Plecanatide is a medication approved for treating certain gastrointestinal disorders. It works by mimicking a naturally occurring peptide in the body that regulates fluid balance in the intestines, promoting bowel movements. The U.S. Food and Drug Administration (FDA) approved this drug on January 19, 2017, based on clinical trials demonstrating its efficacy and safety in treating chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). The pivotal clinical trials included thousands of patients and showed significant improvement in bowel movement frequency and stool consistency compared to placebo.

FDA-approved uses of this drug include:

• Chronic idiopathic constipation (CIC) – Long-term constipation without an identifiable cause
• Irritable bowel syndrome with constipation (IBS-C) – A functional bowel disorder characterised by abdominal pain and constipation

Plecanatide is available as an oral tablet and is typically prescribed in a 3 mg once-daily dose, which can be taken with or without food. The tablet should be swallowed whole and not crushed, split, or chewed to ensure proper release of the medication. It is approved for use in adults aged 18 years and older and is not recommended for children. The drug should be taken at the same time each day for consistent results. If a dose is missed, it should be taken as soon as remembered, but double dosing should be avoided.

Common Side Effects

• Diarrhea
• Bloating
• Gas
• Nausea
• Fatigue
• Upper respiratory tract infections

Serious Side Effects

• Severe diarrhoea leading to dehydration
• Severe abdominal pain
• Allergic reactions (swelling, difficulty breathing, rash)

• Contraindicated in children under six years due to the risk of severe dehydration
• Should not be used in patients with known or suspected mechanical gastrointestinal obstruction
• Serious allergic reactions may occur; discontinue use if symptoms like swelling or breathing difficulties develop
• Potential drug interactions: Caution is advised when taken with other medications affecting bowel motility

Before starting treatment, patients should inform their healthcare provider about any medical history related to gastrointestinal obstructions, severe diarrhoea, or hypersensitivity reactions. Since the medication increases fluid secretion in the intestines, dehydration is a potential risk, especially in elderly patients. Adequate hydration should be maintained throughout the treatment. Patients should also avoid splitting or crushing the tablet to ensure proper drug release and effectiveness.

Patients should start treatment under medical supervision, especially if they have a history of gastrointestinal issues. If diarrhoea occurs, stopping the medication and consulting a healthcare provider is recommended. Pregnant or breastfeeding women should discuss potential risks with their doctor. Since this medication is not approved for pediatric use, it should be kept out of children’s reach.

1. https://clinicaltrials.gov/study/NCT02387359
2. https://go.drugbank.com/drugs/DB13170
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC5871240/
4. https://pubchem.ncbi.nlm.nih.gov/compound/Plecanatide

This content is for informational purposes only and should not replace professional medical advice. Consult a healthcare provider before starting or stopping any medication.