Ironwood Raises 2026 Guidance for a Second Straight Quarter

The Tip Desk · November 11, 2026 · 3 min read

The company now expects LINZESS U.S. net sales of $1.20–$1.25 billion and adjusted EBITDA of more than $350 million after $324.9 million of third-quarter U.S. sales.

Ironwood Pharmaceuticals (IRWD), a biotechnology company developing and commercializing therapies for gastrointestinal and rare diseases, raised its full-year 2026 financial outlook for a second consecutive quarter after LINZESS U.S. net sales reached $324.9 million in the third quarter.

The company now expects LINZESS U.S. net sales of $1.20 billion to $1.25 billion, up from $1.15 billion to $1.20 billion in August, total revenue of $485 million to $510 million from $460 million to $485 million, and adjusted EBITDA of more than $350 million from more than $310 million. It said the sales range represents a greater than 35% increase year-over-year and is still driven by improved net price and mid-single-digit demand growth.

Year-to-date U.S. LINZESS net sales of $880 million already exceeded full-year 2025 U.S. net sales, Chief Executive Officer Tom McCourt said.

Third-quarter U.S. net sales rose 3.2% from $314.9 million a year earlier, after 14% growth in the second quarter and 97% growth in the first. The company said the year-over-year increase reflected 4.9% demand growth and a low single-digit net price decline from unfavorable gross-to-net rebate reserves versus 2025. Total LINZESS prescription demand was 63.4 million capsules.

Ironwood and AbbVie share equally in U.S. brand collaboration profits. Net profit for the LINZESS U.S. brand collaboration, net of commercial and research and development expenses, was $255.9 million, up 9.8% from $233.1 million a year earlier. LINZESS commercial margin was 79.8%. Ironwood recorded $129.9 million in collaboration revenue related to U.S. LINZESS sales, an 8.6% increase from $119.6 million.

Total revenue was $133.0 million, compared with $122.1 million a year earlier. That included $3.1 million in royalties and other revenue. GAAP net income was $59.8 million, or $0.36 a share, versus $40.1 million, or $0.25 a share basic and $0.23 a share diluted, a year earlier. Adjusted EBITDA was a record $97.9 million, compared with $81.8 million a year earlier.

Total costs and expenses were $39.9 million, including $28.3 million of research and development and $11.6 million of selling, general and administrative expenses. A year earlier, costs included $2.2 million of restructuring. Interest expense was $6.2 million on the revolving credit facility, compared with $8.4 million a year earlier on convertible senior notes and the revolving credit facility. Income tax expense was $27.8 million, the majority of which the company said was non-cash.

Cash from operations was $130.8 million, compared with $47.6 million a year earlier. Ironwood repaid $60.0 million on the revolving credit facility in the third quarter, leaving $325.0 million outstanding and $225.0 million of remaining borrowing capacity. Cash and cash equivalents ended the quarter at $86.4 million, compared with $215.5 million at the end of 2025. Accounts receivable were $132.7 million, primarily related to third-quarter collaboration revenues.

The STARS-2 confirmatory Phase 3 trial of apraglutide in short bowel syndrome with intestinal failure is ongoing. Planned activation of more than 100 sites in 22 countries is on track, the company said, after the trial began actively recruiting in the second quarter. Subject to trial results, Ironwood plans to file for regulatory approval in 2029.

In October, Chief Commercial Officer Tammi Gaskins was appointed chief executive officer effective January 1, 2027. McCourt will retire from that role on that date and remain on the board.