Trulance (plecanatide) is a brand-name oral tablet medication prescribed for specific types of constipation in adults. It belongs to the guanylate cyclase-C agonists drug class. The Food and Drug Administration (FDA) first approved Trulance for treating chronic idiopathic constipation (CIC) in 2017 and irritable bowel syndrome with constipation (IBS-C) in 2018.
What is Trulance used for?
Trulance is a prescription medication used to treat the following conditions in adults:
Chronic idiopathic constipation (CIC): Long-lasting constipation that doesn’t have a known cause. Constipation is generally considered chronic if it lasts for at least 3 months. Symptoms of chronic constipation include:
- Having fewer than three bowel movements in 1 week
- Straining during a bowel movement
- Passing lumpy or hard stools
- Having trouble completely emptying your bowels
Irritable bowel syndrome with constipation (IBS-C): Irritable bowel syndrome is a condition that affects the large intestine. It typically causes symptoms such as abdominal pain, gas, and bloating. With IBS-C, you’ll typically have these symptoms together with constipation.
Trulance may also be used for other conditions as determined by your healthcare provider.
Read also: Weight Loss Guide Andalusia, AL
How Trulance Works
Trulance works by increasing the amount of fluid in your intestines. This helps soften your stool, making it easier to have a bowel movement. Trulance also helps to move food through your gut more quickly. Trulance attaches to sites on your small intestine. The drug works to increase the amount of fluid the intestine absorbs, which helps you have a comfortable bowel movement.
Dosage and Administration
Trulance comes as an oral tablet in one strength of 3 milligrams (mg). The usual dosage of Trulance for chronic idiopathic constipation or irritable bowel syndrome with constipation is 3 mg once per day. This is also the recommended maximum dose of Trulance.
Trulance can be taken with or without food. If you have trouble swallowing the tablet whole, you may crush it and mix it with a teaspoonful of applesauce. You can also dissolve the tablet in one ounce (30 milliliters) of water. Swallow the mixture right away.
Trulance can be given through a nasogastric or gastric tube. If you are giving it through a feeding tube, make sure that you or a caregiver understand how to properly prepare and use Trulance. If you have any questions, talk to your healthcare provider.
If you miss a dose of Trulance, you can skip your missed dose. You’ll take your next dose at its usual time. You should not take extra doses of Trulance to make up for a missed dose. If you take extra doses, it can increase your risk of side effects.
Read also: Beef jerky: A high-protein option for shedding pounds?
Trulance may be used as a long-term treatment. If you and your doctor determine that Trulance is safe and effective for you, you may take it long term.
Side Effects of Trulance
Trulance can cause mild or serious side effects. The most common side effect reported by people who took Trulance in clinical trials was mild diarrhea.
Mild Side Effects
Mild side effects of Trulance can include:
- Abdominal bloating or tenderness
- Dizziness
- Infections, such as the common cold or urinary tract infection
- Nausea
- Mild diarrhea
Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.
Serious Side Effects
Serious side effects from Trulance aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Read also: Inspiring Health Transformation
Serious side effects of Trulance can include:
- Severe diarrhea
- Risk of serious dehydration in children
- Allergic reaction
- Increased liver enzyme levels in the blood, which may indicate liver damage
Side Effect Details
Diarrhea: Mild diarrhea is the most common side effect of Trulance. With mild diarrhea, you may have loose stools along with other symptoms such as abdominal pain, bloating, or cramps. In clinical trials, mild diarrhea typically happened within the first 4 weeks of starting Trulance treatment. In rare cases, Trulance may cause severe diarrhea. With severe diarrhea, your symptoms may be so serious that your condition needs to be treated in a hospital. In clinical trials, severe diarrhea typically happened within the first 3 days of starting Trulance treatment. Both mild and severe diarrhea can increase your risk of dehydration.
- Steps you can take: If you have diarrhea, you can stay hydrated by drinking sports drinks or water. Talk with your doctor if you have bothersome or severe diarrhea while taking Trulance. They may have you stop taking the drug until your symptoms ease. In severe cases, your doctor may advise you to go to the hospital for IV rehydration (fluids injected into your body through an IV line).
Risk of serious dehydration in children: Trulance may cause serious dehydration in children. In fact, Trulance has a boxed warning for this side effect. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous. Animal trials found an increased risk of dehydration in young animals that were given Trulance. But animal trials don’t always predict what will happen in humans. It isn’t known for sure if Trulance increases the risk of dehydration in children. Because of how Trulance works in the body, the drug may increase the risk of severe diarrhea in children younger than age 6 years. And severe diarrhea can lead to serious dehydration.
Due to this risk, children younger than age 6 years should not be given Trulance. And doctors typically will not prescribe Trulance for use in people younger than age 18 years. Trulance is not approved for this age group. Your child’s doctor can recommend treatment options for their condition.
Allergic reaction: As with most drugs, some people can have an allergic reaction after taking Trulance. Symptoms of a mild allergic reaction can include: skin rash, itchiness, flushing. A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include: swelling under your skin, typically in your eyelids, lips, hands, or feet; swelling of your tongue, mouth, or throat; trouble breathing.
- What you can do: For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Trulance. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Increased liver enzyme level: Some people may have an increased liver enzyme level while taking Trulance, but this is rare. This side effect is detected through liver function tests that doctors use to check the health of your liver. If you have increased levels of liver enzymes, this can sometimes suggest there’s a problem with your liver. However, liver problems weren’t reported in Trulance studies, nor have they been reported since the drug came on the market.
Does Trulance cause weight gain or weight loss?
No, Trulance should not cause changes in your body weight, such as weight gain or weight loss. These were not side effects that people taking Trulance reported in clinical trials. However, constipation may cause bloating. So, if Trulance works to treat your constipation, you may notice some weight loss as your constipation eases.
How long does Trulance stay in your system?
It isn’t known how long Trulance stays in your system. The drug isn’t absorbed well into your body. The drug works mostly in your digestive system to treat constipation.
Precautions for Trulance
Before taking Trulance, discuss your health history with your doctor. Trulance may not be right for you if you have certain medical conditions or other factors affecting your health.
- Boxed warning: Risk of serious dehydration in children: Trulance has a boxed warning for the risk of serious dehydration in children. A boxed warning is the most serious warning from the FDA. Trulance may increase the risk of severe dehydration in children. In animal studies, this drug caused severe dehydration that led to death in some young animals. But animal studies don’t always predict what will happen in people. Trulance hasn’t been studied in children, and it’s not approved for use in children under the age of 18 years. So it’s not known if it’s safe or effective in this age group. Due to the risk of severe dehydration, Trulance must not be used in children under 6 years old. And due to this risk, doctors usually will not prescribe Trulance for older children either.
- Intestinal blockage: You should not take Trulance if you have an intestinal blockage or bowel obstruction. In this case, your doctor won’t typically recommend Trulance. Instead, they will recommend treating your intestinal blockage.
- Allergic reaction: If you’ve had an allergic reaction to Trulance or any of its ingredients, your doctor will likely not prescribe the drug. Ask your doctor what other medications may be better options for you.
- Alcohol consumption: It’s possible for alcohol to cause constipation. Since Trulance is taken to treat constipation, drinking alcohol may worsen this condition. In addition, it’s possible for alcohol to also cause diarrhea. Since Trulance can also cause diarrhea, drinking alcohol may worsen this side effect.
- Pregnancy and breastfeeding: It’s not known if it’s safe to take Trulance during pregnancy. At this time, there isn’t enough information to determine if Trulance may cause problems during pregnancy, such as congenital anomalies (commonly known as birth defects). However, Trulance isn’t absorbed well into your body. So it’s not likely that a developing fetus would be exposed to the drug. It may be safe to breastfeed your child while you’re taking Trulance. Studies show that Trulance does not pass into the breast milk of people taking the drug.
Drug Interactions
There are no known interactions between Trulance and foods, drinks, or other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Alternatives to Trulance
Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Trulance, talk with your doctor. They can tell you about other medications that may work well for you.
Examples of other drugs that may be used to treat chronic idiopathic constipation include:
- lubiprostone (Amitiza)
- linaclotide (Linzess)
- prucalopride (Motegrity)
- laxatives, such as bisacodyl (Dulcolax), lactulose (Generlac), polyethylene glycol 3350 (MiraLAX), senna (Senokot)
Examples of other drugs that may be used to treat irritable bowel syndrome with constipation include:
- lubiprostone (Amitiza)
- linaclotide (Linzess)
- tegaserod
- laxatives, such as bisacodyl (Dulcolax), magnesium citrate, senna (Senokot)
- bulking agents, such as methylcellulose (Citrucel), psyllium (Metamucil)
- stool softeners, such as docusate (Colace)
How is Trulance supplied (dosage forms)?
Trulance is available as 3 mg oral tablets that are taken by mouth.
How should I store Trulance?
Trulance should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep Trulance in its original container. To help protect Trulance from moisture, do not remove the desiccant from the container.
Financial and Insurance Assistance
If you need financial support to pay for Trulance, or if you need help understanding your insurance coverage, help is available. Salix Pharmaceuticals, the manufacturer of Trulance, offers a savings card program. Using this service may help lower the drug’s cost.