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Trulance

plecanatide
Used for Constipation
Used for Constipation

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.

Reviewed by:
reviewer
Cydnee Ng, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on January 14, 2025
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
basics-icon

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.

When does Trulance (plecanatide) start working?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsTrulance
Drug ClassGC-C agonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$689.53(save 12.39%)
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$604.08
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What are the 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%)

Other Side Effects

IBS-C: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

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
When do Trulance (plecanatide) possible side effects begin and end?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Diarrhea
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (Report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Trulance (plecanatide)

thumbs-up

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

thumbs-down

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

Pharmacist tips for Trulance (plecanatide)

pharmacist

  • 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.

                      faqs

                      Frequently asked questions about Trulance (plecanatide)

                      Does Trulance (plecanatide) cause weight gain or weight loss?
                      People didn't report any changes in body weight while they were taking Trulance (plecanatide) 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.
                      How long does it take for Trulance (plecanatide) to work?
                      In clinical studies, some people with long-term constipation had a bowel movement within the first day of taking Trulance (plecanatide). 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 (plecanatide) every day.
                      How well does Trulance (plecanatide) work?
                      A study showed that about 20% of people with CIC who took Trulance (plecanatide) 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 (plecanatide) had less stomach pain for at least 6 weeks. Follow up with your care team to learn more about how Trulance (plecanatide) might benefit your condition.
                      How long does Trulance (plecanatide) stay in your system?
                      It isn't clear how long Trulance (plecanatide) lasts in your system. Not much of Trulance (plecanatide) 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 (plecanatide) at the same time every day so it can work as best as it can for you.
                      Can I take Trulance (plecanatide) twice a day?
                      No, don't take Trulance (plecanatide) 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 (plecanatide).
                      Do Trulance (plecanatide) side effects go away?
                      It's possible for some side effects of Trulance (plecanatide), such as diarrhea, to get better with time. Most cases of diarrhea happen within 4 weeks of starting Trulance (plecanatide). 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.
                      Is Trulance (plecanatide) a laxative or stool softener?
                      No. Trulance (plecanatide) 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 (plecanatide) 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 (plecanatide).
                      What's the difference between Trulance (plecanatide) and Linzess (linaclotide)?
                      Trulance (plecanatide) 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 (plecanatide) 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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                      What are the 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.

                      risk-warning

                      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.

                      risk-warning

                      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.

                      dosage

                      Trulance (plecanatide) dosage forms

                      The average cost for 1 dose pack of 30 tablets of 3mg of Trulance (plecanatide) is $604.08 with a free GoodRx coupon. This is 12.39% off the average retail price of $689.53.
                      dose pack
                      Dose pack
                      DosageQuantityPrice as low asPrice per unit
                      30 tablets of 3mg1 dose pack$604.08$604.08

                      Typical dosing for Trulance (plecanatide)

                      The typical dose is 3 mg by mouth once a day.

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                      How much does Trulance (plecanatide) cost?

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                      Trulance (brand)
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                      contraindications-icon

                      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

                      alternatives

                      What are alternatives to Trulance (plecanatide)?

                      There are a number of medications that your doctor can prescribe in place of Trulance (plecanatide). Compare a few possible alternatives below.
                      Trulance (plecanatide)
                      Used for:
                      $604.08 Lowest GoodRx priceView Prices
                      Lubiprostone (Amitiza)
                      Used for:

                      • Long-term constipation due to unclear cause (idiopathic)

                      • Constipation due to opioids

                      • Constipation due to irritiable bowel syndrome (IBS) in women 18 years or older

                      $45.00 Lowest GoodRx priceView Prices
                      Linzess (linaclotide)
                      Used for:
                      $563.46 Lowest GoodRx priceView Prices

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                      References

                      Best studies we found

                      Allen, P., et al. (2024). Pediatric functional constipation. StatPearls.

                      Barish, C. F., et al. (2019). Long-term treatment with plecanatide was safe and tolerable in patients with irritable bowel syndrome with constipation. Current Medical Research and Opinion.

                      Bassotti, G., et al. (2021). Chronic idiopathic constipation in adults: A review on current guidelines and emerging treatment options. Clinical and Experimental Gastroenterology.

                      View All References (5)

                      DeMicco, M., et al. (2017). Randomized clinical trial: Efficacy and safety of plecanatide in the treatment of chronic idiopathic constipation. Therapeutic Advances in Gastroenterology.

                      MedlinePlus. (2024). Tube feeding.

                      Rao, S. S. C. (2018). Plecanatide: A new guanylate cyclase agonist for the treatment of chronic idiopathic constipation. Therapeutic Advances in Gastroenterology.

                      Salix Pharmaceuticals Inc. (2024). Trulance immediate release- plecanatide tablet [package insert]. DailyMed.

                      Shah, E. D., et al. (2018). Efficacy and tolerability of guanylate cyclase-c agonists for irritable bowel syndrome with constipation and chronic idiopathic constipation: A systematic review and meta-analysis. The American Journal of Gastroenterology.

                      GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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