Plecanatide

Also known as: Trulance, SP-304

A uroguanylin analog that increases intestinal fluid secretion. FDA-approved as Trulance for chronic constipation and IBS-C. Prescription medication.

Last updated October 26, 2026

Mechanism of Action

Plecanatide is a 16-amino-acid analog of the endogenous peptide uroguanylin, differing by one amino acid. It binds and activates guanylate cyclase-C on intestinal epithelial cells, increasing cyclic GMP, which opens the CFTR channel and drives chloride and bicarbonate secretion into the lumen. The added fluid softens stool and speeds transit. Like uroguanylin, its binding is pH-sensitive and favors the more acidic proximal small intestine. It is minimally absorbed.

Half-life: Not measurable in plasma at labeled doses (minimal absorption)
Administration Routes: Oral
Research Status: Clinical

Reported Benefits

Approved for chronic idiopathic constipation in adults
Approved for irritable bowel syndrome with constipation in adults
Increased complete spontaneous bowel movements in Phase 3 trials

Potential Side Effects

Diarrhea (most common)
Sinusitis and upper respiratory infection
Abdominal distension and flatulence
Boxed warning: risk of serious dehydration in pediatric patients

Common Dosing

Labeled dosing is 3 mg by mouth once daily, with or without food. Dosing is set and supervised by the prescribing clinician.

The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.

Contraindications

Patients under 6 years of age
Known or suspected mechanical gastrointestinal obstruction

No documented stacking partners for Plecanatide yet.

A Randomized Phase III Clinical Trial of Plecanatide, a Uroguanylin Analog, in Patients With Chronic Idiopathic Constipation
2017
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Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials
2018
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Yes. The FDA approved plecanatide as Trulance in January 2017 for chronic idiopathic constipation in adults and in January 2018 for irritable bowel syndrome with constipation in adults.

Both are guanylate cyclase-C agonists that increase fluid in the intestine. Plecanatide mimics uroguanylin and linaclotide resembles guanylin and uroguanylin; they have not been compared in a head-to-head trial, and the choice is made with a clinician.