Constella (linaclotide) is intended for patients who suffer from irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). The medication eases constipation while also reducing abdominal pain and discomfort.

Though unusual, some patients do take Constella to help treat similar conditions.

Constella should never be used in children under age 6, and use is not preferred in patients below age 18. Likewise women who are pregnant or breastfeeding should not use this product, nor should individuals who have a bowel obstruction.

Product Overview

Constella is not absorbed into the bloodstream. Its actions are entirely in the intestines, where it increases fluid secretion while decreasing the sensitivity of pain-detecting nerves. This action helps ease constipation as well as the pain or discomfort associated with constipation.

Technically not a laxative, there is no concern for the body becoming dependent on it with respect to gut motility. It also does not contain any active painkillers and has no addiction concerns.

Side effects are typically mild, but Constella can sometimes produce diarrhea. Mild, sporadic diarrhea is not cause for concern, but if it becomes severe or persistant a doctor should be consulted. In most cases (but not all) if Constella is going to cause severe diarrhea it will start to happen within the first two weeks of treatment.

Most patients do not experience severe side effects, however, and simply have easier, more frequent, and more complete bowel movements while also experiencing reduced or eliminated abdominal pain.

Dosage & Administration

Constella comes in tablets, which should be swallowed whole. Those who have difficulty swallowing whole tablets may open them and sprinkle the contents on soft foods, provided the food is consumed immediately and also not chewed. Capsules may also be mixed with fluids and administered via a gastrostomy tube.

Patients are typically instructed to take Constella just once per day, usually in the morning before breakfast. Whatever time the medication is taken, taking it at the same time each day is ideal.

To treat irritable bowel syndrome with constipation (IBS-C):

• The standard dose is 290 mcg once per day.
• Do not exceed 290 mcg per day.

And to treat chronic idiopathic constipation (CIC):

• The standard dose is 145 mcg once per day.
• Do not exceed 290 mcg per day.

Doctor instructions may vary from the above, and should always be followed. Dosage may be lowered if disruptive side effects are experienced.

It takes about six weeks of regular treatment for maximum benefit to be seen, though most patients start to notice some improvements around a week after starting treatment. Patients taking the medication for CIC generally have faster results than those taking it for IBS-C, though there are exceptions.

Treatment may continue indefinitely as long as it is providing benefit and no serious adverse effects develop. Many patients take Constella for years, though most patients do occasionally stop treatment to see if it's still needed. Unlike with laxatives, there are no known long-term gut motility issues associated with Constella.

Unfortunately this medication doesn't work for everyone; those who don't notice much difference after around six weeks of treatment should discuss alternatives with a doctor.

Side Effects

Constella is well-tolerated in the majority of patients. Side effects are uncommon, usually mild, and often transient:

• Diarrhea
• Gas
• Stomach distention
• Stomach discomfort

The above are not cause for concern unless severe enough to be disruptive.

Rarely some individuals pass blood in stools. If this happens, treatment should end until a doctor can be consulted.

As mentioned above this product sometimes causes severe diarrhea. If experienced treatment should end until a doctor can be consulted. Patients experiencing diarrhea should take care to stay hydrated. Diarrhea and dehydration concerns are largely why this product is not recommended in children.