Trulance is a brand-name prescription drug. It’s FDA-approved to treat the following types of constipation in adults:

For more details about how the drug is used, see the “Trulance uses” section below.

Drug details

Trulance contains the active drug plecanatide and belongs to a drug class called guanylate cyclase-C agonists.

Trulance comes as an oral tablet. It’s available in one strength: 3 milligrams (mg).

FDA approval

The Food and Drug Administration (FDA) first approved Trulance for the treatment of CIC in 2017. In 2018, the FDA approved the drug to treat IBS-C.

Effectiveness

For information about the effectiveness of Trulance, see the “Trulance uses” section below.

Trulance contains the active drug plecanatide. Trulance is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Trulance can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Trulance. These lists do not include all possible side effects.

For more information about the possible side effects of Trulance, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Trulance, you can do so through MedWatch.

Mild side effects

Mild side effects* of Trulance can include:

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.

* This is a partial list of mild side effects from Trulance. To learn about other mild side effects, talk with your doctor or pharmacist, or view Trulance’s prescribing information.
† For more information about this side effect, see “Side effect details” below.

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.

Serious side effects* of Trulance can include:

* For more information about these side effects, see “Side effect details” below.
Trulance has a boxed warning for this side effect in children. This is the most serious warning from the Food and Drug Administration (FDA).

Side effect details

Here are some details on certain side effects this drug may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Trulance.

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 the 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.* With dehydration, your body loses large amounts of water and electrolytes (essential minerals that are found in your body).

* Trulance has a boxed warning for this side effect in children. This is the most serious warning from the Food and Drug Administration (FDA).

Steps you can take

If you have diarrhea, you can stay hydrated by drinking sports drinks or water. Certain foods may also help relieve diarrhea. Examples include bananas, rice, apples, and toast (commonly called the BRAT diet).

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).

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:

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

Call your doctor right away if you have an allergic reaction to Trulance, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

The following information describes Trulance dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms

Trulance comes as an oral tablet.

Drug strength: 3 mg

Trulance is available in one strength of 3 milligrams (mg).

Dosage for chronic idiopathic constipation

The usual dosage of Trulance for chronic idiopathic constipation is 3 mg once per day. This is also the recommended maximum dose of Trulance.

Dosage for irritable bowel syndrome with constipation

The usual dosage of Trulance for irritable bowel syndrome with constipation is 3 mg once per day. This is also the recommended maximum dose of Trulance.

What if I miss a dose?

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 any extra doses of Trulance to make up for a missed dose. If you take extra doses, it can increase your risk of side effects. For details about possible side effects, see the “Trulance side effects” section above.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to use this drug long term?

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.

You may wonder how Trulance compares with other medications that are prescribed for similar uses. Here’s some information about how Trulance and Linzess are alike and different.

Both Trulance and Linzess are used to treat chronic idiopathic constipation and irritable bowel syndrome with constipation. Trulance contains the active drug plecanatide, while Linzess contains the active drug linaclotide. Both Trulance and Linzess belong to a drug class called guanylate cyclase-C agonists.

Trulance comes as an oral tablet, while Linzess comes as an oral capsule.

To learn more about how Trulance compares with Linzess, talk with your doctor or pharmacist.

As with all medications, the cost of Trulance can vary. To find current prices for Trulance tablets in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Trulance. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Trulance, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Trulance, contact your insurance company.

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. For more information and to find out if you’re eligible for support, visit the program website.

To learn more about saving money on prescriptions, read this article.

Mail-order pharmacies

Trulance may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Trulance, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Trulance is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

The Food and Drug Administration (FDA) approves prescription drugs such as Trulance to treat certain conditions.

Trulance for chronic idiopathic constipation

Trulance is FDA-approved to treat chronic idiopathic constipation (CIC). CIC is a type of long-lasting constipation that doesn’t have a known cause.

Constipation is generally considered to be 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

Effectiveness for chronic idiopathic constipation

Clinical trials have shown Trulance to be effective for treating CIC. For information about how the drug performed in clinical trials, see Trulance’s prescribing information.

Trulance for irritable bowel syndrome with constipation

Trulance is FDA-approved to treat 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.

Effectiveness for IBS with constipation

Trulance has been found effective for treating IBS-C. Guidelines from the American College of Gastroenterology recommend Trulance for the relief of IBS-C symptoms.

For information about how the drug performed in clinical trials, see Trulance’s prescribing information.

Trulance and children

Trulance is not approved for use in children. In fact, Trulance has a boxed warning for the risk of serious dehydration in children. To learn more, see “Side effect details” in “Trulance side effects” above.

Clinical trials of Trulance included only adults. It isn’t known for sure if the drug is safe or effective for use in children.

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.

Alternatives for chronic idiopathic constipation

Examples of other drugs that may be used to treat chronic idiopathic constipation include:

Alternatives for irritable bowel syndrome with constipation

Examples of other drugs that may be used to treat irritable bowel syndrome with constipation include:

  • lubiprostone (Amitiza)
  • linaclotide (Linzess)*
  • rifaximin (Xifaxan)
  • tegaserod (Zelnorm)
  • laxatives, such as:
    • bisacodyl (Dulcolax)
    • senna (Senokot)
  • bulking agents, such as:
    • methylcellulose (Citrucel)
    • psyllium (Metamucil)
  • stool softeners, such as docusate (Colace)

* To learn more about how Trulance compares with Linzess, see the “Trulance vs. Linzess” section above.

Here are answers to some frequently asked questions about Trulance.

Is Trulance a laxative?

No, Trulance isn’t a laxative. It’s a type of drug called a guanylate cyclase-C agonist.

Both Trulance and laxatives are used to relieve constipation. Several different types of laxatives are available. And each of these types works differently to ease constipation.

For example, stimulant laxatives trigger muscles in the intestines to move stool along. Bulk-forming laxatives, on the other hand, work by making stool bigger. This creates the urge to have a bowel movement.

Trulance works differently than laxatives to relieve constipation. 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. For more information, see the “How Trulance works” section below.

Is Trulance prescribed in a 6-mg dose?

Not typically. The usual dosage of Trulance for its approved uses is 3 milligrams (mg) once per day.

Clinical trials looked at a 6-mg dose of Trulance for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation. Trial results showed that the 6-mg dose was not more effective than the 3-mg dose. However, the higher dose increased the risk of side effects with Trulance. For this reason, a 6-mg dose of Trulance is not recommended.

To learn more about Trulance’s recommended dosage, see the “Trulance dosage” section above. You can also talk with your doctor or pharmacist.

Is it possible that Trulance is not working for me or has stopped working for me?

In most cases, Trulance is expected to keep relieving constipation for as long as you take it. However, this drug may affect people differently. Be sure to talk with your doctor about what you can expect with Trulance treatment.

If you’re concerned that Trulance isn’t working for you, talk with your doctor. They can advise you on whether a different treatment option is better for your condition.

Does Trulance cause weight loss?

Probably not. Weight loss was not reported as a side effect in clinical trials of Trulance.

Keep in mind that constipation can lead to bloating, which may result in some weight gain. Trulance is used to treat certain types of constipation. As the drug works to relieve your constipation symptoms, you may lose a small amount of weight.

If you’re concerned about weight loss with Trulance, talk with your doctor.

Is Trulance a controlled substance?

No, Trulance is not a controlled substance.

Controlled substances are drugs that the federal government closely regulates. These medications have a high risk of misuse, which means taking a drug in a way other than as prescribed.

These effects aren’t known to happen with Trulance. If you have questions about this, talk with your doctor or pharmacist.

Can Trulance be prescribed for gastroparesis?

Trulance is not approved to treat gastroparesis.

Gastroparesis is sometimes called “stomach paralysis.” It affects how food moves through the digestive tract. Some symptoms of gastroparesis overlap with those of constipation, which Trulance is used to treat. For example, both conditions may cause abdominal pain or bloating.

If you’re interested in using Trulance for gastroparesis, talk with your doctor. They can recommend the best treatment for your condition.

There isn’t a known interaction between Trulance and alcohol.

However, drinking alcohol may cause constipation or diarrhea. If you take Trulance, you already have constipation. And diarrhea is one of the common side effects of Trulance. So drinking alcohol during your treatment could worsen the constipation or increase your risk of experiencing diarrhea.

If you drink alcohol, talk with your doctor about the amount, if any, you may be able to drink during Trulance treatment.

You should take Trulance according to the instructions your doctor gives you.

Trulance comes as an oral tablet that you swallow.

When to take

You’ll likely take Trulance once daily. There’s no best time to take Trulance. You can take your dose at any time during the day.

However, try to take your Trulance doses at the same time each day. This helps make sure you have a consistent level of the drug in your body so that it’s most effective.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, ask your pharmacist if they can put Trulance in an easy-open container. They may also be able to recommend tools that can make it simpler to open lids.

Taking Trulance with food

You can take Trulance with or without food.

Can Trulance be crushed, split, or chewed?

In most cases, you should swallow Trulance tablets whole. You should not split or chew them.

However, if you have trouble swallowing Trulance tablets, you may be able to crush a tablet and mix it with applesauce or water. For details about how to do this, you can view the directions in the drug’s prescribing information. You can also visit the Trulance website. Make sure to talk with your doctor or pharmacist about what might work best for you.

Trulance is approved to treat certain types of constipation in adults. For details about the drug’s uses, see the “Trulance uses” section above.

What happens with constipation

Constipation can occur if food doesn’t move quickly enough through the digestive tract. This can cause stool to be dry and hard, which makes it difficult to pass.

With constipation, you typically have fewer than three bowel movements per week. Other symptoms of constipation include straining during a bowel movement and trouble completely emptying the bowel.

What Trulance does

Trulance works by mimicking a certain protein found in your digestive tract. The way a drug works in your body is called its “mechanism of action.”

Like this protein, Trulance attaches to receptors* on your small intestine. The drug works to increase the amount of fluid absorbed by the intestine, which helps your body create well-formed stool. As a result, Trulance helps you have a more comfortable bowel movement than usual.

* A receptor is a type of protein on a cell’s surface. It enables substances, such as the molecules of a drug, to attach to the protein and relay a chemical message.

How long does it take to work?

People who took Trulance in clinical trials reported constipation relief as early as 1 week after starting treatment with the drug.

You can talk with your doctor about what to expect with Trulance.

Do not use more Trulance than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Trulance

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

It isn’t known if Trulance is safe to take during pregnancy.

There haven’t been enough clinical trials of Trulance in humans to know whether the drug is safe to take while pregnant. Animal trials did not show any harm to offspring born to animals given the drug during pregnancy. However, animal trials don’t always predict what may happen with humans.

Talk with your doctor about whether Trulance is safe for you to take while pregnant.

It’s not known if Trulance is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Trulance.

For more information about taking Trulance during pregnancy, see the “Trulance and pregnancy” section above.

It may be safe to use Trulance while breastfeeding. The drug was not found in the breast milk of people who took the drug in clinical trials.

If you’re breastfeeding or planning to breastfeed while taking Trulance, talk with your doctor. They can recommend safe and healthy ways to feed your child.

There aren’t any known interactions between Trulance and other medications, herbs, supplements, or foods. The manufacturer of Trulance didn’t find any interactions during clinical trials of the drug. However, this doesn’t mean interactions with Trulance can’t happen.

To be safe, talk with your doctor and pharmacist before taking Trulance. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

This drug comes with several precautions.

FDA warning: Risk of serious dehydration in children

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Trulance may cause serious dehydration in children. 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.

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.

To learn more, see the “Side effect details” in the “Trulance side effects” section above.

Other precautions

Before taking Trulance, talk with your doctor about your health history. Trulance may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Bowel obstruction. Before taking Trulance, tell your doctor if you have a bowel obstruction. This condition happens when you have a blockage in your small or large intestine. Doctors typically will not prescribe Trulance if you have a bowel obstruction. Your doctor will likely recommend treatments other than Trulance for your condition.
  • Allergic reaction. If you’ve had an allergic reaction to Trulance or any of its ingredients, your doctor will likely not prescribe Trulance. Ask your doctor about other medications that may be better options for you.
  • Pregnancy. It isn’t known if Trulance is safe to take during pregnancy. For more information, see the “Trulance and pregnancy” section above.
  • Breastfeeding. It may be safe to use Trulance while breastfeeding. For more information, see the “Trulance and breastfeeding” section above.

Note: For more information about the potential negative effects of Trulance, see the “Trulance side effects” section above.

When you get Trulance from the pharmacy, the pharmacist will add an expiration date to the label on the bottle or packaging. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

Trulance tablets should be stored at a room temperature between 68°F and 77°F (20°C and 25°C). You can temporarily store the tablets at a temperature between 59°F and 86°F (15°C and 30°C), such as when traveling.

You should keep the tablets in their original packaging, away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Trulance and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.