Drug Interaction Report

The concomitant use of linaclotide with proton pump inhibitors, laxatives, or nonsteroidal anti-inflammatory drugs may increase the risk of diarrhea. The clinical significance is unknown.

ADJUST DOSING INTERVAL: Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa.

Food taken in conjunction with oral iron supplements may reduce the bioavailability of the iron. However, in many patients intolerable gastrointestinal side effects occur necessitating administration with food.

MANAGEMENT: Ideally, iron products should be taken on an empty stomach (i.e., at least 1 hour before or 2 hours after meals), but if this is not possible, administer with meals and monitor the patient more closely for a subtherapeutic effect. Some studies suggest administration of iron with ascorbic acid may enhance bioavailability. In addition, administration of oral iron products and some oral medications should be separated whenever the bioavailability of either agent may be decreased. Consult the product labeling for specific separation times and monitor clinical responses as appropriate.

ADJUST DOSING INTERVAL: Administration of linaclotide in the fed condition resulted in more gastrointestinal side effects and more frequent and looser stools, than when it was administered under fasting conditions.

MANAGEMENT: It is recommended to take linaclotide 30 minutes before a meal.