Linaclotide

Date: July 2022, Version 3.0

Quick read

Constipation is common in pregnancy and can be treated with some types of laxatives if necessary.

Constipation during pregnancy

Constipation is very common during pregnancy and is thought to be due to the effects of hormonal changes on the bowel. Although uncomfortable, it is generally not harmful to the mother or baby.

How do I avoid or treat constipation in pregnancy?

To avoid constipation, pregnant women are advised to eat a high fibre diet and drink plenty of fluid from early pregnancy onwards. Regular exercise can also help.

If these suggestions are not effective, some types of laxatives can be used safely in pregnancy. A pharmacist or doctor can advise about this.

What information is there about the use in pregnancy of specific laxatives?

Bulk-forming laxatives
Bulk-forming laxatives (e.g. wheat bran, linseed, ispaghula (Fybogel®, Isogel®, Ispage®, Regulan®), methylcellulose (Celevac®), and sterculia (Normacol®) are not absorbed into the bloodstream but increase the bulk of the stools (poo) which helps movement along the bowel. Use of bulk-forming laxatives during pregnancy is common and has not been linked to any problems in the unborn baby.

Lactulose
Lactulose (Duphalac®, Lactugal®, Laevolac®) is a type of sugar that is not digested and therefore draws water into the bowel. This softens the stools and helps them to move along the bowel. Lactulose is commonly used during pregnancy and the manufacturers of Duphalac® state that it may be used during pregnancy if necessary.

Macrogols
Macrogols (Laxido®, Molaxole®, Movicol®) are not absorbed into the bloodstream and increase the water content of the stools, helping them to pass through the bowel. They are quite commonly used in pregnancy and there are no concerns that they can harm the baby.

Glycerin suppositories
Glycerin (also called glycerol) suppositories lubricate and stimulate the bowel. They are generally used for more severe constipation and arequite commonly used during pregnancy with no problems reported.

Bisacodyl
Bisacodyl (Dulcolax®) stimulates the bowel and increases the water content of the stools. No studies have been carried out to examine whether using bisacodyl during pregnancy is linked to problems in the unborn baby, however no problems have been reported.

Senna
Senna (Senokot®) stimulates the bowel muscles, helping to move stools along. One study showed that use of senna during the first twelve weeks of pregnancy (while the baby is developing) is not linked to birth defects.

Docusate sodium
Docusate sodium (Dioctyl®, Docusol®) stimulates the bowel muscles, helping the stools to move along more easily. Three studies have all shown no increased risk of birth defects in the baby and use of docusate sodium during the first 12 weeks of pregnancy.

Sodium picosulfate
Sodium picosulfate (Dulcolax Pico®) stimulates the bowel muscles to help stools to move along more easily. No studies have been carried out to examine whether using sodium picosulfate during pregnancy is linked to problems in the unborn baby. However, no problems have been reported following use during pregnancy.

Linaclotide
Linaclotide stimulates and lubricates the bowel to help stools to move along more easily, and is used to treat moderate to severe irritable bowel syndrome (IBS). There are no published studies on use of linaclotide in pregnancy, and as it is not commonly used, its effects are largely unknown.

Lubiprostone
Lubiprostone lubricates the bowel to help stools to move along more easily. There are no published studies on use of lubiprostone in pregnancy, and as it is not commonly used, its effects are largely unknown.

Prucalopride
Prucalopride stimulates the bowel, to help stools to move along more easily. There are no published studies on use of prucalopride in pregnancy, and as it is not commonly used, its effects are unknown.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care, most women will be offered a very detailed scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

There is no evidence that taking laxatives during pregnancy causes any problems that would require extra monitoring for your baby.

Are there any risks to my baby if the father has taken laxatives?

We would not expect any increased risk to your baby if the father took laxatives before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.