2019). Symptom frequency and development of a generic functional disorder symptom scale suitable for use in studies of patients with irritable bowel syndrome, fibromyalgia syndrome or chronic fatigue syndrome.https://www.sciencedirect.com/science/article/pii/S2095882X18300987
  • Linzess (linaclotide) capsules, for oral use. (2023).https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/09beda19-56d6-4a56-afdc-9a77b70b2ef3/spl-doc
  • Rey E, et al. (2017). Optimizing the use of linaclotide in patients with constipation-predominant irritable bowel syndrome: An expert consensus report.https://link.springer.com/article/10.1007/s12325-016-0473-8
  • Tarar ZI, et al. (2023). Burden of anxiety and depression among hospitalized patients with irritable bowel syndrome: A nationwide analysis.https://link.springer.com/article/10.1007/s11845-022-03258-6

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Medically reviewed by Stan Saji, PharmD, MBA, RPhWritten by Rosanna Sutherby, PharmD Updated on August 27, 2025

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