Gastrointestinal

Plecanatide

A second-generation guanylate cyclase-C agonist peptide licensed for chronic constipation and IBS with constipation.

Strong evidenceApproved drugAdd to compare

What it is

Plecanatide is a 16-amino-acid analogue of uroguanylin, designed to be more stable in the gut than the natural hormone. Like linaclotide it works locally on the intestinal lining and is barely absorbed. It is licensed for chronic idiopathic constipation and irritable bowel syndrome with constipation (Trulance).

How it works

1
Activates guanylate cyclase-C receptors on the gut lining.
2
Increases cGMP, driving chloride and bicarbonate secretion with water into the lumen.
3
Speeds transit and softens stool.
4
Reduces activity in pain-sensing visceral nerves.
5
Its pH-sensitive activity means it acts mainly where the gut is less acidic.

What it's studied for

Chronic idiopathic constipation

Irritable bowel syndrome with constipation

Comparison with placebo on spontaneous bowel movement frequency

Reported and studied effects

Increased complete spontaneous bowel movements per week
Modest improvement in abdominal pain in the IBS trials
Diarrhoea in a minority, usually early
Effects appear within the first week of treatment

Research protocol notes

Research context only

Research context only - prescription medicine. Licensed adult dosing is 3 mg once daily, taken with or without food; the phase 3 programmes ran 12 weeks with a 2-week follow-up and used complete spontaneous bowel movements and abdominal pain as co-primary endpoints.

These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.

Possible side effects and contraindications

Safety profile

Possible side effects

Diarrhoea
Abdominal distension
Flatulence
Nausea
Dehydration with severe diarrhoea

Contraindications and cautions

Children and adolescents under 18 - animal data showed fatal dehydration
Known or suspected mechanical gastrointestinal obstruction
Prior hypersensitivity

A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.

Evidence assessment

Strong evidenceReplicated, large human trials

Replicated, large human trials

Randomised, double-blind, placebo-controlled phase 3 trials for both indications with symptom-based co-primary endpoints.

References

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.

Compare Plecanatide with another peptide →

Related peptides

Other entries in Gastrointestinal.

All Gastrointestinal peptides →

Gastrointestinal

Linaclotide

An oral peptide that stimulates fluid secretion in the gut, approved for irritable bowel syndrome with constipation.

Strong evidenceApproved drug

Gastrointestinal

Teduglutide

A GLP-2 analogue that helps the remaining bowel adapt in short bowel syndrome, reducing the need for intravenous feeding.

Moderate evidenceApproved drug