Plecanatide for Treatment of Chronic Constipation and Irritable Bowel Syndrome

Love BL1. Am J Med. 2018 Dec 11. pii: S0002-9343(18)31154-9. doi: 10.1016/j.amjmed.2018.11.027. [Epub ahead of print]

Author information

1 University of South Carolina College of Pharmacy, Department of Clinical Pharmacy and Outcomes Sciences, Columbia, SC. Electronic address: loveb@cop.sc.edu.


Chronic idiopathic constipation and irritable bowel syndrome with constipation are commonly encountered in ambulatory patients, but limited options exist for patients with persistent or severe symptoms following treatment with non-prescription products. Plecanatide (Trulance, Synergy Pharmaceuticals) is a 16-amino acid peptide analogue of uroguanylin that stimulates guanylate cyclase-C receptors to increase chloride and bicarbonate secretion into the intestine and prevents the absorption of sodium ions, thereby increasing the secretion of water into the lumen. The influx of additional fluid accelerates intestinal transit, softens the stool and facilitates easier defecation. Plecanatide is the second guanylate cyclase-C receptor agonist to be approved by the US Food and Drug Administration for chronic idiopathic constipation and irritable bowel syndrome, but plecanatide is unique since its effects are limited to the proximal small bowel.

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