How Do Guanylate Cyclase-C Agonists Work?

Guanylate cyclase-C agonists are a class of medications used to treat constipation associated with irritable bowel syndrome (IBS) and chronic constipation of unknown cause (idiopathic constipation) in adults. IBS causes stomach pain or cramps, bloating, and infrequent or difficult passage of stools. Guanylate cyclase-C agonists are prescription medicines and may be used alone or with other medications.

Guanylate cyclase-c agonists work in the following ways:

• They increase the production of a chemical called cyclic guanosine monophosphate (cGMP) which, in turn, stimulates the secretion of chloride and bicarbonate into the intestinal lumen, mainly by activation of the cystic fibrosis transmembrane conductance regulator (CFTR) ion channel, resulting in increased intestinal fluid secretions in the gastrointestinal tract, which can soften stools and stimulate bowel movements.
• They help speed up the movement of food through the gut, improve stool texture, and reduce symptoms such as bloating, abdominal pain/discomfort, straining, and feeling of incomplete bowel movements.
• In addition, they reduce the sensitivity of pain by acting on the pain sensing nerves.

Guanylate cyclase-C agonists are used in conditions such as:

• Irritable bowel syndrome (a condition that causes stomach pain or cramps, bloating, and constipation)
• Chronic idiopathic constipation (difficult or infrequent passage of stools that lasts for three months or longer and is not caused by a disease or a medication)

Common side effects include:

• Diarrhea
• Abdominal pain/discomfort/distension
• Bloating
• Flatulence (gas)
• Defecation urgency
• Fecal incontinence (inability to control bowel movements)
• Vomiting
• Leg cramps

Other rare side effects include:

• Severe diarrhea/abdominal pain
• Headache
• Lightheadedness
• Fatigue (feeling of tiredness or lack of energy)
• Upper respiratory tract infections
• Sinusitis (a condition that occurs when your nasal passages become infected and inflamed)
• Viral gastroenteritis (a viral infection of your gastrointestinal tract)
• Increased thirst or urination
• Mood changes
• Confusion
• Bright red or black, tarry stools

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of guanylate cyclase-C agonists drugs include:

• Linaclotide
• Linzess
• Plecanatide
• Trulance