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Plecanatide (Trulance)

Peptide

Plecanatide is a 16-amino acid synthetic uroguanylin analog and guanylate cyclase-C agonist. FDA-approved 2017 for CIC, 2018 for IBS-C. Phase 3: 21% durable CSBM responders vs 10.2% placebo in CIC (P<0.001). 30% overall responders vs 17.8% placebo in IBS-C. Lower diarrhea rate (5%) than linaclotide. Dose: 3 mg once daily.

Quick Answer

What it is

Plecanatide is a 16-amino acid synthetic uroguanylin analog and guanylate cyclase-C agonist. FDA-approved 2017 for CIC, 2018 for IBS-C.

Key findings

  • Grade A: Durable CSBM Response CIC (Constipation)
  • Grade A: Overall Response IBS-C (Constipation-Predominant Irritable Bowel Syndrome (IBS-C))
  • Grade A: Abdominal Pain IBS-C (Constipation-Predominant Irritable Bowel Syndrome (IBS-C))

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

⚠️ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹ️ Quick Facts: Plecanatide (Trulance)

Quick Facts: Plecanatide (Trulance)

  • Best Evidence:Grade A
  • Conditions Studied:2
  • Research Outcomes:8
  • Grade A Findings:4
  • Grade B Findings:1
  • Key Effect:Constipation
A4
B1
C1
D2
2 conditions · 8 outcomes

Detailed Outcomes

|
A
Durable CSBM Response CIC
Phase 3: 21.0% durable overall CSBM responders (3mg) vs 10.2% placebo (P<0.001). Responders had ≥3 CSBMs/week with ≥1 increase for ≥9 of 12 weeks. CSBM frequency increased 2.5/week vs 1.2/week placebo.
large↑Improves
A
Abdominal Bloating
Significant improvement in bloating, cramping, discomfort, and fullness vs placebo. Benefits observed by week 1 and sustained through 12 weeks. Similar efficacy to linaclotide with lower diarrhea rate.
large↓Improves
A
Overall Response IBS-C
Phase 3: 30.2% overall responders (3mg) vs 17.8% placebo (P<0.001). Dual endpoint: ≥30% pain reduction + ≥1 CSBM increase for ≥6 of 12 weeks. Consistent across two identical trials (n=2,189).
large↑Improves
A
Abdominal Pain IBS-C
Significant reduction in worst abdominal pain vs placebo. ≥30% improvement in pain required for FDA responder endpoint. cGMP-mediated visceral analgesia mechanism.
large↓Improves
B
Safety/Tolerability
13 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.
moderate↑Improves
C
GI Protection
4 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves
D
Anti-Inflammatory Activity
2 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves
D
Anti-Cancer Activity
2 preclinical studies support this finding. Primarily preclinical evidence.
small↑Improves

Research Citations (28)

Efficacy and tolerability of plecanatide for irritable bowel syndrome with constipation and chronic idiopathic constipation: a systematic review and meta-analysis.
(2026)
PMID: 41604554
Post-marketing safety assessment of constipation drugs: a real-world pharmacovigilance study based on FAERS database.
(2025)
PMID: 39950440
The Safety of Pharmacotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.
(2025)
PMID: 40471839
Constipation-predominant irritable bowel syndrome treatment options Linaclotide, Lubiprostone, Plecanatide, and Tenapanor: analysis of the FDA Adverse Event Reporting System (FAERS) database.
(2025)
PMID: 40503810
Efficacy and Safety of Plecanatide in Chinese Patients with Functional Constipation: A Phase III Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.
(2025)
PMID: 40571893
Plecanatide Is Efficacious in Women Aged 18 to 40 Years With IBS-C and Bloating: A Pooled Analysis of Two Phase 3, Randomized, Placebo-Controlled Trials.
(2025)
PMID: 41625190
Plecanatide Improves Abdominal Bloating and Bowel Symptoms of Irritable Bowel Syndrome with Constipation
(2024)
PMID: 38691604
Assessing real-world safety of plecanatide: a pharmacovigilance study based on the FDA adverse event reporting system.
(2024)
PMID: 39654622
Efficacy and Safety of Plecanatide in Treatment of Irritable Bowel Syndrome With Constipation and Chronic Idiopathic Constipation.
(2024)
PMID: 39896924
Plecanatide Improves Symptoms of Irritable Bowel Syndrome with Constipation: Results of an Integrated Efficacy and Safety Analysis of Two Phase 3 Trials
(2023)
PMID: 37507497

Related Peptides

Linaclotide (Linzess)

Peptide

2 shared conditions · 9 outcomes

Linaclotide is a 14-amino acid peptide guanylate cyclase-C (GC-C) agonist. FDA-approved 2012 for chronic idiopathic constipation (CIC) and IBS-C. Phase 3: 33.7% FDA responder rate vs 13.9% placebo in IBS-C. Improves bowel frequency, stool consistency, and abdominal pain. Doses: 72-145 mcg (CIC), 290 mcg (IBS-C) once daily.