Ironwood Pharmaceuticals Reports Fourth Quarter and Full Year 2025 Results; Achieves 2025 Financial Guidance and Reiterates Strong 2026 Outlook

LINZESS® (linaclotide) EUTRx demand growth of 11% for full year 2025 year-over-year

Published on Feb. 25, 2026

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Ironwood Pharmaceuticals, Inc. (Nasdaq: IRWD), a biotechnology company developing and commercializing life‑changing therapies for people living with gastrointestinal (GI) and rare diseases, today reported its fourth quarter and full‑year 2025 results and recent business performance. The company achieved its 2025 financial guidance and reiterated a strong outlook for 2026, including expected increases in LINZESS U.S. net sales and disciplined expense management to drive greater than $300 million in adjusted EBITDA.

Why it matters

Ironwood's strong 2025 performance and 2026 outlook demonstrate the company's ability to maximize LINZESS, advance its pipeline, and deliver sustained profits and cash flows. The company's improved financial position enables it to continue advancing apraglutide, a potential new treatment for short bowel syndrome with intestinal failure (SBS-IF), and reduce debt to further strengthen its financial standing.

The details

In 2025, LINZESS delivered 11% EUTRx demand growth year-over-year, continuing to strengthen its position as the prescription market leader for the treatment of IBS-C and CIC. Ironwood's disciplined expense management allowed it to navigate LINZESS pricing headwinds, deliver $24 million in GAAP net income and $138 million in adjusted EBITDA, and generate $127 million in cash flow from operations. For 2026, Ironwood expects increased LINZESS U.S. net sales and disciplined expense management to drive greater than $300 million in adjusted EBITDA. The company also plans to initiate sites for the confirmatory Phase 3 clinical trial, STARS-2, for apraglutide in the second quarter of 2026.

  • In November, the FDA approved LINZESS for the treatment of irritable bowel syndrome with constipation (IBS-C) in patients aged 7 years of age and older.
  • In the fourth quarter of 2025, total LINZESS prescription demand was 63 million LINZESS capsules, a 13% increase compared to the fourth quarter of 2024.
  • For the full year 2025, total LINZESS prescription demand was 234 million LINZESS capsules, an 11% increase compared to the full year 2024.
  • In December 2025, Ironwood, VectivBio AG and Ferring International Center S.A. entered into a license amendment and settlement agreement.
  • Site initiations for the confirmatory Phase 3 clinical trial, STARS-2, for apraglutide are expected to begin in the second quarter of 2026.

The players

Ironwood Pharmaceuticals, Inc.

A biotechnology company developing and commercializing life‑changing therapies for people living with gastrointestinal (GI) and rare diseases.

LINZESS

The #1 prescribed brand in the U.S. for the treatment of patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC).

Apraglutide

A next-generation, long-acting synthetic GLP-2 analog being developed by Ironwood for short bowel syndrome patients who are dependent on parenteral support.

AbbVie Inc.

Ironwood's U.S. partner for the co-development and co-commercialization of LINZESS.

Tom McCourt

Chief executive officer of Ironwood Pharmaceuticals.

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What they’re saying

“In 2025, LINZESS delivered 11% EUTRx demand growth year-over-year, continuing to strengthen its position as the prescription market leader for the treatment of IBS-C and CIC, surpassing 5.7 million unique patients treated since launch.”

— Tom McCourt, Chief executive officer of Ironwood Pharmaceuticals (Business Wire)

“As we enter 2026, we remain focused on our core priorities of maximizing LINZESS, advancing apraglutide and delivering sustained profits and cash flows. We believe our full-year 2026 financial guidance demonstrates the significant progress we've made across these priorities and our ability to drive increasing shareholder value.”

— Tom McCourt, Chief executive officer of Ironwood Pharmaceuticals (Business Wire)

What’s next

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The takeaway

Ironwood's strong 2025 performance and 2026 outlook highlight the company's ability to maximize its lead product LINZESS, advance its pipeline, and deliver sustained profitability. The improved financial position enables Ironwood to continue investing in the development of apraglutide, a potential new treatment for short bowel syndrome, while also reducing debt to strengthen its balance sheet.