Plecanatide
Aliases: Trulance
Last verified: 2026-09-23
The short version
A uroguanylin analogue — GC-C agonist for chronic idiopathic constipation and IBS-C, with less diarrhea than linaclotide.
Identity & type
- Molecular type
- peptide
- Origin
- A uroguanylin analogue — GC-C agonist for chronic idiopathic constipation and IBS-C, with less diarrhea than linaclotide.
Mechanism of action
pH-dependent GC-C activation in the gut → cGMP → fluid secretion.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. 3 mg orally daily.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
3 mg orally daily. Trulance: similar to linaclotide, slightly gentler GI profile; effect felt in the first week.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Trulance: similar to linaclotide, slightly gentler GI profile; effect felt in the first week.
Protocol — official vs community
Official / label
Trulance, for chronic idiopathic constipation and IBS-C in adults: 3 mg orally once daily, with or without food.
Duration: Chronic while indicated.
A uroguanylin analogue with pH-dependent GC-C activation — phase 3 showed a diarrhea rate below linaclotide's, though both are well tolerated overall. Effect on stool frequency is typically felt within the first week.
Community (anecdotal)
Per label: 3 mg orally once daily.
- Cycle:
- Continuous.
- Break:
- None by design.
Like linaclotide, a commodity prescription drug with patient chatter but no gray-market protocol life.
Human evidence
Phase III for CIC and IBS-C.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Diarrhea (less frequent than linaclotide).characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials