WHAT IS THIS MEDICINE?
Constella contains linaclotide, a locally acting guanylate
cyclase-C (GC-C) receptor agonist. It works inside the gut — increasing fluid
secretion into the intestine, speeding bowel transit, and reducing abdominal
pain and bloating. It is indicated for moderate to severe irritable bowel
syndrome with constipation (IBS-C) in adults.
Also used for chronic idiopathic constipation, refractory
constipation and opioid induced constipation
2. HOW TO TAKE THIS MEDICINE
Chronic idiopathic constipation, refractory: 145mcg once
daily, if inadequate after one month, increase to a max 290 mcg once daily.
Irritable bowel syndrome with constipation: 290 mcg once
daily
Opioid-induced constipation, refractory: 145 mcg once daily.
Treatment response
should be assessed after 4 weeks; continue only if there is a meaningful
benefit.
3. POSSIBLE SIDE EFFECTS
Common side effects include the following. Contact your
doctor or pharmacist if any side effect worries you.
|
Side Effect |
Frequency |
What To Do |
|
Diarrhoea |
Very common |
Most common reason for stopping; reduce dose or
stop if severe |
|
Abdominal pain |
Common |
Usually improves as treatment continues |
|
Flatulence |
Common |
Dietary adjustment may help |
|
Headache |
Uncommon |
Usually mild and transient |
|
Gastroesophageal reflux |
Uncommon |
Take medicine before first meal as directed |
|
Severe diarrhoea |
Uncommon |
Stop and seek medical advice; rehydrate |
|
Hypokalaemia |
Rare |
Monitor electrolytes if severe diarrhoea occurs |
|
⚠ IMPORTANT WARNING |
|
Constella is contraindicated in children under 2
years and should NOT be used in patients with known or suspected mechanical
gastrointestinal obstruction. Severe diarrhoea can lead to dehydration — stop
and seek medical help if diarrhoea becomes severe. |
4. WHO SHOULD NOT TAKE THIS MEDICINE
Contraindicated in patients under 2 years, gastrointestinal
obstruction, severe diarrhoea, and known hypersensitivity to linaclotide. Not
for use in pregnancy or breastfeeding without specialist advice.
5. DRUG INTERACTIONS
No clinically significant drug-drug interactions have been
established, as linaclotide acts locally in the gut and is not absorbed
systemically. However, avoid concomitant use with other laxatives (increased
diarrhoea risk) and inform your doctor of all medicines.
6. HOW TO STORE
Store below 30°C in original bottle with the desiccant
capsule included — moisture reduces effectiveness. Keep tightly closed. Do not
remove the desiccant from the bottle. Keep out of reach of children.
7. PRESCRIPTION STATUS
Prescription Only Medicine (POM). Initiation by a
gastroenterologist or physician with experience in IBS management.
|
💚 PATIENT TIP |
|
Take Constella on an empty stomach, 30 minutes
before breakfast — this is when it works best. Eating before taking the
capsule reduces its efficacy. If diarrhoea is troublesome, try taking it
slightly later (closer to the 30-minute mark rather than earlier). |
8. PHARMACIST'S NOTE
Counsel patients that diarrhoea is common in the first 2
weeks of treatment and typically improves. If severe diarrhoea occurs, patients
should stop the medication and seek medical review. The desiccant in the bottle
must remain inside — removal reduces shelf-life significantly.
9. FREQUENTLY ASKED QUESTIONS
|
FREQUENTLY ASKED QUESTIONS |
|
Q: What is IBS-C? A: Irritable bowel syndrome with constipation
(IBS-C) is a functional gut disorder causing abdominal pain, bloating, and
chronic constipation that significantly affects quality of life. |
|
Q: How long before I see
results? A: Some patients notice improvement in bowel
habits within the first week. Abdominal pain and bloating may take 2–4 weeks
to improve. Continue for at least 4 weeks before deciding if it is working. |
|
Q: What if I get severe
diarrhoea? A: Stop the medication and contact your doctor.
Drink plenty of fluids to replace what is lost. Your doctor may advise
restarting at a lower dose once diarrhoea resolves. |
|
Q: Is Constella suitable
for long-term use? A: Clinical trials support up to 12 months of
continuous use. Beyond this, your doctor will reassess the need for ongoing
treatment. |
|
Q: Why must I keep the
desiccant in the bottle? A: Linaclotide capsules degrade rapidly in
humid conditions. The desiccant absorbs moisture and protects the capsules
from premature breakdown. |