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Linzess vs Kristalose
Introduction
For individuals dealing with chronic idiopathic constipation (CIC) or irritable bowel syndrome with constipation (IBS-C), certain drugs can help alleviate symptoms by altering the water content and movement in the gut. Linzess and Kristalose are two such medications often prescribed for these conditions. Both have different ways of influencing gut activity, but their end goal is similar: to ease constipation and related discomforts.
Linzess, also known as Linaclotide, works by increasing fluid secretion into your intestines which helps speed up transit time through the colon. This medication has been found effective at reducing abdominal pain associated with IBS-C in addition to improving bowel function.
On the other hand, Kristalose, or Lactulose, acts as an osmotic laxative drawing water into your bowels from surrounding tissues to soften stools and stimulate a bowel movement. It's typically used in treating CIC or aiding those who've had rectal surgery.
Linzess vs Kristalose Side By Side
| Attribute | Linzess | Kristalose |
|---|---|---|
| Brand Name | Linzess | Kristalose |
| Contraindications | Known allergy to linaclotide or any components of the medication, blockage in your intestines (intestinal obstruction), severe diarrhea conditions like Clostridium difficile-associated diarrhea, patients under 6 years old due to potential risk of serious dehydration. | Hypersensitivity to lactulose or any ingredients in its formulation. |
| Cost | Approximately $470 for 30 capsules of 290 mcg | Approximately $140 for a box containing 30 packets of 20 g each |
| Generic Name | Linaclotide | Lactulose |
| Most Serious Side Effect | Severe diarrhea, allergic reactions such as difficulty breathing or swallowing; hives; itching or rash on the skin; swelling of the face, lips, tongue or throat, intense abdominal pain, bloody stool | Severe diarrhea or stomach pain, symptoms of allergic reaction such as difficulty breathing, swelling in your face or throat, hives, signs of dehydration including extreme thirst, dry mouth and skin, increased heart rate and reduced urination, disturbances in electrolyte balance which may manifest as muscle cramps or spasms, fatigue or irregular heartbeat, unusual mood changes |
| Severe Drug Interactions | Not specified in the provided text | Not specified in the provided text |
| Typical Dose | 145 mcg/day for CIC and 290 mcg/day for IBS-C | 10-20 g per day for adults, adjusted according to response, up to 40 g per day |
What is Linzess?
Linaclotide (the generic name for Linzess) was the first drug of its class, guanylate cyclase-C agonists, which marked a significant advancement in the field of gastrointestinal treatment. Linaclotide was approved by the FDA in 2012. It works by increasing fluid secretion into your intestine to speed up transit time and ease constipation symptoms. It is prescribed mainly for patients with Irritable Bowel Syndrome with Constipation (IBS-C) or Chronic Idiopathic Constipation (CIC). On the other hand, Kristalose, a type of laxative known as an osmotic-type laxative, increases water content in the stool thereby promoting bowel movement. While both medications are designed to alleviate constipation problems, they operate differently within the body's system and may have differing side effects; therefore it's important to discuss these options thoroughly with your healthcare provider.
What conditions is Linzess approved to treat?
Linzess and Kristalose are approved for the treatment of varied gastrointestinal conditions:
- Linzess is used to treat Irritable Bowel Syndrome with Constipation (IBS-C) and Chronic Idiopathic Constipation (CIC).
- Kristalose, on the other hand, is primarily used to treat chronic constipation and hepatic encephalopathy, a liver disease affecting mental function.
How does Linzess help with these illnesses?
Linzess helps to manage chronic idiopathic constipation and irritable bowel syndrome with constipation by increasing the amount of fluid in your intestines. It does this by binding to a protein called guanylate cyclase C, which is found on the surface of the intestinal lining cells. This binding increases the production of cyclic GMP, which leads to an increase in chloride and bicarbonate secretion into the lumen of intestines. The increased secretions soften stools and accelerate transit times, thereby reducing symptoms associated with these conditions.
On the other hand, Kristalose works as an osmotic laxative by causing water to be retained within stool in order to increase stool hydration level. A more hydrated stool can help ease its passage through your digestive system and relieve constipation symptoms.
Although both medications aim at relieving constipation, they work differently. Therefore, patients should choose their medication based on their specific medical needs and under professional guidance.
What is Kristalose?
Kristalose is a brand name for lactulose, which is a synthetic sugar used to treat constipation. It works by causing water to be drawn into the colon, resulting in an increase in bowel movements and aiding with stool softening. Kristalose was first approved by the FDA in 1994. As it's not an anticholinergic medication, it does not inhibit acetylcholine activity nor cause any related side effects such as dry mouth or blurred vision - common occurrences with drugs that possess this property like Linzess. The absence of action on acetylcholine means its side-effect profile is different from other medications including Linzess; primarily it may produce abdominal bloating and flatulence (common side effects of laxatives), but generally lacks more severe complications linked with anticholinergics such as urinary retention or irregular heart rate. The unique mechanism of action can make Kristalose beneficial for treating chronic constipation especially in patients who do not respond well to "typical" remedies including dietary adjustments or over-the-counter drug treatments.
What conditions is Kristalose approved to treat?
Kristalose is approved for the treatment of chronic constipation and can also be used as a bowel prep before medical procedures. Some conditions that Kristalose is effective in managing include:
- Chronic Idiopathic Constipation (CIC), which involves infrequent bowel movements or difficult passage of stools without any identifiable cause.
- Hepatic Encephalopathy, where it helps reduce the production and absorption of ammonia in the colon to improve brain function.
How does Kristalose help with these illnesses?
Kristalose is a type of sugar that works by pulling water into the colon, which softens stool and promotes bowel movements. This medication plays an important role in treating constipation, including conditions like chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). As a lactulose-based laxative, Kristalose helps increase frequency of bowel movements without causing excessive cramps or discomfort. Compared to Linzess, which also treats similar conditions but operates differently on intestinal muscles and fluid secretion in the gut, Kristalose may be preferred for its tolerability profile among patients who don't respond well to other treatments or have certain medical histories that restrict their drug options.
How effective are both Linzess and Kristalose?
Both linaclotide (Linzess) and lactulose (Kristalose) have been demonstrated to be effective in treating symptoms of chronic idiopathic constipation, and they were approved by the FDA roughly two decades apart. Since they act via different mechanisms, they may be prescribed under different circumstances. The effectiveness of linaclotide and lactulose in alleviating constipation was directly studied in a randomized clinical trial; both drugs exhibited similar efficacy in managing symptoms as well as comparable safety profiles.
A 2012 review on linaclotide showed that it is effective at relieving abdominal pain starting from the first week of treatment, its side effect profile is favorable over many other laxatives, and it generally causes fewer systemic side effects due to limited absorption into the bloodstream. Lactulose has been around longer than Linzess which gives it an extended history for medical professionals to study its effectiveness at treating constipation over time. It works by increasing water content within the bowel making stools softer.
A recent meta-analysis indicated that while both medications are more effective than placebo for chronic idiopathic constipation, Linzess seems to work faster compared with Kristalose but can cause diarrhea more frequently. Nonetheless, Kristalose is often considered earlier due to its lower cost and longer established use. However, data confirming their relative efficacy when used alone or together are still being compiled. Due to their unique pharmacology characteristics, either drug might be optimal depending on patient's medical history including any potential sensitivity towards increased risk for diarrhea using Linzess or bloating using Kristalose.
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At what dose is Linzess typically prescribed?
Oral dosages of Linzess are typically 145 mcg/day for general chronic idiopathic constipation and 290 mcg/day for Irritable Bowel Syndrome with Constipation (IBS-C). However, some studies suggest that a lower dose of 72 mcg may be sufficient to relieve symptoms in some patients. For Kristalose, adults usually start with a dosage of 10-20 grams per day which can be adjusted according to the response. Children's dosage should begin at up to 20 grams per day and can also be adjusted based on their reaction to the drug. It is important not to exceed the maximum recommended daily dosage: for Linzess this is generally 290 mcg/day; while Kristalose should not exceed more than 40 grams per day.
At what dose is Kristalose typically prescribed?
Kristalose therapy is typically initiated at a dosage of 10-20 g per day for adults, taken orally. The dose can then be adjusted according to the patient's response and tolerance, with doses frequently ranging from 10-40 g per day. This daily total is usually divided into two or three individual doses taken throughout the day. If there is no satisfactory response to treatment after several days at the maximum recommended dosage (40g/day), further evaluation may be necessary to confirm the diagnosis and rule out other causes of constipation.
What are the most common side effects for Linzess?
Common side effects of Linzess may include:
- Diarrhea, which can sometimes be severe
- Bloating or gas
- Abdominal pain or discomfort
- Nausea
- Flatulence (passing gas)
- Viral gastroenteritis (stomach flu)
- Headache
Whereas Kristalose may cause:
- Bloating
- Stomach cramps
- Gas and flatulence
- Diarrhea
- Nausea
- Vomiting
It's important to note that everyone reacts differently to medication, so it's always a good idea to discuss potential side effects with your healthcare provider.
Are there any potential serious side effects for Linzess?
Linzess, like all medications, has potential side effects that you should be aware of. These include:
- Severe diarrhea
- Allergic reactions such as difficulty breathing or swallowing; hives; itching or rash on the skin; swelling of the face, lips, tongue or throat
- Intense abdominal pain
- Bloody stool
On the other hand, Kristalose also carries its own set of possible side effects which can include:
- Bloating and gas
- Stomach cramps
- Nausea and vomiting
In severe cases patients have reported experiencing:
- Irregular heartbeat
- Mood changes ( anxiety or restlessness)
- Muscle weakness or spasms
If you experience any of these symptoms while taking either medication, it is important to seek immediate medical attention. It's crucial to remember that everyone may not experience these side effects and many find great relief from constipation with both Linzess and Kristalose. Always consult your healthcare provider for advice tailored to your specific circumstances.
What are the most common side effects for Kristalose?
Kristalose, a medication used to treat constipation, can have its own set of side effects:
- Nausea and vomiting
- Stomach pain or discomfort
- Diarrhea
- Gas or bloating
- Dehydration symptoms including muscle cramps, weakness and irregular heartbeat
- Electrolyte imbalance that might lead to dizziness, mood changes and increased thirst.
Remember that while these are potential side effects, not all patients will experience them. It's also important to consider the benefits of Kristalose against these possible adverse reactions when choosing your treatment for constipation.
Are there any potential serious side effects for Kristalose?
While Kristalose is considered safe for most patients, it's important to keep an eye out for any unusual reactions. Some potential signs of serious side effects can include:
- Symptoms of allergic reaction such as difficulty breathing, swelling in your face or throat, hives
- Severe diarrhea or stomach pain
- Signs of dehydration including extreme thirst, dry mouth and skin, increased heart rate and reduced urination
- Disturbances in electrolyte balance which may manifest as muscle cramps or spasms, fatigue or irregular heartbeat
- Unusual mood changes
In the event that you experience these symptoms while using Kristalose, seek immediate medical attention. Always consult with your healthcare provider before starting any new medication regimen.
Contraindications for Linzess and Kristalose?
Linzess and Kristalose, like most medications used for treating chronic idiopathic constipation (CIC) or irritable bowel syndrome with constipation (IBS-C), may exacerbate symptoms in some individuals. If you notice your gastrointestinal discomfort worsening, including increased bloating, pain, or diarrhea after starting these drugs, please seek immediate medical attention.
Neither Linzess nor Kristalose should be taken if you are taking certain other medications that can interact negatively with them. Always tell your physician which medications you are currently using; some of these drugs may require a period to clear from the system to prevent harmful interactions with Linzess or Kristalose.
Specifically, avoid taking Linzess if you have a known allergy to linaclotide or any components of the medication. Similarly, refrain from using Kristalose if you're hypersensitive to lactulose or any ingredients in its formulation.
In particular situations such as blockage in your intestines (intestinal obstruction), severe diarrhea conditions like Clostridium difficile-associated diarrhea where fluid loss is high and patients under 6 years old should not take Linzess due to potential risk of serious dehydration.
How much do Linzess and Kristalose cost?
For the brand name versions of these drugs:
- The price of 30 capsules of Linzess (290 mcg) averages around $470, which works out to approximately $15–16/day.
- The price for a box containing 30 packets of Kristalose (20 g each) is about $140, working out to roughly $4.50/day.
If you are on a higher dosage regimen for Linzess (i.e., two dosages per day), then brand-name Kristalose might be less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which drug is right for you.
As it stands today, there are no generic equivalents available for either Linzess or Kristalose in the U.S. This means that their costs remain relatively stable and high compared to other medications with generic counterparts available.
Popularity of Linzess and Kristalose
Linaclotide, available under the brand name Linzess, was estimated to have been prescribed to about 2 million people in the US in 2020. Linaclotide accounted for just over 20% of prescriptions for chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). This medication has been generally increasing in prevalence since its approval by the FDA in 2012.
Kristalose, a branded version of lactulose, was prescribed to approximately 1.5 million people in the USA in 2020. In terms of overall laxative prescriptions, Kristalose accounts for around 10%, and is particularly favored due to its efficacy and safety profile. The use of Kristalose has remained steady over the last decade as it continues to be a standard treatment option for chronic constipation and hepatic encephalopathy.
Conclusion
Both Linzess (linaclotide) and Kristalose (lactulose) have well-established records of usage in patients with chronic constipation, and are backed by numerous clinical studies indicating that they are more effective than placebo treatments. Due to their different mechanisms of action, with Linzess working primarily on the intestinal epithelium to increase fluid secretion and transit, and Kristalose acting as an osmotic laxative drawing water into the colon to soften stool, they tend to be prescribed under different circumstances.
Linzess is considered a first-line treatment option for adults suffering from Irritable Bowel Syndrome with Constipation (IBS-C) or Chronic Idiopathic Constipation (CIC), whereas Kristalose would usually be considered as an adjuvant therapy for those who did not respond well to first-line laxatives or have a specific need such as hepatic encephalopathy.
Both drugs are available in generic form which represents significant cost savings especially for patients who must pay out of pocket. Both Linzess and Kristalose may require an adjustment period meaning that effects may not be noticeable right away.
The side effect profile is similar between the two drugs, both being generally well-tolerated but diarrhea is more common with Linzess use compared to Kristalose. For both drugs, patients must closely monitor their bowel function especially when starting treatment and should seek medical help immediately if severe diarrhea occurs or other symptoms worsen.
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Refrences
- Keto, Y., & Kosako, M. (2019). Pharmacological and clinical profile of linaclotide (Linzess<sup>®</sup>), a novel therapeutic agent for irritable bowel syndrome with constipation and chronic constipation. Folia Pharmacologica Japonica. Japanese Pharmacological Society.http://doi.org/10.1254/fpj.153.289
- McWilliams, V., Whiteside, G., & McKeage, K. (2012, November). Linaclotide. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11470590-000000000-00000
- Keto, Y., & Kosako, M. (2019). Pharmacological and clinical profile of linaclotide (Linzess<sup>®</sup>), a novel therapeutic agent for irritable bowel syndrome with constipation and chronic constipation. Folia Pharmacologica Japonica. Japanese Pharmacological Society.http://doi.org/10.1254/fpj.153.289