A medicine for chronic constipation and constipation-type IBS

Plecanatide

A daily tablet used for chronic constipation and constipation-type IBS in adults.

What is Plecanatide?

Plecanatide is a medicine taken by mouth for long-term (chronic) constipation and for constipation-predominant irritable bowel syndrome (IBS-C) in adults. It works in the bowel to draw fluid into the gut and help stools move along, making them softer and easier to pass. The most important side effect is diarrhoea, which can sometimes be severe; if this happens, treatment may need to be paused or stopped. It is for adults only and must not be given to young children. It is taken once a day, with or without food.

Class: Guanylate cyclase-C agonist (for constipation) · Brands: Trulance

Education and reference only. This is a plain-language guide to Plecanatide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Guanylate cyclase-C agonist (for constipation) → Brands: Trulance
Plecanatide (Guanylate cyclase-C agonist (for constipation)) — Meds Global Health reference card with 2D molecular structure
Plecanatide — Guanylate cyclase-C agonist (for constipation). The image shows the active ingredient's 2D molecular structure.

What it is

Plecanatide is a medicine used in adults for chronic constipation and for constipation-predominant irritable bowel syndrome (IBS-C), where constipation comes with tummy pain and bloating. It belongs to a group of medicines that act locally in the bowel to increase fluid and help things move along. It is taken by mouth as a once-daily tablet. It is generally used when simpler measures and ordinary laxatives have not given enough relief, and it is for adults only because it can be harmful in young children.

How it works

Plecanatide acts on receptors in the lining of the bowel (called guanylate cyclase-C receptors), switching on a process that draws fluid into the gut. This extra fluid softens the stool and helps it move through the bowel more easily, relieving constipation. In IBS-C, this gentler, more regular bowel movement can also ease the discomfort and bloating that go with it. Because it works locally in the gut, very little is absorbed into the rest of the body. Its main effect, and its main side effect, both come from this fluid-drawing action: too much can cause diarrhoea.

Company & origin

Originated / developed by: Specialist manufacturer.

A medicine used for chronic constipation and constipation-predominant irritable bowel syndrome in adults, taken as a daily tablet.

What it treats

Conditions Plecanatide is used for

Irritable bowel syndrome (IBS)A common long-term gut disorder causing abdominal pain and changes in bowel habit without …

Practical use

How to take Plecanatide

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take one tablet by mouth once a day, with or without food, at about the same time each day.
  • If you get significant or watery diarrhoea, stop taking it and contact your prescriber.
  • Keep up a good fluid intake while taking it, especially if your stools become loose.
  • Do not give it to children; it is for adults only and can be dangerous in young children.
  • Tell your prescriber about new symptoms such as bleeding from the back passage or unexplained weight loss.

Weighing it up

Advantages & disadvantages of Plecanatide

Advantages

  • Helps relieve chronic constipation and constipation-type IBS when simpler measures are not enough.
  • Taken as a simple once-daily tablet, with or without food.
  • Works locally in the gut, with very little absorbed into the rest of the body.

Disadvantages

  • Diarrhoea is the main side effect and can sometimes be severe.
  • Must not be used in young children because of the risk of dangerous fluid loss.
  • May need to be paused or stopped if diarrhoea becomes troublesome.

Practical use

Good to know

The most important thing to know about plecanatide is that its main side effect is diarrhoea, which can occasionally be severe and lead to dehydration. If you get significant or watery diarrhoea, stop taking it and contact your prescriber, who may pause or stop treatment. A crucial safety point is that it must not be given to young children, in whom medicines of this type can cause dangerous fluid loss; it is for adults. It is taken once a day and can be taken with or without food. It helps to keep up good fluid intake while taking it. As with any change in bowel habit, tell your prescriber about new or unusual symptoms such as bleeding or unexplained weight loss, which need checking.

Who should not take it / use with caution

  • It must not be given to young children, in whom it can cause dangerous fluid loss.
  • People who have had a serious allergic reaction to plecanatide should not take it.
  • It should not be used if there is a known or suspected blockage in the bowel.

Monitoring

  • Reviewing how well constipation or IBS symptoms improve.
  • Watching for diarrhoea and signs of dehydration, especially early on.
  • Reviewing whether treatment is still needed over time.

Side effects

  • Diarrhoea, which is the most common side effect and can sometimes be severe.
  • Tummy pain, bloating or wind in some people.
  • Rarely, severe diarrhoea leading to dehydration, which needs prompt medical attention.

Key interactions

  • It has few well-established medicine interactions, as very little is absorbed into the body.
  • Other medicines that loosen the bowel may add to the risk of diarrhoea.
  • Tell your prescriber about all your medicines so your treatment can be reviewed.

Available as: Tablets taken by mouth.

Answers

Plecanatide: frequently asked questions

What is plecanatide used for?

It is used in adults for chronic constipation and for constipation-predominant IBS, by drawing fluid into the bowel to soften stools and help them pass.

What is its main side effect?

Diarrhoea is the most common side effect and can sometimes be severe; if this happens, stop taking it and contact your prescriber.

Can children take it?

No. It must not be given to young children because medicines of this type can cause dangerous fluid loss; it is for adults only.

Do I take it with food?

It can be taken with or without food, once a day at about the same time each day.

What if I get watery diarrhoea?

Stop taking it, keep up your fluids and contact your prescriber, who may pause or stop the treatment.

The wider class

About Guanylate cyclase-C agonist (for constipation)

Plecanatide belongs to the guanylate cyclase-c agonist (for constipation) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

LaxativesDifferent types for different problems — chosen by cause and stool consistency. BisacodylA stimulant laxative for short-term relief of constipation; it can cause tummy cramps and …DocusateA gentle stool-softener laxative that makes stools easier to pass; it works mildly and is …LactuloseAn osmotic laxative that softens stools by drawing water into the bowel; it takes a day or…Ispaghula huskA bulk-forming laxative (fibre) that must be taken with plenty of water; never take it jus…Sodium picosulfateA stimulant laxative, usually taken at night, for short-term constipation or to clear the …Magnesium hydroxideA gentle osmotic laxative that also works as an antacid, best known as milk of magnesia.…Glycerol suppositoriesA simple suppository inserted into the back passage to relieve constipation quickly.…SennaA stimulant laxative that encourages the bowel to move, used for short-term relief of cons…MacrogolAn osmotic laxative that draws water into the bowel to soften stool and relieve constipati…Arachis oil enemaA peanut (arachis) oil retention enema used rectally to soften hard, impacted stools so th…Co-danthramerA combination stimulant laxative used mainly for constipation in people receiving palliati…Co-danthrusateA combination stimulant laxative used mainly for constipation in people receiving palliati…ElobixibatA laxative for chronic constipation that works by increasing bile acids in the bowel to dr…Glycerol suppositoryA rectal suppository that relieves constipation by softening the stool and gently stimulat…Magnesium citrateAn osmotic laxative used for constipation and to clear the bowel before procedures, workin…MethylcelluloseA bulk-forming laxative that adds bulk to the stool to ease constipation, taken with plent…NaldemedineA once-daily tablet that treats constipation caused by opioid painkillers without reducing…NaloxegolA once-daily tablet for opioid-induced constipation that blocks opioids in the gut without…Phosphate enemaA phosphate rectal enema used for rapid relief of constipation and to clear the bowel befo…PrucaloprideA daily tablet used for chronic constipation when ordinary laxatives have not worked well …Sodium citrate enemaA small osmotic enema inserted into the back passage to relieve occasional constipation, w…SterculiaA bulk-forming laxative made from plant fibre that treats constipation and helps regulate …

Browse by body system

Digestive systemConditions and medicines for the gut — acid reflux, ulcers, IBS, constipation, nausea and …

Authoritative sources

  • BNF
  • NICE CKS

Building a medicines information resource?

We create evidence-led, dose-free drug and formulary references for teams.

Talk to us ☎ +44 7448 439750
☎ Call Get a Proposal