Medically reviewed by Drugs.com. Last updated on Aug 18, 2019.
(ple KAN a tide)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Trulance: 3 mg
Brand Names: U.S.
- Gastrointestinal Agent, Miscellaneous
- Guanylate Cyclase-C (GC-C) Agonist
Plecanatide and its active metabolite bind and agonize guanylate cyclase-C on the luminal surface of intestinal epithelium. Intracellular and extracellular cyclic guanosine monophosphate (cGMP) concentrations are subsequently increased resulting in chloride and bicarbonate secretion into the intestinal lumen. Intestinal fluid increases and GI transit time is accelerated.
Minimal systemic availability; plasma concentrations are not measurable when used at recommended doses
Minimal tissue distribution is expected given immeasurable plasma concentrations when used at recommended doses.
Metabolized within GI tract to active metabolite; parent drug and metabolite undergo proteolytic degradation within the intestinal lumen to smaller peptides and amino acids.
Use: Labeled Indications
Chronic idiopathic constipation: Treatment of chronic idiopathic constipation (CIC) in adults
Irritable bowel syndrome with constipation: Treatment of irritable bowel syndrome with constipation (IBS-C) in adults
Pediatric patients <6 years; mechanical gastrointestinal obstruction (known or suspected).
Chronic idiopathic constipation (CIC): Oral: 3 mg once daily
Irritable bowel syndrome with constipation (IBS-C): Oral: 3 mg once daily
Refer to adult dosing; use with caution.
Administer with or without food. Swallow tablet whole.
For patients with swallowing difficulties, tablets can be crushed and administered orally either in applesauce or with water or administered with water via a nasogastric or gastric feeding tube. Mixing crushed tablets in other soft foods or in other liquids has not been tested.
Administration in applesauce: Crush tablet to a powder and mix with 1 teaspoonful (5 mL) of room temperature applesauce. Swallow entire mixture immediately. Do not store mixture for later use.
Administration in water: Combine tablet and ~30 mL of room temperature water into a cup and mix by gently swirling for at least 10 seconds; the tablet will fall apart in the water. Swallow the entire contents of the mixture immediately. If any portion of the tablet is left in the cup, add another 30 mL of water to the cup, swirl for at least 10 seconds, and swallow immediately. Do not store mixture for later use.
Administration via a nasogastric or gastric feeding tube: Combine tablet and 30 mL of room temperature water into a cup and mix by gently swirling for at least 15 seconds; the tablet will fall apart in the water. Flush the nasogastric or gastric feeding tube with 30 mL of water using an appropriate syringe. Draw up the mixture using the syringe and immediately administer via the nasogastric or gastric feeding tube. If any portion of the tablet is left in the cup, add another 30 mL of water to the cup, swirl for at least 15 seconds, and using the same syringe, administer via the nasogastric or gastric feeding tube. Using the same or a fresh syringe, flush the nasogastric or gastric feeding tube with at least 10 mL of water after administration. Do not store mixture for later use.
Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Do not subdivide or repackage; protect from moisture.
There are no known significant interactions.
1% to 10%:
Central nervous system: Dizziness (1% to <2%)
Gastrointestinal: Diarrhea (4% to 5%), abdominal distension (<2%), abdominal tenderness (<2%), flatulence (<2%), nausea (1% to <2%), severe diarrhea (≤1%)
Genitourinary: Urinary tract infection (1% to <2%)
Hepatic: Increased serum ALT (<2%), increased serum AST (<2%)
Respiratory: Sinusitis (<2%), upper respiratory tract infection (<2%), nasopharyngitis (1% to <2%)
ALERT: U.S. Boxed WarningRisk of serious dehydration in pediatric patients:
Plecanatide is contraindicated in patients younger than 6 years; in nonclinical studies in young juvenile mice, administration of a single oral dose of plecanatide caused deaths due to dehydration. Avoid use of plecanatide in patients 6 years to younger than 18 years of age. The safety and effectiveness of plecanatide has not been established in patients younger than 18 years.
Concerns related to adverse effects:
• Diarrhea: May cause diarrhea; may occur within the first month of treatment (severe diarrhea may occur within the first 3 days of treatment). Consider discontinuation of therapy and rehydration if severe diarrhea occurs.
• Pediatric patients: [US Boxed Warning]: Use is contraindicated in pediatric patients <6 years. Avoid use in pediatric patients 6 to 17 years of age. In studies in young juvenile mice, administration of a single oral dose of plecanatide caused deaths due to dehydration. The safety and effectiveness of plecanatide has not been established in patients <18 years.
Frequency of straining during bowel movements; spontaneous bowel movement quality and frequency
Plecanatide and its metabolite are not measurable in plasma when used at recommended doses. Maternal use is not expected to result in fetal exposure.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Have patient report immediately to prescriber severe or persistent diarrhea (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about plecanatide
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- En Español
- 148 Reviews
- Drug class: guanylate cyclase-C agonists
Other brands: Trulance