# So I'm back - Amitiza, Linzess, Trulance



## Jasesun23 (Nov 11, 2016)

So I've been diagnosed with IBS-C / CIC. As far back as I can remember I've had mild to medium C. BM every 3ish days but thought no big deal. About 2-2.5 years ago it got much worse. Would go 5 plus days. Started taking a lot of Dulcolax, Miralax, etc. They didn't help much.

Went to a GI Doctor. 5 mins in office said lets try Linzess 145mg. Took it and it cause major D which don't get me wrong was amazing compared to being backed up for so long. However I thought maybe there was something better. So 2 months later he gave me a script for Amitiza 24mg twice a day. It was like a miracle cure. For 4 months everything was perfect. BM perfectly formed, would go every day maybe sometimes every other day. Then is slowly stopped working but still worked okay for another 4-5 months. Then it just stopped.

Went to make an apt with the doctor and found out he no longer took my insurance so my GP recommended another GI for me. Went to him he said let try 72mg Linzess which they didn't make the year before and also scheduled a Colonoscopy. While 72mg Linzess was not as good as the Amitiza it did its job. No more pain or bloating. BM were not as well formed as Amitiza, more toward the 5ish on the Bristol Stool chart. Didn't make much of a difference to me as long as I had no discomfort or pain and was going regularly. Now 8ish months later 72mg Linzess isn't working that well. BM are less frequent. Pain/uncomfortableness is very present. It doesn't matter really when I take Linzess, with food or not. Today I double the does and drank a large starbucks, had a BM but my Gut still doesn't feel good.

Called my GI to make an apt. Will take 3 weeks. I asked if it would be possible to get some samples of Trulance since I have not tried that yet. I got 14 days and will start it tomorrow. Fingers crossed

I truly feel for others who have what I have and for those who have much worse. While I'm not in "pain pain" the extreme uncomfortability present 24 hours a day affects my life in every facet. I'm uncomfortable just sitting at work. I'm worried every time I'm about to eat something. I am a very active person, running, biking, lifting. For the past 3 weeks I haven't wanted to do any working out. I can say without hesitation I feel like 2 different people, one when the meds are working and the other when they are not. Right now my plan is hopefully the Trulance will work for the foreseeable future, and when that stops working maybe just rotating the old one in might do the trick until more is understood about the condition. I'm attempting to try Fodmap to see if it helps but when the medicine is working it doesn't matter one bit what I eat, so I'll have no clue if Fodmap is helping.

So in closing I hope suffers are having a good day, or better than normal. Anyone wants to give me so advice please do. Any advice on Trulence will be appreciated. I plan to go back and read every post about it. I'm tempted to try that supplement Flossy swears by, but again when my medicine is working I don't need anything. No burping, no lower back pain, no gas, no stomach distension, no constipation, I feel like I should feel.

And Annie7 want to say thank you, I've posted a handful of times on here over the years and your are always there with some advice and kind words. I'm sure everyone on here appreciates that.


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## dac122 (Feb 13, 2012)

My experience with Trulance is it works very similar to Linzess. I think its mechanism of action is identical. If it gives you too much D try splitting the pill and taking each half twice per day. It does not split easily, tends to crumble, so take the part that cumbles immediately and save the in tact part for later.

With regards to Linzess, have you tried 145mcg or 290mcg? Have you tried taking 72mcg more than once per day? I take it three times per day.


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## annie7 (Aug 16, 2002)

Hi Jasesun

thank you so much for the kind words. i really appreciate it.

so sorry linzess and amitiza quit on you and that you are having so many problems.

have you by any chance tried misoprostol (cytotec). it can be used off label for chronic C. i tried it. it took a few days to kick in but then it worked for a while. i took it with senna, like the article below suggests. it's worth a try if trulance doesn't help you. to me, misoprostol seemed to work a lot like linzess.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2036.1997.00237.x

note: misoprostol should not be used by a woman who is pregnant or trying to get pregnant as it can cause a miscarriage.

one other thing--the FDA has approved a new drug application for prucalopride. finally!! this med has been available in canada, europe and other countries for several years. what makes prucalopride special is that it's a high affinity selective serotonin type 4 (5-HT4) receptor agonist--a prokinetic med that stimulates colonic peristalsis, increasing bowel motility. for those of us who remember zelnorm, it's similar to zelnom, but with a better safety profile. prucalopride is a prokinetic so it works a lot differently than amitiza, linzess and trulance. all of which merely add fluid to the colon.

if you can get your doc to write you a script for it, you can buy prucalopride online from canadadrugs.com. they need a script in order to send it to you.

https://www.ibsgroup.org/forums/topic/348977-fda-accepts-new-drug-application-for-prucalopride-for-cic/

good luck with everything. hope you can find some relief. take care.


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## Jasesun23 (Nov 11, 2016)

dac122 said:


> My experience with Trulance is it works very similar to Linzess. I think its mechanism of action is identical. If it gives you too much D try splitting the pill and taking each half twice per day. It does not split easily, tends to crumble, so take the part that cumbles immediately and save the in tact part for later.
> 
> With regards to Linzess, have you tried 145mcg or 290mcg? Have you tried taking 72mcg more than once per day? I take it three times per day.


Dac122. The first medication I was given 2 years ago was linzess 145mg. It gave me all D and it lasted on and off for an hour. At that time there was no 72mg. So I switched to Amitiza. It wasn't till 9 months I've tried to double up on Linzess 72 mg but haven't gotten great results. Today I took a double dose separated by a half hour along with a large cup of Starbucks coffee. It did the job and I had a BM. It took a couple hours and my gut area feels decent. So there is definitely a chance that 145 mg every day or even 290 mg will work. I just picked 3 - trial packs of Trulence from my Dr office which I believe is 21 days. I'll give that a chance and see how it does. If not I do have the option of higher doses of Linzess.

Dac122 what milligram do you 3 times a day? Does insurance cover 3 bottles or do you pay out of pocket for that? Know that you take it multiple times is nice to know as I have further options, so thanks for replying.


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## flossy (Dec 8, 2012)

Hi Jasesun23 -

I've read many posts that say the same things about the meds you spoke about: Many people get diarrhea from them, and if and when that finally stops they work well for about a year - maybe two - and then that is that, back to constipation.

Good luck with your new medication.

P.S. Dr. Schulze will probably have to wait a little bit longer for your first order!


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## Jasesun23 (Nov 11, 2016)

Annie - besides over the counter products the only prescription drugs I've tried are Linzess and Amitiza. I'm glad to hear there are even more options as well. Will def read into that

I guess I'm lucky that these medicines work for a couple months. The longest I've gone with really bad issues is a couple months. I couldn't imagine years in that condition. Hopefully in time they will find what causes this and have a cure.


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## dac122 (Feb 13, 2012)

Jasesun23 said:


> Dac122 what milligram do you 3 times a day? Does insurance cover 3 bottles or do you pay out of pocket for that? Know that you take it multiple times is nice to know as I have further options, so thanks for replying.


I take 72mcg three times per day. As you can image my insurance would not cover, until we documented failure of single doses 72, 145, 290 once per day, and:

1. Documented history of IBS-C and/or CIC; infrequent bowl movements, bloating, abdominal pain, sensation of incomplete evacuation, poor appetite. 
2. Documentation I had tried other required therapies (Amitiza, MiraLAX, fiber, stool softeners, stimulant laxatives, Trulance); and all were either ineffective or had intolerable side effects.

I believe my Doc pointed out that taking 3 times per day 72mcg is within daily therapeutic guidelines (i.e., less than 290mcg); and is to minimize side effects and maximize effectiveness.

The key words and phrases to use when describing what has not worked are ineffective and intolerable side effects


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## Jasesun23 (Nov 11, 2016)

Unfortunately 4 days of Trulance and nothing. Man that went the exact opposite of what I though. After reading the forums it seemed that most people got too much D. 4 days of taking it and no BM at all. Very disappointing.


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## annie7 (Aug 16, 2002)

so sorry trulance didn't work for you. yes, that is disappointing.


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## dac122 (Feb 13, 2012)

For me it worked about the same as a single dose of Linzess, so I am likewise surprised it didn't at least work somewhat. Sorry to hear. Hope you can find something that will work with Linzess.


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## annie7 (Aug 16, 2002)

have you tried the 290 mcg dose of linzess yet?


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## dac122 (Feb 13, 2012)

annie7 said:


> have you tried the 290 mcg dose of linzess yet?


Yes, I would try 290.

If that is too much try delaying longer before eating (hour or more). If that does not work you could try two 145 throughout the day.


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## Jasesun23 (Nov 11, 2016)

Unfortunately the earliest apt I could get with my GI is in about 2 weeks. I'll have to wait till then to see about upping the Linzess dose. I have not tried 290 yet. I did double up on the 72mg a couple days to see if that would help but I didn't notice any improvement.

I'm having awful heartburn and non stop burping in the last week. To be honest the Linzess worked so well for so long I don't remember all my symptoms from last year. Is bad heartburn a symptom of people with IBS-C?


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## dac122 (Feb 13, 2012)

Jasesun23 said:


> Unfortunately the earliest apt I could get with my GI is in about 2 weeks. I'll have to wait till then to see about upping the Linzess dose. I have not tried 290 yet. I did double up on the 72mg a couple days to see if that would help but I didn't notice any improvement.


I would not wait, but instead contact your GI and ask to up the dose, or even better if they have samples to see. I've done that many times with my Doc. I would bet good money they've had patients who had to up their dose, or a drug that flat out stopped working.


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## annie7 (Aug 16, 2002)

agree with dac.

just call your gastro's office and ask them to send a message to your doc that you need to have your dosage upped. i've done several times that without any problem at all.


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## Jasesun23 (Nov 11, 2016)

next door neighbor is a doctor. He gave me some prescription strength Pantoprazole 40mg. Tried 2 20mg OTC generic nexium and that did nothing. But this 40mg Pantoprazole has really helped the last 2 days. Burping and Acid reflux has gone from a 10 to around a 3. Of course constipation is still there but it doesn't feel as bad, the bloating and stomach pain has decreased.

If it stays like this I think I can make it till the 15th. I called them and asked for the trial Trulance and they gave me 3 weeks worth no problem. After a week of it doing not much I stopped. I'm doubling up on the 72mg of Linzess I have, probably have 15 pills left. That's not doing much. I'm sure if I called and asked for the 290mg they would call it in but like I said I think I can wait till I get to the Dr. and we can discuss the next move.

Maybe I just had a bad H Pylori outbreak or something to cause this extreme burping and heartburn. I'm going to ask Dr to do as many tests as he can.


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## Jasesun23 (Nov 11, 2016)

Went to my latest apt with GI doc. Didn't do much. Talked to him for 10-15 mins. When I told him the Linzess stopped working and now I had constipation, bloating, heart burn and burping. He said the heart burn and burping are most likely completely separate from the IBS-C. Asked is I changed my diet recently to cause the Acid Reflux and burping. I have not been eating great for the past 2 months, more junkish food and some late night eating. He believe thats whats caused that. He did say if I wanted an Endoscopy that would be no problem. I told him with the Esomeprazole the heart burn and burping is slowing down, and I'm going to stop taking it. See how I feel in a week or two. If I still have heart burn and acid I'll call to schedule the Endoscopy.

As far as the ISB-C he though it was crazy that Trulance didn't have any effect for the 9 days I took it and that Linzess 290mg didnt have any effect for the couple days I took it. But when I told him The last 5 days I've been taking the rest of the Trulance I've had liquid D 4 out of the 5 days, he said that sounds more like it. He think maybe whatever caused the heartburn and burping might have somehow affected how the drugs were working. And now that I've got that part managed the drugs might start working again .

He said he'd write me any script for any drug I wanted to try again. Amitiza, stronger LInzess, or continue Trulance. So even though Trulance worked 4 out of the last 5 days all liquid D is not what I want for the foreseeable future. His favorite drug is Linzess. He gave me 145mg. Todl me to try it for a week and if nothing we can go right to Amitiza.

Lastly I asked about H Pylori- he said if we do the Endoscopy he'll test for that. Asked about SIBO and he said there just not enough evidence of that really being an issue in his opinion. Seemed to shrug off a transit study

So I basically left with the plan of give it a little time and the acid reflux and burping should clear up. And we will keep working on the IBS-C medication till we get something that works well. Not ideal but not a bad approach.

Edit:

This was also interesting, When I got the Abdominal X ray after not having a BM in 7 days thinking I might have a blockage, the x ray showed I not only did not have a blockage but there was barely any stools in my colon at all. Guess this zero carb / zero fiber diet really doesn't leave that much in your colon.


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## sjw596 (Feb 19, 2014)

As I and many others have found, the drugs seem to work for a while and then quit. Linzess was great for 1.5 years, as I progressed up to the 290s. Amitiza never worked. I've been on Trulance for about a year, and is efficacy has been diminishing. I've also tried all of the suggested variations on how/when to take the drugs. I tried resuming Linzess after being off of it for a year, bit it didn't help. I've been supplementing the Trulance with MoM for the most part, and Miralax. My GI doc said that I can take 2 doses of Miralax/MoM a day, and that MoM and Miralax basically are the same. Both are osmotics, so I suppose one could take a dose of Miralax in the morning and MoM at night. MoM has a quicker result, e.g., overnight if I take 3/4 of a full dose.

My GI said that I have an abundance of colon, even after losing a foot to a cecal volvulus. That's why I may feel "empty," while a CT will show a lot of stool in my colon. The GI said that, when I have a "normal" BM, I basically empty only the portion of my descending colon above the sigmoid. So, there's lots of room behind there.


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## Jasesun23 (Nov 11, 2016)

Starting 4th day of Amitiza - 24 mg twice a day. So far haven't had any positive results. Besides no drugs working it also concerns me what has these drugs done to us to make our bodies no longer receptive to them. They must of permanently "changed" some receptors that it no longer works. If it was just getting used to them, then a year off them would make them work again for at least a little bit.

It is just so frustrating not knowing what is wrong with me or what I could do to help. I mean I have no problem doing something if Drs told me it would work. Honestly if doctors said you can only eat Bananas for the rest of your life and you'd have normal BMs, I'd be like okay cool I can do that. I'd have no problem buying some supplements on Amazon for a couple hundred dollars a year if I know they would have decent results. The only slight positive I see in this is it seems like the medical profession is making progress in the Gut area, the microbiome, nutrition and how food effects the gut. But even then I think we are pretty far off if that is even the problem.


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## flossy (Dec 8, 2012)

Jasesun23 said:


> Starting 4th day of Amitiza - 24 mg twice a day. So far haven't had any positive results. Besides no drugs working it also concerns me what has these drugs done to us to make our bodies no longer receptive to them. They must of permanently "changed" some receptors that it no longer works. If it was just getting used to them, then a year off them would make them work again for at least a little bit.
> 
> It is just so frustrating not knowing what is wrong with me or what I could do to help. I mean I have no problem doing something if Drs told me it would work. Honestly if doctors said you can only eat Bananas for the rest of your life and you'd have normal BMs, I'd be like okay cool I can do that. I'd have no problem buying some supplements on Amazon for a couple hundred dollars a year if I know they would have decent results. The only slight positive I see in this is it seems like the medical profession is making progress in the Gut area, the microbiome, nutrition and how food effects the gut. But even then I think we are pretty far off if that is even the problem.


Have you tried I.F. # 1 yet or no? (.......Hmmmmmm, I wonder.....)


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## Jasesun23 (Nov 11, 2016)

No I have not. Def will give it a try down the line.


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## sjw596 (Feb 19, 2014)

As I also have posted before, just note that IF #1 contains senna, which is a stimulant laxative, and I believe senna is the primary ingredient that results in a BM. If others have taken it regularly for years, more power to them. IF #1 is not meant to be taken frequently, let alone daily, much as you would not take Ex Lax routinely. You can do your own research on the potential harm that stimulants (natural or otherwise) can cause. If you can obtain an answer from the maker, you'll find that the product is for occasional use, and I'll guess that occasional use is fine. What "occasional' means I can't say. Take all the Miralax and Mg you want (up to where Mg can be toxic). Ask your GI doc; I'm not a doctor.

We're kind of in the same boat, but I've never taken an OTC remedy without careful scrutiny. and a finding of medically proven efficacy. Actually, you can't go wrong with your thoughts on bananas! I eat an overly ripe one daily (greener bananas tend to be constipating; it has to do with the breakdown of carbs). While I found Amitiza worthless for the most part, I did find that it took about 8 days to have any positive effect. Good luck!


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## flossy (Dec 8, 2012)

sjw596 said:


> As I also have posted before, just note that IF #1 contains senna, which is a stimulant laxative, and I believe senna is the primary ingredient that results in a BM. If others have taken it regularly for years, more power to them. IF #1 is not meant to be taken frequently, let alone daily, much as you would not take Ex Lax routinely. You can do your own research on the potential harm that stimulants (natural or otherwise) can cause. If you can obtain an answer from the maker, you'll find that the product is for occasional use, and I'll guess that occasional use is fine. What "occasional' means I can't say. Take all the Miralax and Mg you want (up to where Mg can be toxic). Ask your GI doc; I'm not a doctor.
> 
> We're kind of in the same boat, but I've never taken an OTC remedy without careful scrutiny. and a finding of medically proven efficacy. Actually, you can't go wrong with your thoughts on bananas! I eat an overly ripe one daily (greener bananas tend to be constipating; it has to do with the breakdown of carbs). While I found Amitiza worthless for the most part, I did find that it took about 8 days to have any positive effect. Good luck!


*'Is chronic use of stimulant laxatives harmful to the colon?'*

It's only one paragraph long - read below:

https://www.ncbi.nlm.nih.gov/pubmed/12702977

I've been on I.F. # 1 daily for over 3 years now and have had no adverse effects whatsoever. It _can_ be taken safely daily, I'm living proof. Dr. Schulze was on it for 12 years, it's in his book:

https://www.herbdoc.com/blog/book/create-powerful-health-5-day-bowel-detox

- Just for the record I now take less than half the amount of I.F. # 1 than what I did when I first started using it (plus a couple of magnesium pills every day).

- Fasting helped me a lot.

- To me? God put all those natural anti-constipation ingredients on our Earth for a reason: To help us boo-boo. I'd much rather take something natural then something made with pharmaceuticals, but that's just me. And speaking of pharmaceuticals, there are no long-term studies on the long-term effects of Linzess because it's so new. It's still a little bit of a gamble, me thinks.

Personally, I think people who have your viewpoint have likely been tricked by Big Pharma: Natural is bad, pharmaceuticals are good.

Ephedrine is bad, Adderall is good.

Heroin is bad (I agree with that one!), Oxy is good.

Senna is bad, our anti-constipation meds are good.

Personally? I.F. # 1 has been a lifesaver for me.

If something came out better than I.F. I would have no reason jumping ship, but so far? No go.

I know you're way smarter than me sjw596, I remember your posts about when this website was infected and was very impressed, but I just can't agree with ya here. That's all.

P.S. I hope ^that^ all made sense, my sleeping pills are kickin' in!


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## sjw596 (Feb 19, 2014)

I don't agree that I'm "way smarter" than you are, but thanks for the compliment! The reply that the IF #1 folks sent to me some time ago was that the product was not intended for indefinite, daily use. I also think that the article conflicts with most medical thinking, but it is noteworthy. If I could be convinced by my GI that it would be okay, I'd order a lifetime supply of IF #1







I'll share the article with my GI's PA at my next appointment. It's good that you point out as much info as you have, so that we have as many resources as possible. Thank you.


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## annie7 (Aug 16, 2002)

oh yes, sjw--of course you want to get your gastro doc's approval for all this.

i was dx'd with colonic inertia, pfd, a long twisted colon , rectal hyposensitivity and mega rectum. like you, i developed a cecal volvulus. the surgeon removed half my colon. i found that half a dead colon does not work any better than a whole dead colon.

anyway, none of the C meds worked for me and even enemas (the big, quart size ones) stopped working. since i had a tendency to develp impactions rather easily, both my gastro docs (one of whom is the head of the University of Michigan's gastroenterology department) as well as my colorectal surgeon told me to take stimulant laxatives daily, since that was the only way i could go. my gastro docs told me that taking daily laxatives was better than developing an impaction-- or worse yet, an obstrucion (i'd had those, too) my U of M gastro also had me doing half a colonoscopy prep once a week--things were that bad.

so that was my experience. but, like i said--of course you'd want to get your gastro docs approval here.


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## sjw596 (Feb 19, 2014)

Thanks, Annie. I lost a foot of colon, but the GI said that I still have an abundance: "tortuous/redundant." At the moment, I'm using the Trulance, usually with Mg at night (500 mg - 3,600 mg. I've added Miralax in the a.m., but that usually gives me too much discomfort. The GI said to use the osmotics and keep things moving to avoid impaction. I've never had one, but it can't be pleasant. Sometimes enemas don't seem to clean me out as much as I would like, although I may not have a BM the day after an enema. It seems as though one bottle of Fleet (the saline type) isn't enough I guess stuff needs time to move into my descending colon. My sitz marker test was okay. I don't think that missing a day or so of a BM won't cause impaction. Only a colonoscopy prep would empty me, but I don't think that even "normal" people empty most of their colons. I actually had a prep before the surgeon released me after the right hemi, as things didn't wake up on their own. I'm looking at a Mg product named Garden of Life - a tsp in water and it's fizzy and flavored. It provides 350 mg of Mg Carbonate. MoM is Oxide/Hydroxide. Ever hear of the fizzy types?


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## annie7 (Aug 16, 2002)

when i had my hemicolectomy, the surgeon removed about 28 inches of my colon. and yes, like you, my gastro doc told me that i still had a tortuous redundant colon, even with that much of it gone.

i failed both my sitz marker tests. didn't have a bm the entire time. on the morning of day four of my first test, i was no longer able to urinate. that evening i went to the ER where they pumped a liter and a half of urine out of me and told me to go home and abort the test ( which i was more than happy to do) because my colon was so full of stool that it was blocking off the bladder.

for my second colonoscopy, they had me do the two day prep because of my C. on the monring of my appointment, i was still pooping out liquid brown stool. they had to suction me out in order to do the procedure.

you're right--it's not normal for people to dump the contents of the entire colon when they go. from what i've read, it's just the rectum and some of the sigmoid that gets emptied--not the whole thing.

i've not heard of that specific Mg product. i have heard of similar products like natural calm, mag ox and mag 07 etc. i tried mag07 but it didn't help. good luck if you try the garden of life product.


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## Jasesun23 (Nov 11, 2016)

Amitiza still doesn't seem to be working that well. 2 years ago within a day my gut uncomfortableness was gone and I was having BM. Been taking it for couple days now. Having some BMs but the distress in my stomach region is not going away. Took a left over Trulance to clean myself out to feel better. Doubt its good that I double dose every once in awhile but.

Going to give the Amitiza 2 weeks or so. If it really doesn't help I'll talk to my doctor and maybe use Trulance as a cleanout every 3rd day or so. Or maybe try cutting it in half.


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## sjw596 (Feb 19, 2014)

> good luck if you try the garden of life product.

It's horrible. While it may fizz when water is added, as the directions state, it really doesn't dissolve. Leaves small lumps that make it distasteful. I returned the remainder of the bottle to the store. I'll stick with tablets.


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## annie7 (Aug 16, 2002)

oh that's too bad.

gadren on life is supposed to be a good, reputable company, too. you'd think they'd have a quality product.


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## wgbutler (Mar 15, 2018)

Jasesun23 said:


> Amitiza still doesn't seem to be working that well. 2 years ago within a day my gut uncomfortableness was gone and I was having BM. Been taking it for couple days now. Having some BMs but the distress in my stomach region is not going away. Took a left over Trulance to clean myself out to feel better. Doubt its good that I double dose every once in awhile but.
> 
> Going to give the Amitiza 2 weeks or so. If it really doesn't help I'll talk to my doctor and maybe use Trulance as a cleanout every 3rd day or so. Or maybe try cutting it in half.


I wish they made 2mg (or 1.5mg) Trulance. The 3 is just a bit too much. I'm usually on the toilet for about 4 hours when it kicks in. Every once in awhile I get lucky and only have to go 2 or 3 times in total but those times are few and far between.

I've tried cutting the pill in half but one side usually crumbles into dust so you can't save it for the next day. It's frustrating, but the few times I have only taken a half pill it seems to make a noticeable difference in the duration of the diarrhea.

I do tolerate it better than Linzess, which gives me even worse diarrhea and painful stabby sensations in my lower left abdomen.

Amitiza does nothing for me at all except give me uncontrollable diarrhea (just shooting out water, no stools) for about 4-5 hours and making me feel like I have a bad case of the flu for 24 hours.


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## Jasesun23 (Nov 11, 2016)

Wgbutler - its interesting how different meds work for different people

my history quickly

145mg Linzess - gave me straight D so changed after a week

24mg 2x a day Amitiza- worked for 10 months and gave me almost perfect stools. Never once D

72mg Linzess- worked for 10 months gave me stools more to the Bristol stool scale 5,6,7 ish depending on the day.

Now Linzess and Amitiza nothing. I know this happens to a lot of people but it just seems crazy that it just stops working. Blood pressure med doesn't just stop working, heart medicine doesn't just stop working. Okay maybe they do but I don't know.

Trulance - sometimes takes 30 mins to hit me, sometimes a couple hours to hit me. Once I go the first time after that its all Liquid D for the next 3-4 bathroom trips over about 30-60 mins. The Trulance is really soft, if I leave it in my mouth for 5 seconds it dissolves. Maybe I'll talk to my Dr about cutting it in half for 1.5 mg.


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## dac122 (Feb 13, 2012)

Jasesun23 said:


> Maybe I'll talk to my Dr about cutting it in half for 1.5 mg.


Why wait? I would be very surprised if your Doc had a problem with splitting. When I mentioned it to mine he had no concerns other than it might not work. Since most Docs play defensive medicine these days, they like no risk propositions. That's why they like Trulance. Trulance (Amatiza, Linzess) are considered very safe drugs because very little is absorbed. In fact, they studied using 6 mg of Trulance daily instead of 3 but settled on 3 because there was no statistical difference.


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## annie7 (Aug 16, 2002)

it would be nice if synergy, the pharma that makes trulance, starting offering it in the lower dose, like what allergan/ironwood did with linzess.


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## Jasesun23 (Nov 11, 2016)

Dac122 I don't have to wait. I'm going to finish 8 more days of Amitiza, thats the samples I have left. After that I will try 1.5 mg of Trulance.


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## jza (Oct 4, 2016)

Jasesun23 said:


> Wgbutler - its interesting how different meds work for different people
> 
> my history quickly
> 
> ...


Trulance is very difficult to split. I tried splitting, but the pill often just crumbles since it's so small and not scored.


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## sjw596 (Feb 19, 2014)

annie7 said:


> oh that's too bad.
> 
> gadren on life is supposed to be a good, reputable company, too. you'd think they'd have a quality product.


I did find a very good liquid Mg from Trace Minerals: https://traceminerals.com/liquid-magnesium/. It tastes pleasant (citrus) and provides 300 mg of Mg Citrate in a tablespoon. I'm not suggesting it's a cure, but if a liquid works better for you and you prefer citrate, it's a option. it's about $15 per 16 oz. bottle (32 servings). Then again, a tbsp (15 ml) of MoM provides about 1200 mg of Mg oxide. The max adult dose of MoM is 60 ml. I suppose that you can mix MoM with almost any liquid if the taste is offputting.


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## annie7 (Aug 16, 2002)

thanks for the tip. i no longer need to take magnesium to go but my neuro suggested that i take 600 mg of magnesium daily for my migraines. i take mag glycinate because it's supposed to be highly absorbable. it's not as good as mag citrate or mag oxide for C because of it's high absorbability (according to what i've read).


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## Jasesun23 (Nov 11, 2016)

Just an update for me. Still have discomfort throughout my ab/back region. Its strange cuz I've been taking 290mg Linzess and its giving me all D. For almost a year 72mg of Linzess a day was working. Then it stop about 2 months ago I tried a week of 2-72mg linzess for a total of 144mg, it did nothing. Then for 5 days I took 4-72mg linzess for a total of 290mg a day. It did nothing. Then two weeks ago I took 7 days of 144mg linzess, it did nothing. Now the last 5 days of 290mg seems to be working too well, because its all D. I'm just baffled. Maybe what ever is wrong with me got really bad for a couple months and now is normalizing back to where 72mg or 144mg linzess might work again.

Also after last apt with Dr he said there was not much more he could do since we tried every medicine. He told me he would send me for a CT scan of the Abdomen and Pelvis, but it was up to me. I really want to figure out what exactly is wrong with me so I said okay let's do it. But now I'm stressing that a single CT scan is equal to 200 x-rays. I think they did 2-3 passes on me. But what is done is done. I'm the type when I reads something like that it stresses me out with worry for a couple weeks, but it will pass.

So as of right now I'm taking 290mg of Linzess, its giving me multiple trips to the bathroom with D. Last about 45 mins. So I know there is nothing in me but I'm still having the discomfort in my gut/back that is not going away. Usually that lessens or goes away when the C stops and the medicine is working. Will update with the result of the CT scan. 200 x-rays , thats crazy. I have friends that won't even go in the scan at the airport for fear of that radiation.


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## annie7 (Aug 16, 2002)

sorry about the discomfort in your back and gut.

i know it's hard, but try not to worry about the CT scan. i think having it was a good idea. you want to see what's going on in there. i've had many ct scans-- lots of scans of the abdomen and pelvis --also multiple scans of the sinuses, lungs etc. i probably glow in the dark







--just kidding. you'll be fine.

i know you've tried every c med that is available now but prucalopride should be approved early next year. hopefully that will help. if you can get your doc to write you a script for it, you can buy it online from canadadrugs.com.


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## Jasesun23 (Nov 11, 2016)

Should start a new thread called How awesome is Annie7


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## annie7 (Aug 16, 2002)




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