Linzess use in the evening

[mrcasjen]

I have just been prescribed Linzess for my chronic C, it is so bad right now I can't eat without pain, seriously impacted throughout my colon.  I do not want to take it during the day due to my work schedule.  I am thinking I could take it when I get off work at 4pm since we don't eat till the earliest 5 but sometimes as late as 7.  My stomach should be empty since I won't eat since lunch.  I don't go to bed till around 10pm so should have plenty of time to clean out.  Thoughts on whether this would be ok to do or not?

[Jeffrey Roberts]

My hunch is that it isn't so fast acting and you will likely have to build up some tolerance to it for 1 week before getting into a regular schedule. I have heard that you may have some D during the first week of use.

Let me try and ask a doctor for you.

[Jeffrey Roberts]

As a follow-up, a gastroenterologist that I asked seemed to feel that your plan is sound and is ok.

Please let us know how you are doing.

[Cheryl]

I have been taking 73 mg of Linzess for a week. So far, I still don't have much bowel movement. But all my pain has stopped. Do you think taking this product at night wold be more effective than in the morning?

[annie7]

hi-- there are ways of tweaking linzess.  one of my gastro docs has done research and has run clinical trials on linzess.  he told me that linzess works on the same receptors that food does.  so generally, the closer you take it to eating a meal, the  quicker linzess works.  it also might give you more diarrhea this way--which, depending on your point of view, may or may not be desirable. when i had constipation problems, i always preferred D to  C.  but that's me.

 and conversely, the more time that elapses between taking linzess and eating, the less D you get.  so if you're getting too much D, try taking it an hour before breakfast instead of a  half hour before as prescribed.  you'll probably have less D that way.  some people even  take it  two hours before eating or at night, on an empty stomach, before they go to bed.  

it's all in experimenting and finding out what works best for you.  

and of course, you could always try the higher doses--145 mcg or 290 mcg.

good luck. hope you can get it to work for you.

[Titus]

Hello, 

I have not been on Linzess that long (5 days).  Mornings are pretty good -- there is some diarrhea but I can deal with it.  During the afternoon and evening my bloating and pain increase starting at 2:00.  It is difficult to sleep.  Would taking the Linzess in the evening help with this?  Another possibility is half hour before dinner even.  Perhaps there is no way to know the answer without trying.  Any input appreciated.  Thank you

[MissKateGB]

Hello, 

I am prescribed the highest dosage. This is the 2nd time I am being given this medication. I cannot seem to find the right combination of its usage, as all this medication does for me is bloat me and makes me incredibly tired and irritable. My stomach expands and I get incredibly bloated and uncomfortable, with feeling hot and cold. I at times waddle from how badly I am swollen. I've taken it right as I wake up, I've taken it a few hours after waking up, before food, after food, during food, same results. Can someone please tell me the most effective way to take this medication, as I have been incredibly uncomfortable for years now (had three ulcers removed from the stomach recently, in addition to IBS C). I miss wearing jeans. 

 

Thank you,

Kate

 

[Jeffrey Roberts]

It sounds like you have tried a great deal of combinations.

Have you tried spacing out the total daily dosage throughout the day to see if that helps with the bloating?

[MissKateGB]

Hi, 

Thank you for your response. I am on just one pill a day, the highest dosage (290 I think?) so I am not quiet sure as to how to space it out through out the day. Do you mean to take them at different times?

 

Kate

 

[Jeffrey Roberts]

I thought perhaps you were using a smaller size, taken 2 (145 mcg) or 4 (72 mcg) times daily rather than a single 290 mcg capsule

I read that you can open the capsules if all you have are 290 mcg capsules.

 

Quote

 

There's more than one way to take LINZESS. Now adult patients who have trouble swallowing capsules can open the LINZESS capsule and 1:

• • Sprinkle on applesauce, or
  • Add to water, or
  • Mix with water and administer via a nasogastric or gastrostomy tube

 

Here's what I read about common reactions so you might benefit from taking smaller doses throughout the day.

Common Adverse Reactions (incidence ≥2% and greater than placebo)

• In IBS-C clinical trials: diarrhea (20% vs 3% placebo), abdominal pain (7% vs 5%), flatulence (4% vs 2%), headache (4% vs 3%), viral gastroenteritis (3% vs 1%) and abdominal distension (2% vs 1%).
• In CIC trials of a 145 mcg dose: diarrhea (16% vs 5% placebo), abdominal pain (7% vs 6%), flatulence (6% vs 5%), upper respiratory tract infection (5% vs 4%), sinusitis (3% vs 2%) and abdominal distension (3% vs 2%). In a CIC clinical trial of a 72 mcg dose: diarrhea (19% vs 7% placebo) and abdominal distension (2% vs <1%).

[MissKateGB]

Hm. I am usually rather weary of splitting pills into two as I am always afraid that it either wont work or I will somehow mess it up haha. I am also on Pantoprazole, which I suppose somehow balances out the pain and suffering. I checked yesterday and Linzess had me walking around with 3lbs of water weight which is also why I was so uncomfortable. Today my stomach feels like there are bruises on the inside from the medication.

[Jeffrey Roberts]

Pantoprazole is a PPI for upper GI acid and pain, so not sure the Linzess and Pantoprazole are dealing with the same thing.

[MissKateGB]

They are not, but most certainly are reacting to each other. Perhaps I can experiment with Linzess just every other day? I am afraid to take it at this point as it severely interferes with my life and entire body. Any further suggestions would be greatly appreciated. 

 

Thank you.

[Dee]

Hello, I was on Linzess and had my dosage lowered due to being in it a week and still having Diarrhea throughout the day. It is almost impossible for me to take Linzess in the AM due to my schedule. And I was taking it before I started my day. I ended up getting off of it. So it has been quite a few months. I am afraid to take it during the day. Is it not good to take it at night? I started back on it and have been taking it at night. And it has me going but I am in the bathroom off and on for about three hours. I am almost afraid to take it again in the AM. 

[Jll]

I have been on Linzess 72mcg for about a year.  I only take when I get bloated as I do go with out the linzess but I do not eliminate enough.  (About 3 times a week)  lately I am feeling like I need it more often.  I have stomach cramping at night and the urge to go but cant.  I hate taking pharmaceuticals.  Does or has  anyone else only taken it as need?  Do you find yourself more constipated on the days you do not take it? 

[Nicole]

I take the 290mcg dose daily. The only way I can take it is taking it at 1 AM so that it does it work overnight. If I take it in the morning, I am left bloated and miserable for hours during the day.

[Caroline77]

I take 290mg dosage at 450-515am bc I work at 730 and it works 85% of the time. On the days I go in later in the day or am off work I still take it at same time but I go back to sleep til730/8a. I find that if I lay down or go back to sleep I have no BM and end up with the severe bloating and CC. Is there any evidence that you need to stay awake or up and moving after taking? I see people take it in the middle of the night or before bed and it wakes when they get up. That’s def not the case for me. I know everyone’s bodies are different and react differently. I just wondered if anyone had experienced it not working if you lay

down or go back to sleep after taking. Any comments or suggestions are much appreciated! Thanks:)

[Jeffrey Roberts]

That's interesting. I don't think I have ever been asked the question about whether you need to be awake or moving after talking Linzess. I have to think that it doesn't make a difference.

This is what the drug label says about administering it. Sometimes the label indicates that you must be sitting up or do not lie down after taking a medication. That's not the case here.

 

0. 2.2 Preparation and Administration Instructions

   • Take LINZESS on an empty stomach, at least 30 minutes prior to the first meal of the day

   • If a dose is missed, skip the missed dose and take the next dose at the regular time. Do not take 2 doses at the same time.

   • Do not crush or chew LINZESS capsule or capsule contents.

   • Swallow LINZESS capsule whole.

   • For adult patients with swallowing difficulties, LINZESS capsules can be opened and

     administered orally in either applesauce or with water or administered with water via a nasogastric or gastrostomy tube. Sprinkling of LINZESS beads on other soft foods or in other liquids has not been tested.

     Oral Administration in Applesauce:

    1. Place one teaspoonful of room-temperature applesauce into a clean container.

2. Open the capsule.

3. Sprinkle the entire contents (beads) on applesauce.

4. Consume the entire contents immediately. Do not chew the beads. Do not store the

   bead-applesauce mixture for later use.

Oral Administration in Water:

1. Pour approximately 30 mL of room-temperature bottled water into a clean cup.

2. Open the capsule

3. Sprinkle the entire contents (beads) into the water

4. Gently swirl beads and water for at least 20 seconds.

5. Swallow the entire mixture of beads and water immediately.

6. Add another 30 mL of water to any beads remaining in cup, swirl for 20 seconds, and

   swallow immediately.

7. Do not store the bead-water mixture for later use.

Note: The drug is coated on the surface of the beads and will dissolve off the beads into the water. The beads will remain visible and will not dissolve. Therefore, it is not necessary to consume all the beads to deliver the complete dose.

Administration with Water via a Nasogastric or Gastrostomy Tube:

1. Open the capsule and empty the beads into a clean container with 30 mLof room-

   temperature bottled water.

2. Mix by gently swirling beads for at least 20 seconds

3. Draw-up the beads and water mixture into an appropriately sized catheter-tipped

   syringe and apply rapid and steady pressure (10 mL/10 seconds) to dispense the

   syringe contents into the tube.

4. Add another 30 mL of water to any beads remaining in the container and repeat the

   process

5. After administering the bead-water mixture, flush nasogastric/ gastrostomy tube with a

   minimum of 10 mL of water.

Note: It is not necessary to flush all the beads through to deliver the complete dose.

https://media.allergan.com/actavis/actavis/media/allergan-pdf-documents/product-prescribing/Final_labeling_text_10-2018-AR-updates-LINZESS-clean.pdf

 

[Lisalivinlife13]

How does Linzess affect other meds being absorbed? I take other meds for lupus and hypothyroid and other....how should I time my other meds with Linzess?

[Jeffrey Roberts]

Maybe use this link to look for Drug Interactions:

https://www.webmd.com/interaction-checker/default.htm

[Brenda.diaz0886]

Hi I just started 145. Linzess however I don't eat breakfast , I only drink coffee with a splash of cream. Should I drink it then or before I eat lunch? Please advice this is. My 3rd day but nothing. Just my stomach feels bubbly but that's it .hope it works soon :(

[Luna]

Hello

If I take Linzess at bed or if I take it then sit  and not active it will not work for me at all. The only time it works for me is if I take it after I eat AND have to walk around and be active. 
Then Diarrhea for a few hours .
Then goes away 

[ELA504]

On 3/1/2020 at 6:35 AM, Brenda.diaz0886 said:

Hi I just started 145. Linzess however I don't eat breakfast , I only drink coffee with a splash of cream. Should I drink it then or before I eat lunch? Please advice this is. My 3rd day but nothing. Just my stomach feels bubbly but that's it .hope it works soon :(

Did it ever start working for you? I started this week and was wondering the same thing. Nothing yet.

[delly8134]

I just started Linzess..145. This is my 2nd day. I also have mild to moderate Gastroparesis.  I had to stop taking Senna tea.  Colonoscopy showed some damage due to stimulant laxative.  I'm taking Linzess in the AM and wait almost an hour to have coffee with some coconut cream.  So far it's not working and my abdomen is bloated, like it's been.  I'm 72 yrs.old. .I'll keep on with the Linzess in the morning.  How long do I wait before I try changing the time or taking it with food?

[Tony]

I found that at 3PM I stop eating, At 5PM I take 290LZ, at 5 30 I have dinner, by 8 30 I am cleaning out with loose but pleasant bowl movements.  I also found you tend to need more after a while, so I space it out, maybe Ducolax on Monday, Linzess on Wed, etc,