Linaclotide (Linzess®)

SELF ADMINISTRATION - ORAL 

Indications for Prior Authorization:

  • Treatment of chronic idiopathic constipation (CIC) in adults

  • Treatment of irritable bowel syndrome with constipation (IBS-C) in adults

Patients must meet the following criteria for the indication(s) above:

Chronic idiopathic constipation (CIC)

  • Diagnosis of CIC confirmed by chart note documentation, AND
  • 18 years of age or older, AND
  • Member has increased fiber intake and tried-failed a stimulant laxative or osmotic laxative as confirmed by chart note documentation, AND
  • Member is not concomitantly taking Trulance, Amitiza or Motegrity

Irritable bowel syndrome with constipation (IBS-C)

  • Diagnosis of IBS-C confirmed by chart note documentation, AND
  • 18 years of age or older, AND
  • Member has increased fiber intake and tried-failed an osmotic laxative as confirmed by chart note documentation, AND
  • Member is not concomitantly taking Trulance, Amitiza or Motegrity

The following conditions do not meet the criteria for use as established by WHA P&T committee:

  • All non-FDA approved uses not listed in the approved indications

Dosing:

  • Chronic idiopathic constipation (CIC): Oral: 145 mcg once daily; 72 mcg once daily may be used based on patient presentation or tolerability

  • Irritable bowel syndrome with constipation (IBS-C): Oral 290 mcg once daily

Approval:

  • 1 year

Last review date: November 14, 2019