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Linzess vs Motegrity
Introduction
For individuals suffering from chronic constipation or irritable bowel syndrome with constipation (IBS-C), certain drugs that alter the function of the intestines can help in alleviating discomfort and managing symptoms. Linzess and Motegrity are two such medications prescribed for these conditions. They each influence different mechanisms within the gastrointestinal system, but both aid in relieving constipation.
Linzess is classified as a guanylate cyclase-C agonist which works by increasing fluid secretion into your intestine to ease stool passage. On the other hand, Motegrity is identified as a selective serotonin 5-HT4 receptor agonist—it enhances movement through your digestive tract by stimulating muscle contractions that propel stools along.
Linzess vs Motegrity Side By Side
| Attribute | Linzess | Motegrity |
|---|---|---|
| Brand Name | Linzess | Motegrity |
| Contraindications | Bowel blockage (intestinal obstruction), caution in patients with liver disease or kidney disease | Bowel blockage (intestinal obstruction), caution in patients with liver disease or kidney disease |
| Cost | $472 for 30 capsules (145 mcg) | $418 for 30 tablets (2 mg) |
| Generic Name | Linaclotide | Prucalopride |
| Most Serious Side Effect | Severe diarrhea causing lightheadedness and fainting | Signs of an allergic reaction such as hives, difficulty breathing, swelling around your face or throat |
| Severe Drug Interactions | Not specifically mentioned, but it's important to inform your doctor about all medications and health supplements you are taking. | Not specifically mentioned, but it's important to inform your doctor about all medications and health supplements you are taking. |
| Typical Dose | 72-290 mcg/day, commonly 145 mcg/day | 2 mg per day, up to 4 mg/day if no improvement |
What is Linzess?
Linaclotide (the generic name for Linzess) was the first drug of the class of guanylate cyclase-C agonists, which marked a significant progression from former classes of drugs used to treat gastrointestinal disorders. Linaclotide was first approved by the FDA in 2012. Linzess works by increasing levels of cyclic GMP in intestinal lining cells, leading to increased fluid and accelerated transit in the intestines. It is prescribed primarily for individuals suffering from irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC). Unlike other medications that may have broad effects on body systems, Linzess has a localized effect within your gut with minimal systemic exposure.
On the other hand, Prucalopride (the generic name for Motegrity), is a serotonin-4 receptor agonist that stimulates colonic peristalsis, increasing bowel motility. This drug is also utilized to treat chronic idiopathic constipation and was approved by FDA later than linaclotide in 2018. Both are effective treatments but they work differently; therefore their side-effect profiles vary as well.
What conditions is Linzess approved to treat?
Linzess is approved for the treatment of different gastrointestinal disorders:
- Chronic Idiopathic Constipation (CIC)
- Irritable Bowel Syndrome with Constipation (IBS-C)
- Opioid-induced constipation in adult patients with chronic non-cancer pain.
How does Linzess help with these illnesses?
Linzess works 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 the guanylate cyclase C receptor found on the lining of your intestines, leading to an increase in cyclic guanosine monophosphate (cGMP). This cGMP then triggers a series of events that result in accelerated intestinal transit and increased fluid secretion into the intestine. The end result is softer, easier-to-pass stools and relief from abdominal pain. Like serotonin for depression, maintaining higher levels of cGMP can limit discomfort associated with these conditions and help patients manage their symptoms more effectively.
What is Motegrity?
Motegrity, also known as prucalopride, is a serotonin 5-HT4 receptor agonist. This means that it stimulates the action of serotonin at these specific receptors in the gut, enhancing colonic motility and thus helping to alleviate constipation. Prucalopride was approved by the FDA in 2018.
Unlike linzess (linaclotide), which acts by increasing fluid secretion into your intestines to help speed up stool transit time, Motegrity works primarily through stimulating muscle movement in the colon. Its mode of action does not involve an effect on serotonin reuptake; therefore its side-effect profile differs from drugs like Linzess that influence fluid secretion.
One key benefit is that Motegrity can be effective for chronic idiopathic constipation - those cases where no obvious cause can be identified even after extensive testing - especially when patients have failed other treatments. Common side effects include headache and abdominal pain but serious adverse effects are rare.
What conditions is Motegrity approved to treat?
Motegrity (prucalopride) is a medication that's been approved by the FDA for certain digestive disorders. The conditions Motegrity can help with include:
- Chronic idiopathic constipation (CIC), where it aids in improving bowel movements and relieving symptoms.
- Irritable Bowel Syndrome with Constipation (IBS-C), where it helps to alleviate abdominal pain and improve stool consistency.
How does Motegrity help with these illnesses?
Motegrity, also known as prucalopride, is a highly selective serotonin type 4 (5-HT4) receptor agonist that stimulates colonic peristalsis, thereby increasing bowel motility. This process enhances the frequency of bowel movements and reduces the symptoms associated with chronic idiopathic constipation.
Unlike Linzess which works by drawing water into your intestines to speed up stool passage, Motegrity primarily functions by stimulating the natural contractions of the colon muscles to push food through more effectively. This direct action on intestinal muscle contractions makes it an effective choice for those who have not responded adequately to other treatments such as Linzess or over-the-counter options. It's worth noting that while both medications are designed to alleviate constipation symptoms, they work in fundamentally different ways and may therefore be more suitable for certain individuals based on their specific needs.
How effective are both Linzess and Motegrity?
Both Linaclotide (Linzess) and Prucalopride (Motegrity) have established histories of success in treating patients with chronic idiopathic constipation and irritable bowel syndrome with constipation. They were initially approved by the FDA within a few years of each other, Linzess in 2012 and Motegrity in 2018. Since they act on different receptors, they may be prescribed under different circumstances. The effectiveness of Linzess and Motegrity in alleviating symptoms was directly studied; both drugs exhibited similar efficacy as well as promising safety profiles.
A comprehensive review on linaclotide demonstrated that it is effective at relieving abdominal pain starting from the first week of treatment, improving stool frequency, consistency, and straining associated with chronic idiopathic constipation or irritable bowel syndrome with constipation. Further studies report that linaclotide has become one of the most widely prescribed drugs for these conditions due to its effectiveness.
On the other hand, prucalopride seems to be more effective than placebo in improving bowel movement frequency according to a 2014 meta-analysis study. Nonetheless, prucalopride is typically considered only after initial treatments such as lifestyle modifications or over-the-counter remedies fail to alleviate symptoms effectively enough for patient satisfaction. Besides increasing stool frequency significantly better than placebo during clinical trials lasting up to twelve weeks long, prucalopride also showed good overall tolerability without any significant cardiovascular side effects compared to placebo among patients suffering from severe chronic constipation.
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At what dose is Linzess typically prescribed?
Oral dosages of Linzess range from 72-290 mcg/day, with studies showing that 145 mcg/day is often sufficient for treating chronic idiopathic constipation and irritable bowel syndrome with constipation in most adults. On the other hand, Motegrity should be started at a dose of 2 mg once daily. If there is no response after a few weeks, the dosage can be increased to up to 4 mg/day under doctor's supervision. It's important to note that these medications are not intended for use by children or adolescents and maximum dosage should not be exceeded in any case.
At what dose is Motegrity typically prescribed?
Motegrity treatment generally starts at a dosage of 2 mg per day. This dose is typically administered once daily, and it can be taken without regard to the timing of meals. For patients with insufficient symptom control or tolerance issues, the dose may be adjusted according to individual patient response. The maximum recommended dose is 4 mg per day, which may be tested if there's no improvement in symptoms after several weeks on the initial dosage regimen. As always, any changes in medication dosages should only take place under the guidance of your healthcare provider.
What are the most common side effects for Linzess?
Common side effects of Linzess include:
- Diarrhea
- Abdominal pain, bloating, and discomfort
- Flatulence (excessive gas)
- Viral gastroenteritis (stomach flu symptoms like nausea or vomiting)
- Headache
- Heartburn
On the other hand, Motegrity may also cause side effects such as:
- Headache
- Abdominal pain
- Nausea
- Diarrhea -Dizziness -Fatigue
Both these medications are used to treat constipation predominant irritable bowel syndrome and chronic idiopathic constipation. Always consult with your healthcare provider for advice about potential side effects before taking any medication.
Are there any potential serious side effects for Linzess?
While taking Motegrity, certain side effects can occur that may need immediate medical attention. These include:
- Symptoms of an allergic reaction such as difficulty breathing or swelling in your face or throat
- Severe stomach pain or bloating, which could be indicative of a blockage in your intestines
- Diarrhea causing lightheadedness and fainting
- Increased heart rate and chest palpitations
- Unusual mood swings, including feelings of depression or thoughts about self-harm
- Red or purple skin rash with blistering and peeling indicating severe skin reactions
If you experience any symptoms like these while on Motegrity, it is crucial to seek immediate medical assistance. Always remember to discuss the potential risks and benefits with your healthcare provider before starting any new medication regimen.
What are the most common side effects for Motegrity?
Motegrity, another medication for chronic idiopathic constipation and irritable bowel syndrome, can cause side effects including:
- Headache
- Abdominal pain or discomfort
- Nausea and vomiting
- Bloating and gas
- Diarrhea
- Fatigue or low energy levels
- Dizziness It's important to note that these side effects are generally mild to moderate in nature. However, if they persist or worsen over time, it is crucial to consult a healthcare professional promptly. Motegrity may also increase the risk of suicidal ideation - individuals should be monitored closely for significant changes in mood behavior while on this medication.
Are there any potential serious side effects for Motegrity?
While Motegrity is generally well-tolerated, it may cause some serious side effects in certain cases. If you experience any of the following symptoms while on Motegrity, discontinue use and consult a healthcare professional immediately:
- Signs of an allergic reaction such as hives, difficulty breathing, swelling around your face or throat
- Persistent or severe diarrhea which might result in dehydration
- Unusual lightheadedness, fainting spells or rapid heartbeat indicating low blood pressure
- Severe abdominal pain that does not go away
- Abnormal mood changes including suicidal thoughts or actions
- Confusion resulting from electrolyte imbalance due to excessive diarrhea.
Always remember to discuss these potential side effects with your healthcare provider before starting treatment with Motegrity.
Contraindications for Linzess and Motegrity?
Both Linzess and Motegrity, along with most other medications for constipation-predominant Irritable Bowel Syndrome (IBS-C), may aggravate symptoms in some people. If you notice your IBS-C symptoms worsening or a sudden change in bowel habits that persists over two weeks, seek immediate medical attention.
Neither Linzess nor Motegrity should be taken if you have been diagnosed with a bowel blockage (intestinal obstruction). Inform your doctor about all the medications and health supplements you are currently taking as certain drugs may interact negatively with these medicines. Always consult your healthcare provider before starting new medication to avoid potential harmful drug interactions.
In addition to this, both Linzess and Motegrity require caution when administered to patients suffering from liver disease or kidney disease. Your doctor needs to know if you have any of these conditions prior to prescribing either of these drugs.
How much do Linzess and Motegrity cost?
For the brand name versions of these drugs:
- The cost for 30 capsules of Linzess (145 mcg) averages around $472, which works out to approximately $15.73/day.
- The price of 30 tablets of Motegrity (2 mg) is about $418, working out to roughly $13.93/day.
As such, if you are in the standard dosage range for both medications, then brand-name Motegrity is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you; factors like efficacy and side effects are also crucial.
Currently, there are no generic versions available for either Linzess or Motegrity as they are still under patent protection. Therefore, costs will remain relatively high until their respective patents expire and generic equivalents become available on the market.
Popularity of Linzess and Motegrity
Linaclotide, more commonly known by its brand name Linzess, is a drug primarily prescribed for chronic idiopathic constipation and Irritable Bowel Syndrome with constipation. In 2020, it was estimated that about 2 million prescriptions were made for this medication in the US. This accounted for approximately 20% of prescriptions related to functional gastrointestinal disorders.
Prucalopride or Motegrity, on the other hand, is a newer treatment option introduced as an alternative to linaclotide. It was approved by the FDA at the end of 2018 and has been gaining traction since then. Although exact prescription numbers are not available due to it being relatively new in the market, prucalopride is becoming increasingly popular among patients who do not respond well to linaclotide or other similar drugs.
While both medications have been shown to be effective in treating symptoms associated with these conditions they target different mechanisms within your body's system which could result in varying side effects.
Conclusion
Both Linzess (linaclotide) and Motegrity (prucalopride) are effective treatments for chronic idiopathic constipation and irritable bowel syndrome with constipation, supported by numerous clinical trials demonstrating their efficacy over placebo. Both drugs might be used together in some circumstances, but this is subject to careful consideration by a healthcare provider due to potential drug interactions. They work differently: Linzess increases the secretion of chloride and water in the intestines, which can soften stools and stimulate bowel movements, while Motegrity enhances colonic peristalsis by stimulating serotonin receptors.
Both medications are available as branded products; generic versions aren't currently available, representing a significant cost factor particularly for self-paying patients. Both Linzess and Motegrity may require an adjustment period before effects become noticeable.
The side effect profiles of both drugs are similar; generally well-tolerated but with diarrhea being more common with Linzess than Motegrity. It's crucial that patients monitor any changes or discomforts when starting these therapies - if they notice any worsening symptoms or distressing effects such as severe diarrhea or persistent vomiting, medical help should be sought immediately.
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Refrences
- Vijayvargiya, P., & Camilleri, M. (2019, May 23). Use of prucalopride in adults with chronic idiopathic constipation. Expert Review of Clinical Pharmacology. Informa UK Limited.http://doi.org/10.1080/17512433.2019.1620104
- 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
- Roque, M. V., & Camilleri, M. (2011, June). Linaclotide, a synthetic guanylate cyclase C agonist, for the treatment of functional gastrointestinal disorders associated with constipation. Expert Review of Gastroenterology & Hepatology. Informa UK Limited.http://doi.org/10.1586/egh.11.30
- Love, B. L., Johnson, A., & Smith, L. S. (2014, July 1). Linaclotide: A novel agent for chronic constipation and irritable bowel syndrome. American Journal of Health-System Pharmacy. Oxford University Press (OUP).http://doi.org/10.2146/ajhp130575