Deepika vegiraju at 08:56, 4 February 2023

2023-02-04T08:56:52Z

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== '''What is Plecanatide?''' ==

* Plecanatide ('''Trulance''') is '''a guanylate cyclase-C agonist''', used for the treatment of [[Chronic constipation|chronic idiopathic constipation]] (CIC) and [[irritable bowel syndrome]] with [[constipation]].

[[File:Plecanatide sequence.svg|thumb|Plecanatide sequence]]

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== '''What are the uses of this medicine?''' ==

Plecanatide ('''Trulance''') is a prescription medicine used in adults to treat:
* a type of [[constipation]] called [[Chronic constipation|chronic idiopathic constipation]] (CIC). [[Idiopathic]] means the cause of the constipation is unknown.
* [[irritable bowel syndrome]] with constipation (IBS-C).

== '''How does this medicine work?''' ==

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* Plecanatide (ple kan’ a tide) is '''synthetic analogue of uroguanylin, the endogenous guanylate cyclase-C receptor agonist''' which '''acts by increasing intracellular concentrations of cyclic guanosine monophosphate (cGMP) which activates the cystic fibrosis transmembrane conductance regulator (CFTR) ion channel'''.
* The '''CFTR ion channel stimulates secretion of chloride and bicarbonate into the lumen of the intestine''' which '''increases intraluminal fluid and speeds intestinal transit'''.
* In several prelicensure clinical trials, plecanatide therapy was associated with increases in the number of spontaneous bowel movements, improved stool consistency and alleviation of symptoms of [[chronic constipation]].

== '''Who Should Not Use this medicine ?''' ==

This medicine cannot be used in:
* Patients less than 6 years of age due to the risk of serious [[dehydration]].
* Patients with known or suspected mechanical gastrointestinal obstruction.

== '''What drug interactions can this medicine cause?''' ==

* Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

== '''Is this medicine FDA approved?''' ==

* Plecanatide was approved for therapy of chronic idiopathic constipation in adults in 2017, the second guanylate cyclase agonist approved for this indication in the United States, the first being [[linaclotide]].
* Plecanatide is available in tablets of 3 mg under the brand name '''Trulance'''.

== '''How should this medicine be used?''' ==

'''Recommended dosage:'''
The recommended adult dosage of Trulance is:
* CIC: 3 mg taken orally once daily.
* IBS-C: 3 mg taken orally once daily.

'''Administration:'''
* Plecanatide comes as a tablet to take by mouth.
* Take Trulance exactly as your doctor tells you to take it.
* Take Trulance by mouth, 1 time each day with or without food.
* If you miss a dose, skip the missed dose. Take the next dose at your regular time. Do not take 2 doses at the same time.
* Trulance tablets should be swallowed whole.
* Adults who cannot swallow Trulance tablets whole may crush the Trulance tablet and mix with applesauce or dissolve Trulance in water before swallowing.
* Trulance tablets may also be taken with water by adults through a nasogastric or gastric feeding tube.
* It is not known if Trulance is safe and effective when crushed and mixed with other foods or dissolved in other liquids.

'''Taking Trulance in applesauce:'''
* Crush the Trulance tablet in a clean container until it is a powder and mix with 1 teaspoon of room temperature applesauce.
* Swallow all of the Trulance and applesauce mixture right away.
* Do not keep the Trulance and applesauce mixture for future use.

'''Taking Trulance in water:'''
* Place the Trulance tablet in a clean cup and pour 1 ounce (30 mL) of room temperature water into the cup.
* Gently swirl the Trulance tablet and water for at least 10 seconds.
* The Trulance tablet will fall apart in the water.
* Swallow all of the Trulance tablet and water mixture right away.
* Do not keep the mixture for future use.
* If you see any part of the tablet left in the cup, add another 1 ounce (30 mL) of water to the cup, swirl for at least 10 seconds, and swallow right away.

'''Taking Trulance through a nasogastric or [[gastric feeding tube]]:'''
* Gather the supplies you will need to take your Trulance dose.
* Your doctor should tell you what size catheter tip syringe you will need for your dose.
* Ask your doctor if you have any questions about how to give Trulance the right way.

== '''What are the dosage forms and brand names of this medicine?''' ==

This medicine is available in fallowing doasage form:
* '''As Tablets:''' 3 mg

This medicine is available in fallowing brand namesː
* '''Trulance'''

=='''What side effects can this medication cause?'''==

The most common side effects of this medicine include:
* [[diarrhea]]

* Other adverse events include abdominal pain, [[bloating]], [[flatulence]] and headache.

Less common side effects may include:
* nausea, [[nasopharyngitis]], [[upper respiratory tract infection]], [[urinary tract infection]], and [[dizziness]].

==''' What special precautions should I follow?''' ==

* Trulance is contraindicated in patients less than 6 years of age. The safety and effectiveness of Trulance in patients less than 18 years of age have not been established. Avoid the use of Trulance in patients 6 years to less than 18 years of age.
* [[Diarrhea ]]was the most common adverse reaction in four placebo-controlled clinical trials, two in patients with CIC and two in patients with IBS-C. If severe diarrhea occurs, suspend dosing and rehydrate the patient.
* Accidental ingestion of Trulance in children, especially in children less than 6 years of age, may result in severe diarrhea and [[dehydration]]. Instruct patients to take steps to store Trulance securely and out of reach of children and to dispose of unused Trulance.
* Tell your doctor if you may have or have a blockage in your stomach or intestines. Your doctor will probably tell you not to take plecanatide.
* It is not known if Trulance passes into your breast milk. Talk with your doctor about the best way to feed your baby if you take Trulance.
* Plecanatide has not been linked to serum enzyme elevations during treatment or to episodes of clinically apparent liver injury.

== '''What to do in case of emergency/overdose?''' ==

Symptoms of overdose may include:
* diarrhea
* dehydration

Management of overdosage:
* {{overdose}}

== '''Can this medicine be used in pregnancy?''' ==

* The available data on Trulance use in pregnant women are not sufficient to inform any drug-associated risks for major birth defects and miscarriage.
* It is not known if Trulance will harm your unborn baby.

=='''Can this medicine be used in children?'''==

* Trulance is contraindicated in pediatric patients less than 6 years of age. Avoid use of Trulance in patients 6 years to less than 18 years of age.
* The safety and effectiveness of Trulance in patients less than 18 years of age have not been established.

== '''What are the active and inactive ingredients in this medicine?''' ==

* '''Active ingredient:''' plecanatide
* '''Inactive ingredients:''' magnesium stearate and microcrystalline cellulose

== '''Who manufactures and distributes this medicine?''' ==

'''Manufactured for:'''
* [[Synergy Pharmaceuticals Inc.]] 420 Lexington Avenue, Suite 2012 New York, New York

* Trulance® is a registered trademark of Synergy Pharmaceuticals Inc.

== '''What should I know about storage and disposal of this medication?''' ==

* Store Trulance at room temperature between 68°F to 77°F (20°C to 25°C).
* Keep Trulance in a secure place and in the bottle or blister pack that it comes in.
* The Trulance bottle contains a desiccant packet to help keep your medicine dry (protect it from moisture). Do not remove the desiccant packet from the bottle.
* The Trulance bottle contains a polyester coil to help protect the tablets during shipping. Remove the polyester coil from the bottle and throw it away after opening the bottle.
* Keep the container of Trulance tightly closed and in a dry place.
* Safely throw away Trulance that is out of date or no longer needed.

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[[Category:Drugs acting on the gastrointestinal system and metabolism]]
[[Category:Cyclic peptides]]

Plecanatide - Revision history

Deepika vegiraju at 08:56, 4 February 2023