Linaclotide


 

  Issues for Surgery


Exacerbation of irritable bowel syndrome and constipation if omitted.


  Advice in the Perioperative period


Elective and Emergency Surgery
Continue.

Consider checking U&E’s pre-operatively if patient reports severe diarrhoea.

Post-operative Advice
Restart post-operatively once enteral intake resumed.

Review if patient develops reduced gastrointestinal motility (e.g. ileus) post-operatively1, 2.

Patients undergoing Colorectal Surgery
Review the need for linaclotide post-operatively.


  Interaction(s) with Common Anaesthetic Agents


None1, 2, 3.


  Interaction(s) with other Common Medicines used in the Perioperative Period


No pharmacokinetic interactions are anticipated1, 2; however, concurrent use of Non-Steroidal Anti-inflammatory drugs (NSAIDs) or proton pump inhibitors (PPIs) with linaclotide may increase the risk of diarrhoea2, 3.  Caution is advised in patients who are also prescribed oral medications with a narrow therapeutic range as absorption may be affected2.


  Further Information


None relevant.


  References


  1. Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 4th March 2021]
  2. Summary of Product Characteristics – Constella® (linaclotide) 290micrograms hard capsules. Allergan Ltd. Accessed via www.medicines.org.uk 04/03/2021 [date of revision of the text September 2020]
  3. Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 4th March 2021]