What is Plecanatide: Uses, Dosage, Side Effects and More

Plecanatide is a prescription medication that helps treat chronic constipation and irritable bowel syndrome with constipation (IBS-C). This gentle yet effective treatment works by encouraging your intestines to produce more fluid, which softens stool and makes bowel movements easier and more comfortable.

What is Plecanatide?

Plecanatide is a synthetic peptide medication that mimics a natural hormone in your body called guanylin. It belongs to a class of drugs called guanylate cyclase-C agonists, which sounds complex but simply means it helps your intestines work more effectively.

This medication comes as a small tablet that you take by mouth once daily. Unlike some harsh laxatives that can cause cramping or urgency, plecanatide works gently with your body's natural processes to restore normal bowel function.

The FDA approved plecanatide in 2017 after clinical studies showed it could significantly improve bowel movement frequency and reduce straining in people with chronic constipation.

What is Plecanatide Used For?

Plecanatide treats two main conditions that affect millions of people worldwide. Your doctor might prescribe it if you're struggling with persistent digestive issues that impact your daily life.

The primary use is for chronic idiopathic constipation, which means long-term constipation without an obvious underlying cause. This condition involves having fewer than three bowel movements per week, along with symptoms like straining, hard stools, or feeling like you can't completely empty your bowels.

Plecanatide also treats irritable bowel syndrome with constipation (IBS-C). This condition combines the constipation symptoms mentioned above with abdominal pain, bloating, and changes in bowel habits that have persisted for at least three months.

How Does Plecanatide Work?

Plecanatide works by activating specific receptors in your intestinal lining called guanylate cyclase-C receptors. When these receptors are activated, they trigger a cascade of events that increases fluid secretion into your intestines.

This extra fluid helps soften your stool and stimulates natural bowel movements. Think of it as helping your intestines remember how to work properly rather than forcing them to act unnaturally.

The medication is considered moderately strong compared to over-the-counter options like fiber supplements, but gentler than prescription stimulant laxatives. Most people notice improvements within the first week of treatment, though some may need up to two weeks to experience full benefits.

Unlike stimulant laxatives that can lose effectiveness over time, plecanatide maintains its benefits with continued use and doesn't typically cause dependency.

How Should I Take Plecanatide?

Take plecanatide exactly as your doctor prescribes, typically one 3-mg tablet once daily. You can take it with or without food, but taking it at the same time each day helps maintain consistent levels in your body.

Swallow the tablet whole with a full glass of water. Don't crush, chew, or break the tablet, as this can affect how the medication works in your system.

If you have trouble swallowing pills, you can crush the tablet and mix it with a small amount of applesauce or water. Use this mixture immediately and don't save it for later.

Stay well-hydrated throughout the day when taking plecanatide. Drinking plenty of water helps the medication work more effectively and reduces the risk of side effects.

How Long Should I Take Plecanatide For?

The duration of plecanatide treatment varies depending on your individual condition and response to the medication. Many people with chronic constipation need long-term treatment to maintain regular bowel function.

Your doctor will likely start you on a trial period of several weeks to assess how well the medication works for you. If you experience significant improvement in your symptoms, they may recommend continuing the treatment.

Some people with IBS-C may need ongoing treatment to manage their condition effectively. Others might be able to reduce their dose or take breaks from the medication once their symptoms improve.

Never stop taking plecanatide suddenly without consulting your doctor, as your constipation symptoms may return. Your healthcare provider will help you determine the best long-term treatment plan for your specific situation.

What Are the Side Effects of Plecanatide?

Like all medications, plecanatide can cause side effects, though most people tolerate it well. Understanding what to expect can help you feel more confident about your treatment.

The most common side effects are generally mild and related to the medication's mechanism of action. Here are the side effects you might experience:

• Diarrhea (affects about 5% of people)
• Abdominal pain or discomfort
• Flatulence (gas)
• Abdominal bloating
• Nausea
• Headache

These common side effects usually improve as your body adjusts to the medication, often within the first few days of treatment.

More serious but rare side effects require immediate medical attention. While uncommon, you should contact your doctor right away if you experience:

• Severe or persistent diarrhea that doesn't improve
• Signs of dehydration (dizziness, dry mouth, decreased urination)
• Severe abdominal pain that's different from your usual symptoms
• Blood in your stool
• Severe nausea or vomiting

Most people find that starting with proper hydration and taking the medication consistently helps minimize side effects.

Who Should Not Take Plecanatide?

Plecanatide isn't suitable for everyone, and certain medical conditions or situations make it unsafe to use. Your doctor will carefully review your medical history before prescribing this medication.

You should not take plecanatide if you're under 18 years old, as safety and effectiveness haven't been established in children and adolescents. The medication is also not recommended if you're pregnant or breastfeeding unless the benefits clearly outweigh the risks.

Specific medical conditions that make plecanatide inappropriate include:

• Known bowel obstruction or suspected bowel obstruction
• Severe inflammatory bowel disease (Crohn's disease or ulcerative colitis)
• Severe kidney disease
• History of severe diarrhea or chronic diarrhea conditions
• Allergy to plecanatide or any of its components

Tell your doctor about all your medical conditions, especially if you have a history of kidney problems, inflammatory bowel conditions, or are taking other medications that might interact with plecanatide.

Plecanatide Brand Names

Plecanatide is available under the brand name Trulance in the United States. This is currently the only brand name version available, though generic versions may become available in the future.

Trulance is manufactured by Bausch Health Companies and comes in 3-mg tablets. The medication is typically covered by most insurance plans, though coverage may vary depending on your specific plan and medical necessity.

If cost is a concern, ask your doctor about patient assistance programs or pharmacy discount programs that might help reduce your out-of-pocket expenses.

Plecanatide Alternatives

Several other medications can treat chronic constipation and IBS-C if plecanatide isn't right for you. Your doctor might consider these alternatives based on your specific symptoms and medical history.

Other prescription medications in the same class include linaclotide (Linzess) and lubiprostone (Amitiza). These work through slightly different mechanisms but have similar effects on bowel function.

Over-the-counter options that your doctor might recommend include:

• Polyethylene glycol (MiraLAX)
• Psyllium fiber supplements
• Docusate sodium (Colace)
• Bisacodyl (Dulcolax)

Your healthcare provider will help determine which treatment option is most appropriate for your specific condition and symptoms.

Is Plecanatide Better Than Linaclotide?

Both plecanatide and linaclotide are effective treatments for chronic constipation and IBS-C, but they have some differences that might make one more suitable for you than the other.

Plecanatide may cause less severe diarrhea compared to linaclotide, making it a better choice for people who are sensitive to this side effect. Clinical studies suggest that plecanatide has a lower incidence of treatment-limiting diarrhea.

Linaclotide, on the other hand, has been available longer and has more extensive clinical data supporting its use. It's also available in multiple dose strengths, allowing for more flexible dosing options.

The choice between these medications often comes down to your individual response, side effect tolerance, and cost considerations. Your doctor will help you determine which option is most appropriate for your specific situation.