Trulance
Trulance (plecanatide) is used to treat adults with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (long-term constipation of an unknown cause). It belongs to a group of medications called guanylate cyclase-C (GC-C) agonists. The usual dosage is 1 tablet by mouth once a day. A possible side effect of the medication is diarrhea. This medication isn't available as a generic, but you can get it as the brand name Trulance.
What is Trulance (plecanatide)?
What is Trulance (plecanatide) used for?
How Trulance (plecanatide) works
Trulance (plecanatide) is a guanylate cyclase-C (GC-C) agonist. It turns on GC-C, a protein that works in the intestines. This helps raise the amount of fluid in your intestines and speed up the movement of food through your gut. These actions soften stool, relieve belly pain, and help you have regular bowel movements.
Drug facts
Side effects of Trulance (plecanatide)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea (up to 5%)
Less Common Side Effects
IBS-C:
- Nausea
- Dizziness
- Upper respiratory tract infection (e.g., sore throat, cough, stuffy nose, runny nose)
- Urinary tract infection
CIC:
- Sinus infection
- Upper respiratory tract infection (e.g., sore throat, cough, stuffy nose, runny nose)
- Bloating and feeling full in the belly
- Flatulence (gas)
- Stomach pain
Trulance (plecanatide) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe diarrhea
- Bloody stools or black stools that look like tar
- Dehydration: confusion, exhaustion, dizziness, fainting, racing heart
The following Trulance (plecanatide) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (Report these to your care team if they continue or are bothersome):
- Diarrhea
- Dizziness
- Nausea
- Sore throat
- Runny or stuffy nose
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Pros and cons of Trulance (plecanatide)
Pros
- Can take at any time of the day with or without food
- Only need to take once a day
- Might start to see overall improvement after a week of taking the medication every day
Cons
- Doesn’t provide immediate relief from constipation like laxatives do
- Not a good option for people with a gut blockage
- Not safe for children younger than 18 years of age
Pharmacist tips for Trulance (plecanatide)
- Take Trulance (plecanatide) once a day, with or without food.
- Swallow the Trulance (plecanatide) tablet whole. If you have trouble swallowing it whole, you can follow the instructions to crush the tablet and mix it with either applesauce or water. Once prepared, take the medication right away.
- If you're mixing a crushed tablet with applesauce, crush 1 tablet of Trulance (plecanatide) into a powder in a clean container. Then, mix it with 1 teaspoonful of room-temperature applesauce. Eat the mixture right away. Don't save any of the leftover mixture for later use.
- If you're mixing a crushed tablet with bottled water, place 1 tablet of Trulance (plecanatide) into a clean cup. Then, pour 30 mL (2 tablespoons) of room-temperature water into the cup. Swirl the cup for 10 seconds to mix and then drink right away. If there’s some of the tablet left in the cup, add another 30 mL of water to the cup, mix for 10 seconds, and drink immediately. Don't save any leftover solution.
- If you have a feeding tube, flush it with 30 mL of room-temperature water before giving Trulance (plecanatide). Place 1 tablet in a clean cup of 30 mL of water. Swirl the mixture for 15 seconds and then draw it up into an appropriate syringe. Then, push the syringe plunger down to give the medication through the tube. If you see any tablet bits remaining, add another 30 mL of water to the cup and repeat the process. Once complete, flush the feeding tube with at least 10 mL of water.
- Stop taking Trulance (plecanatide) and contact your prescriber right away if you have severe diarrhea. Severe diarrhea can lead to dehydration. Your prescriber can discuss with you whether it’s safe for you to continue taking Trulance (plecanatide).
- Stop taking Trulance (plecanatide) and get medical help right away if you feel very tired, dizzy, exhausted, or confused. These can be signs of severe dehydration.
- If you miss a dose of Trulance (plecanatide), don't double up to make up for it. Just wait to take your usual dose at your usual time the next day.
- Keep Trulance (plecanatide) in its original bottle. Don't remove the desiccant packet included inside the bottle because it helps keep your medication dry. Store Trulance (plecanatide) in a dry place at room temperature.
- Ask your prescriber whether it's safe to take other laxatives, like bisacodyl (Dulcolax), with Trulance (plecanatide). This combination can sometimes lead to worse side effects, like diarrhea.
Common questions about Trulance
People didn't report any changes in body weight while they were taking Trulance during clinical studies. Talk to your prescriber if you notice concerning weight gain or weight loss so they can help you figure out what might be causing this change in weight.
In clinical studies, some people with long-term constipation had a bowel movement within the first day of taking Trulance. Some people saw an overall improvement in the number of episodes of constipation after about a week of starting the medication. Whether you have long-term constipation or IBS-C, your symptoms should generally get better over the next several weeks as you continue to take Trulance every day.
A study showed that about 20% of people with CIC who took Trulance had improvement in their gut condition after 12 weeks. They had at least 3 complete, natural bowel movements per week and at least 1 more per week than they usually do. By comparison, about 13% of people who took a placebo had similar results after 12 weeks. Another study showed that up to 41% of people with IBS-C who took Trulance had less stomach pain for at least 6 weeks. Follow up with your care team to learn more about how Trulance might benefit your condition.
It isn't clear how long Trulance lasts in your system. Not much of Trulance gets absorbed into your body after you take the medication. Once swallowed, the medication gets broken down in your gut. It's important to take Trulance at the same time every day so it can work as best as it can for you.
No, don't take Trulance more than once a day. Otherwise, it can cause serious side effects, like severe diarrhea. This can potentially cause you to lose too much fluids from your body, leading to dehydration. Follow your prescriber's directions carefully when you're taking Trulance.
It's possible for some side effects of Trulance, such as diarrhea, to get better with time. Most cases of diarrhea happen within 4 weeks of starting Trulance. Talk to your prescriber if you have any side effects that are very bothersome or that don't seem to be getting better as you continue to take this medication.
No. Trulance isn't a laxative, which means it's also not a stool softener. Examples of laxatives include stool softeners like docusate (Colace) and stimulant laxatives like bisacodyl. Laxatives are often used to provide quick relief from occasional constipation. And they're typically taken on an as-needed basis. But Trulance is a type of medication called a guanylate cyclase-C (GC-C) agonist. It's taken once every day to manage long-term constipation and symptoms related to IBS-C. Ask a healthcare professional to learn more about differences between laxatives and Trulance.
Trulance and Linzess (linaclotide) are both treatment options for IBS-C as well as for chronic idiopathic constipation (CIC). Both medications are taken once a day and work in similar ways. In fact, studies show that Trulance and Linzess (linaclotide) work just as well as one another for IBS-C or CIC. Linzess (linaclotide) is also FDA approved to treat functional constipation in children. Talk with your prescriber to compare between the two medications and discuss which is right for you.
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Risks and warnings for Trulance (plecanatide)
Trulance (plecanatide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious dehydration in children younger than 6 years of age
Children younger than 6 years of age can’t take Trulance (plecanatide). Based on animal studies, young children can be at risk for life-threatening dehydration with Trulance (plecanatide) treatment. Also avoid Trulance (plecanatide) in people between 6 to 18 years of age to be safe.
Keep Trulance (plecanatide) out of reach from children to prevent them from accidentally taking the medication. If you think or know that a child has accidentally taken Trulance (plecanatide), contact 911 or the poison control center (1-800-222-1222) right away.
Severe diarrhea
Although rare, Trulance (plecanatide) can cause severe diarrhea. This can lead to life-threatening dehydration. Make sure to drink plenty of fluids while you're taking this medication.
Stop taking Trulance (plecanatide) and get medical help right away if you develop severe diarrhea, dizziness, or exhaustion. You’ll need to see a healthcare professional so they can help prevent (or treat) severe dehydration.
Trulance (plecanatide) dosage
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30 tablets of 3mg | 1 dose pack | $560.87 | $560.87 |
Typical dosage for Trulance (plecanatide)
The typical dose is 3 mg by mouth once a day.
How much does Trulance (plecanatide) cost?
$560.87
Trulance (plecanatide) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Trulance (plecanatide) will not be safe for you to take.
- Children younger than 6 years of age
- Known or suspected gut blockage
What are alternatives to Trulance (plecanatide)?
