Plecanatide
Also known as: Trulance
Plecanatide is a uroguanylin analog that activates guanylate cyclase-C on the luminal surface of the intestine, raising cyclic GMP and driving chloride and bicarbonate secretion through CFTR to increase intestinal fluid and transit.
- Drug class
- Guanylate cyclase-C (GC-C) agonist
- Primary targets
- Guanylate cyclase-C (GC-C), CFTR chloride channel, Intestinal epithelium
- Dose reference
- Reference (label, not a recommendation): one 3 mg tablet orally once daily; phase 3 trials studied 3 mg and 6 mg
- Half-life
- Not calculable; minimally absorbed with negligible systemic availability, plasma levels below limit of quantitation
- Developer / origin
- Synergy Pharmaceuticals (Trulance assets later acquired by Bausch Health)
- Reference year
- 2017
- Evidence score
- 4/5 - Approved with supportive randomized phase 3 evidence
Approved uses
- Chronic idiopathic constipation (CIC) in adults
- Irritable bowel syndrome with constipation (IBS-C) in adults
Approved with supportive randomized phase 3 evidence
Plecanatide is FDA-approved for chronic idiopathic constipation (2017) and IBS-C in adults (2018), supported by multiple randomized, double-blind, placebo-controlled phase 3 trials showing modest but statistically significant symptom improvement at a 3 mg once-daily oral dose.
Investigational compound with human randomized or phase 2/3 evidence.
Evidence basis
- FDA Trulance prescribing information establishing approved indications, 3 mg once-daily dosing, boxed dehydration warning, and negligible systemic absorption
- Phase 3 CIC trial (n=1,394) showing durable CSBM responder rates of ~21% (3 mg) and ~19.5% (6 mg) vs ~10% placebo
- Two identical phase 3 IBS-C trials (Brenner et al., Am J Gastroenterol 2018) showing improved abdominal pain and constipation vs placebo over 12 weeks
- Modest absolute benefit and lack of head-to-head superiority data versus linaclotide and standard laxatives temper the strength of evidence
Key references
- PubMedA Randomized Phase III Clinical Trial of Plecanatide, a Uroguanylin Analog, in Patients With Chronic Idiopathic Constipation
- PubMedEfficacy, safety, and tolerability of plecanatide in patients with IBS-C: results of two phase 3 randomized clinical trials
- FDATRULANCE (plecanatide) tablets label with boxed warning
How to read this entry
Dose references and half-life values are pulled from trial protocols, labels, reviews, or published summaries where available. They are context for research and comparison, not a personal dosing recommendation.
Status matters: approved drugs have regulated indications; investigational compounds are still being studied; research-only peptides do not have established human dosing, safety, or efficacy for consumer use.
Plecanatide guides
Read the matching guide or adjacent research pages for more context.
Peptide calculators
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