Linaclotide Dosing Calculator

Dose

290 mcg once daily

Frequency

Once daily on empty stomach

Duration

Ongoing

Route

Oral

FDA-approved dose for IBS-C; taken 30 minutes before first meal of the day

Dose

145 mcg once daily

Frequency

Once daily on empty stomach

Duration

Ongoing

Route

Oral

FDA-approved dose for CIC; some patients prefer this lower dose even for IBS-C to reduce diarrhea

Dose

72 mcg once daily (increasing as tolerated)

Frequency

Once daily on empty stomach

Duration

Ongoing

Route

Oral

Community-discussed approach of starting at lowest dose and titrating up to manage diarrhea side effect

Dose

145 mcg orally once daily on an empty stomach. A 72 mcg dose is also available for patients who have difficulty tolerating the 145 mcg dose.

Frequency

Once daily oral capsule

Duration

Ongoing as needed for symptom management

72 mcg dose approved for CIC patients who cannot tolerate 145 mcg. Both doses should be taken on an empty stomach at least 30 minutes before first meal.

How much bacteriostatic water should I add to a 5 mg vial of Linaclotide?

The community standard is 2 mL of bacteriostatic water for a 5 mg Linaclotide vial. That gives a concentration of 2.50 mg/mL, so a 290 mcg dose is 11.6 units on a U-100 insulin syringe. Adding 1 mL instead doubles the concentration to 5.00 mg/mL and halves the draw to 5.8 units. Less water = smaller injection volume but harder to measure precisely.

How many syringe units is a 290 mcg dose of Linaclotide?

On a standard U-100 insulin syringe, a 290 mcg dose of Linaclotide is 11.6 units when the 5 mg vial is reconstituted with 2 mL of bacteriostatic water (2.50 mg/mL). If you use 1 mL of bac water instead, draw 5.8 units (5.00 mg/mL).

What is the standard Linaclotide dose?

Clinical protocols for Linaclotide typically use 290 mcg–30 mcg once daily via subcutaneous injection. 290 mcg is a common starting dose. Swallow capsule whole; do not break or chew. May also be opened and sprinkled on applesauce or administered via nasogastric tube in water. Take consistently at least 30 minutes before first meal.

How long does a vial of Linaclotide last at 290 mcg once daily?

A 5 mg vial of Linaclotide contains roughly 17 doses at 290 mcg per injection. At once daily dosing, that is approximately 17 days (about 2 weeks) of supply per vial. Reconstituted Linaclotide should generally be used within 28 days when refrigerated.

Where do you inject Linaclotide?

Linaclotide is typically administered subcutaneously. Common subcutaneous sites are the lower abdomen (at least an inch from the navel), the outer thigh, and the love handles. Rotate sites with each injection to reduce localized irritation and bruising.

Can I use sterile water instead of bacteriostatic water for Linaclotide?

Bacteriostatic water (containing 0.9% benzyl alcohol as a preservative) is strongly preferred for multi-dose vials like Linaclotide because it inhibits microbial growth and lets a single vial be used over multiple weeks. Sterile water has no preservative and should generally be reserved for single-use preparations only.