Peptides / Gut and digestion

Synthetic analog · 16 amino acids · 1,682 Da

Plecanatide

ApprovedNot banned in sport

Plecanatide (Trulance) is a uroguanylin analog that acts in the gut, approved in the US for chronic constipation and IBS with constipation in adults. Studies in people tested it mostly on bowel movements, and tracked stomach and other side effects. PepBank shows 157 results on plecanatide from 21 studies in people, and 21 from animal and lab studies. The strongest evidence is a randomized trial in people. Data as of 2026-10-30.

Also known as Trulance

16 amino acids, from first to lastNDECELCVNVACTGCL

Evidence level: Large trials in people157 of 178 results come from studies in people, including randomized trials.

Results in people

157

88% of 178 results

Results in animals

9% of 178 results

Results in lab cells

3% of 178 results

From computer models

0% of 178 results

Overview

Plecanatide at a glance

What it is	Synthetic analog, 16 amino acids
Approval	Approved in the US (Trulance)
In sport	Not listed as banned by WADA
Studies	24 studies with results. All of them gave plecanatide, with 178 results. 157 in people16 in animals5 in lab cells
Best study in people	Randomized controlled trial with 2,176 people (2023)
Clinical trials	14 registered: 1 active or planned, 10 with posted results
Community use	Adults with chronic idiopathic constipation or irritable bowel syndrome with constipation

The science

What is plecanatide?

Plecanatide is a 16-residue uroguanylin analog with two disulfide bridges.

Amino acids in one chain

The history of plecanatide

2011October
A registered trial of plecanatide started (NCT01429987).
2013
The oldest paper on plecanatide in PepBank is from 2013.

Plecanatide structure and chemistry

The key facts about the molecule. Long codes are in the closed section below.

Sequence, 16 amino acidsFrom the first amino acid to the last

N1−D−EC−E5LCVNV10ACTGC15L

Darker means more water-repelling+ and − show charge in the body

Structure

Plecanatide is a synthetic analog of 16 amino acids, with a ring, 2 disulfide bonds, no changed amino acids.

Formula

C₆₅H₁₀₄N₁₈O₂₆S₄

Molecular weight

1,682 g/mol

CAS number

467426-54-6

Target

Guanylate cyclase C (gene GUCY2C): agonistEvidence: Official prescribing information, mechanism of action

Development

Highest phase: past the trial stage (see status).

Identifiers

PubChem 70693500, ChEMBL CHEMBL2103867, UNII 7IK8Z952OK, DrugBank DB13170

Full sequence, SMILES and InChIKey

InChIKey
NSPHQWLKCGGCQR-DLJDZFDSSA-N

SMILES
C[C@H]1C(=O)N[C@H]2CSSC[C@@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@@H](CSSC[C@H](NC(=O)CNC(=O)[C@@H](NC2=O)[C@@H](C)O)C(=O)N[C@@H](CC(C)C)C(=O)O)C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N1)C(C)C)CC(=O)N)C(C)C)CC(C)C)CCC(=O)O)NC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](CC(=O)O)NC(=O)[C@H](CC(=O)N)N

See charge, composition and 3D structure on the Scientific page

The evidence

What plecanatide studies show

Results grouped by what the studies measured. Each card shows where its results come from.

Large trials in people157 of 178 results come from studies in people, including randomized trials.

Stomach and gut

96 results · 86 in people · 6 animal · 4 lab

Overall response was 25.6% with plecanatide 3 mg versus 16.0% with placebo in IBS-C. International journal of general medicine, 2023

Top results

Overall response was 25.6% with plecanatide 3 mg versus 16.0% with placebo in IBS-C. (International journal of general medicine, 2023)
In adults with constipation, plecanatide 3 mg increased durable bowel response versus placebo. (Therapeutic advances in gastroenterology, 2017)
In mice with chemically induced colitis, plecanatide reduced colitis severity. (World journal of gastrointestinal pharmacology and therapeutics, 2015)

Daily life and fitness

5 results · 5 in people

At treatment end, plecanatide-treated CIC patients had a median satisfaction score of 4.0, indicating quite satisfied. Current medical research and opinion, 2018

Top results

At treatment end, plecanatide-treated CIC patients had a median satisfaction score of 4.0, indicating quite satisfied. (Current medical research and opinion, 2018)
In adult pharmacovigilance reports, plecanatide was linked to patient dissatisfaction. (Therapie, 2025)
At week 53 or treatment end, 72.4% of plecanatide-treated IBS-C patients were very or quite satisfied. (Current medical research and opinion, 2019)

Pain

4 results · 2 in people · 2 animal

In IBS-C with moderate-to-severe bloating, plecanatide reduced abdominal pain more than placebo. Digestive diseases and sciences, 2024

Top results

In IBS-C with moderate-to-severe bloating, plecanatide reduced abdominal pain more than placebo. (Digestive diseases and sciences, 2024)
In IBS-C with mild bloating, plecanatide reduced abdominal pain more than placebo. (Digestive diseases and sciences, 2024)
In rats, plecanatide reduced TNBS-induced abdominal contractions during colorectal distension. (World journal of gastroenterology, 2018)

Cancer

2 results · 2 animal

In mice with DSS-induced inflammation, plecanatide reduced polypoid, flat and indeterminate dysplasia formation. World journal of gastrointestinal pharmacology and therapeutics, 2017

Top results

In mice with DSS-induced inflammation, plecanatide reduced polypoid, flat and indeterminate dysplasia formation. (World journal of gastrointestinal pharmacology and therapeutics, 2017)
In mice, plecanatide reduced proliferation. (World journal of gastrointestinal pharmacology and therapeutics, 2017)

Immune system and inflammation

1 result · 1 animal

In mice with DSS-induced inflammation, plecanatide decreased cytokine, chemokine and growth factor secretion measured in colon explants. World journal of gastrointestinal pharmacology and therapeutics, 2017

Top results

In mice with DSS-induced inflammation, plecanatide decreased cytokine, chemokine and growth factor secretion measured in colon explants. (World journal of gastrointestinal pharmacology and therapeutics, 2017)

Weight and appetite

1 result · 1 animal

In mice with chemically induced colitis, plecanatide improved the body weight assessment. World journal of gastrointestinal pharmacology and therapeutics, 2015

Top results

In mice with chemically induced colitis, plecanatide improved the body weight assessment. (World journal of gastrointestinal pharmacology and therapeutics, 2015)

All 24 plecanatide studies by area Open the Scientific page

Key plecanatide studies

Studies in people come first, then studies in animals and in the lab.

People
Plecanatide Improves Symptoms of Irritable Bowel Syndrome with Constipation: Results of an Integrated Efficacy and Safety Analysis of Two Phase 3 Trials
Brenner et al. 2023 · International journal of general medicine · 2,176 people · cited by 4
9 results
People
Plecanatide Is Effective and Safe in the Treatment for Chronic Idiopathic Constipation: Results of a Phase II Trial
Barish et al. 2021 · Digestive diseases and sciences · 946 people · cited by 7
7 results
People
Efficacy and Safety of Plecanatide in Chinese Patients with Functional Constipation: A Phase III Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Bai et al. 2025 · Drugs · 648 people · cited by 0
8 results
People
Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials
Brenner et al. 2018 · The American journal of gastroenterology · cited by 125
11 results
People
A Randomized Phase III Clinical Trial of Plecanatide, a Uroguanylin Analog, in Patients With Chronic Idiopathic Constipation
Miner et al. 2017 · The American journal of gastroenterology · cited by 108
10 results

All 24 Plecanatide studies

Plecanatide clinical trials

ClinicalTrials.gov lists 14 trials of plecanatide. 1 is active or planned, and 10 have posted results. PepBank does not show trial results.

Solid bars are dates that happened. Hatched bars are planned dates. Data from ClinicalTrials.gov.

Open-label Extension (OLE) Study of Plecanatide for Chronic Idiopathic Constipation (CIC)

Phase 3completed2,370 people

Long Term Safety Study of Plecanatide

Phase 3completed2,272 people

12-Week Study of Plecanatide for CIC (The National CIC3 Study)

Phase 3completed1,410 people

All 10 Plecanatide trials

Status and safety

Is plecanatide approved?

FDA

United States

Approved

An approved medicine contains it.

EMA

European Union

Status unknown

Status unknown.

WADA

Sport

Not banned

Not on the 2026 Prohibited List.

Yes. Approved in the US (Trulance). The FDA label for Trulance says: “Adults with chronic idiopathic constipation or irritable bowel syndrome with constipation” Not listed as banned by WADA.

Laws and labels change, so check the regulator for the current status.

Plecanatide side effects and safety

PepBank has 54 safety results from studies of plecanatide. 54 of them come from studies in people.

Safety results from studies (54)

Diarrhea occurred in 4.9% with plecanatide 3 mg versus 1.3% with placebo. (Clinical and translational gastroenterology, 2023)
In Chinese patients with functional constipation, treatment-related diarrhea occurred more often with plecanatide than placebo. (Drugs, 2025)
In healthy volunteers, adverse event rates were comparable with plecanatide and placebo. (Digestive diseases and sciences, 2013)
In IBS-C, diarrhea occurred in 4.3% with plecanatide 3 mg versus 1.0% with placebo. (The American journal of gastroenterology, 2018)
In CIC, diarrhea occurred in 5.9% with plecanatide 3 mg versus 1.3% with placebo. (The American journal of gastroenterology, 2017)
In adults with constipation, diarrhea occurred in 3.2% with plecanatide 3 mg versus 1.3% with placebo. (Therapeutic advances in gastroenterology, 2017)
In IBS-C, diarrhea occurred in 4.3% with plecanatide 3 mg versus 1.0% with placebo. (International journal of general medicine, 2023)
In the plecanatide IBS-C study, 27.3% of patients had adverse events. (Current medical research and opinion, 2019)
In young adults with IBS-C and bloating, plecanatide was well tolerated. (Journal of gastroenterology and hepatology, 2025)
Plecanatide adverse events in the open-label CIC study resembled those in prior double-blind studies. (Current medical research and opinion, 2018)
The pooled CIC and IBS-C analysis found no new safety issues with plecanatide. (Clinical therapeutics, 2020)
In the CIC trial, diarrhea was the most frequently reported adverse event. (Digestive diseases and sciences, 2021)
FAERS contained 861 plecanatide-associated cases and 2057 adverse event reports. (Frontiers in pharmacology, 2024)
FAERS contained 49 muscle spasm reports linked to suspected plecanatide exposure. (Frontiers in pharmacology, 2025)
In US adverse event reports (FAERS) from 2013 to 2023, plecanatide had 811 reports and 2230 flagged signals across 19 body-system classes. (Hospital pharmacy, 2026)
In IBS-C, diarrhea occurred in 4.0% with plecanatide 6 mg versus 1.0% with placebo. (The American journal of gastroenterology, 2018)
In IBS-C, diarrhea caused discontinuation in 1.2% with plecanatide 3 mg versus 0 with placebo. (The American journal of gastroenterology, 2018)
In IBS-C, diarrhea caused discontinuation in 1.4% with plecanatide 6 mg versus 0 with placebo. (The American journal of gastroenterology, 2018)
In CIC, diarrhea occurred in 5.7% with plecanatide 6 mg versus 1.3% with placebo. (The American journal of gastroenterology, 2017)
In adults with constipation, diarrhea occurred in 4.5% with plecanatide 6 mg versus 1.3% with placebo. (Therapeutic advances in gastroenterology, 2017)
In IBS-C, diarrhea occurred in 4.0% with plecanatide 6 mg versus 1.0% with placebo. (International journal of general medicine, 2023)
In IBS-C, diarrhea caused discontinuation in 1.2% with plecanatide 3 mg versus 0 with placebo. (International journal of general medicine, 2023)
In IBS-C, diarrhea caused discontinuation in 1.4% with plecanatide 6 mg versus 0 with placebo. (International journal of general medicine, 2023)
Diarrhea occurred in 5.4% with plecanatide 6 mg versus 1.3% with placebo. (Clinical and translational gastroenterology, 2023)

See every safety result on the Scientific page

Doses studied (28 shown)

The doses that these studies used. They are not recommendations.

Dose as reported	Class	Species	Route	Duration	Design	Source
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people · n = 1,453	Brenner 2023
6 mg	Human	human	Not reported	12 weeks	Randomized trial in people · n = 1,452	Brenner 2023
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people · n = 648	Bai 2025
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Brenner 2018
6 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Brenner 2018
3 mg once daily	Human	human	oral	12 weeks	Randomized trial in people	Miner 2017
6 mg once daily	Human	human	oral	12 weeks	Randomized trial in people	Miner 2017
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people	DeMicco 2017
6 mg	Human	human	Not reported	12 weeks	Randomized trial in people	DeMicco 2017
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Cash 2023
6 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Cash 2023
0.3 mg	Human	human	oral	12 weeks	Randomized trial in people	Barish 2021
3.0 mg	Human	human	oral	12 weeks	Randomized trial in people	Barish 2021
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Moshiree 2022
6 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Moshiree 2022
3 or 6 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Brenner 2018
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people · n = 605	Brenner 2025
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people · n = 1,762	Rao 2023
3 mg	Human	human	Not reported	12 weeks	Randomized trial in people · n = 1,104	Brenner 2024
0.1 to 48.6 mg	Human	human	oral	single dose	Randomized trial in people · n = 71	Shailubhai 2013
3 mg	Human	human	Not reported	Not reported	Randomized trial in people	Menees 2020
6 mg	Human	human	Not reported	Not reported	Randomized trial in people	Menees 2020
6 mg	Human	human	Not reported	12 weeks	Randomized trial in people	Rao 2023
6 mg once daily	Human	human	Not reported	up to 53 weeks	Trial in people without random groups · n = 2,272	Barish 2019
3 or 6 mg once daily	Human	human	oral	up to 72 weeks	Trial in people without random groups	Barish 2018
3 or 6 mg	Human	human	Not reported	Not reported	Trial in people without random groups	Menees 2020
0.05-0.5 mg/kg once daily	Animal	mouse	oral	Not reported	Study in live animals	Shailubhai 2015
0-20 ppm	Animal	mouse	oral	Not reported	Study in live animals	Chang 2017

From the community

How people use it

What people report online. It comes from forums and guides, not from studies.

Community-reported. Not tested in trials.

The official US label reports prescription use. The regimen below is label information.

Reported routines and cautions

What people use it for

Adults with chronic idiopathic constipation or irritable bowel syndrome with constipationS1

Reported regimens

Regimens that community sources report for Plecanatide. Community-reported, not tested in trials.
Context	Route	Amount	How often	How long	Agreement	Sources
Adults with chronic idiopathic constipation or irritable bowel syndrome with constipation who can swallow Trulance immediate-release tablets wholeOfficial label dosing of an approved product	oralSelected formulation: Trulance tablet swallowed whole. The label permits use with or without food.	3 mg per dose	once daily	Not stated	Single official US label source.	S1

Cautions

The label warns about serious dehydration in children. Use is contraindicated below age 6 and with known or suspected mechanical gastrointestinal obstruction. Avoid use from age 6 to below 18. If severe diarrhea occurs, suspend dosing and rehydrate the patient.S1

Status notes

No product-specific central EMA authorisation was established. This does not decide national authorisations.S2

Community sources

S1Trulance US prescribing information (opens in a new tab)dailymed.nlm.nih.gov
S2EMA regulatory information (opens in a new tab)ema.europa.eu

Gaps

This record covers one selected adult label regimen for whole Trulance tablets. It does not establish a separate non-vendor community regimen. The full label gives separate crushed-tablet and feeding-tube instructions. Those administration methods are outside this selected regimen. The label gives no fixed treatment duration. EMA central and national authorisation status remain unresolved.

Questions and more

Ask a question about plecanatide

The answer links to every study it uses.

What does the evidence say about plecanatide?Is plecanatide tested in people?Compare with Linaclotide Compare with Teduglutide

Sources

Database: PepBank data for plecanatide (data version 308560)
Regulator: FDA status record
Regulator: EMA status record
Regulator: WADA status record
Trial registry: ClinicalTrials.gov
Community: community sources (forums and guides), as summarized in the PepBank community file

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

PepBank is a research reference. Talk to a doctor before you use any peptide.

Ask your AI about plecanatide

Plecanatide

ApprovedNot banned in sport

Also known as Trulance

What it is

Synthetic analog, 16 amino acids

Approval

Approved in the US (Trulance)

In sport

Not listed as banned by WADA

Studies

24 studies with results. All of them gave plecanatide, with 178 results.
157 in people16 in animals5 in lab cells

Best study in people

Randomized controlled trial with 2,176 people (2023)

Clinical trials

14 registered: 1 active or planned, 10 with posted results

Community use

Adults with chronic idiopathic constipation or irritable bowel syndrome with constipation

Dose as reported

Class

Species

Route

Duration

Design

Source

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people · n = 1,453

Brenner 2023

6 mg

Human

human

Not reported

12 weeks

Randomized trial in people · n = 1,452

Brenner 2023

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people · n = 648

Bai 2025

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Brenner 2018

6 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Brenner 2018

3 mg once daily

Human

human

oral

12 weeks

Randomized trial in people

Miner 2017

6 mg once daily

Human

human

oral

12 weeks

Randomized trial in people

Miner 2017

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people

DeMicco 2017

6 mg

Human

human

Not reported

12 weeks

Randomized trial in people

DeMicco 2017

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Cash 2023

6 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Cash 2023

0.3 mg

Human

human

oral

12 weeks

Randomized trial in people

Barish 2021

3.0 mg

Human

human

oral

12 weeks

Randomized trial in people

Barish 2021

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Moshiree 2022

6 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Moshiree 2022

3 or 6 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Brenner 2018

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people · n = 605

Brenner 2025

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people · n = 1,762

Rao 2023

3 mg

Human

human

Not reported

12 weeks

Randomized trial in people · n = 1,104

Brenner 2024

0.1 to 48.6 mg

Human

human

oral

single dose

Randomized trial in people · n = 71

Shailubhai 2013

3 mg

Human

human

Not reported

Randomized trial in people

Menees 2020

6 mg

Human

human

Not reported

Randomized trial in people

Menees 2020

6 mg

Human

human

Not reported

12 weeks

Randomized trial in people

Rao 2023

6 mg once daily

Human

human

Not reported

up to 53 weeks

Trial in people without random groups · n = 2,272

Barish 2019

3 or 6 mg once daily

Human

human

oral

up to 72 weeks

Trial in people without random groups

Barish 2018

3 or 6 mg

Human

human

Not reported

Trial in people without random groups

Menees 2020

0.05-0.5 mg/kg once daily

Animal

mouse

oral

Not reported

Study in live animals

Shailubhai 2015

0-20 ppm

Animal

mouse

oral

Not reported

Study in live animals

Chang 2017

Context

Route

Amount

How often

How long

Agreement

Sources

Adults with chronic idiopathic constipation or irritable bowel syndrome with constipation who can swallow Trulance immediate-release tablets wholeOfficial label dosing of an approved product

oralSelected formulation: Trulance tablet swallowed whole. The label permits use with or without food.

3 mg per dose

once daily

Not stated

Single official US label source.

Plecanatide

Plecanatide at a glance

What is plecanatide?

The history of plecanatide

Plecanatide structure and chemistry

What plecanatide studies show

Stomach and gut

Daily life and fitness

Pain

Cancer

Immune system and inflammation

Weight and appetite

Key plecanatide studies

Plecanatide clinical trials

Is plecanatide approved?

Plecanatide side effects and safety

How people use it

What people use it for

Reported regimens

Cautions

Status notes

Community sources

Ask a question about plecanatide

Related peptides

Sources

Plecanatide

Plecanatide at a glance

What is plecanatide?

The history of plecanatide

Plecanatide structure and chemistry

What plecanatide studies show

Stomach and gut

Daily life and fitness

Pain

Cancer

Immune system and inflammation

Weight and appetite

Key plecanatide studies

Plecanatide clinical trials

Is plecanatide approved?

Plecanatide side effects and safety

How people use it

What people use it for

Reported regimens

Cautions

Status notes

Community sources

Ask a question about plecanatide

Related peptides

Sources