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-operatively^{1, 2}.

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

  Interaction(s) with Common Anaesthetic Agents

None^{1, 2, 3}.

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

No pharmacokinetic interactions are anticipated^{1, 2}; however, concurrent use of Non-Steroidal Anti-inflammatory drugs (NSAIDs) or proton pump inhibitors (PPIs) with linaclotide may increase the risk of diarrhoea^{2, 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 4^th 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 4^th March 2021]