What Is Trulance? Uses, Dosage, and What You Need to Know in 2026

Trulance is a prescription medication used to treat two types of constipation-related conditions in adults: chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). If you've been prescribed Trulance — or are wondering whether it's right for you — here's everything you need to know in plain language.

What Is Trulance?

Trulance is the brand name for plecanatide, a drug that belongs to a class of medications called guanylate cyclase-C (GC-C) agonists. It was developed by Synergy Pharmaceuticals and FDA-approved on January 19, 2017 for chronic idiopathic constipation, with a second approval following in January 2018 for irritable bowel syndrome with constipation. It is now manufactured and marketed by Salix Pharmaceuticals.

Trulance is available only as a brand-name medication — there is no generic version, and one is not expected until at least 2034. It comes as a 3 mg tablet taken once daily.

What Does Trulance Treat?

Trulance is FDA-approved to treat two conditions in adults:

Chronic Idiopathic Constipation (CIC)

CIC is long-term constipation with no identifiable structural or biochemical cause. "Idiopathic" simply means "of unknown cause." Patients with CIC experience infrequent bowel movements (fewer than 3 per week), hard or lumpy stools, straining, and feelings of incomplete emptying — without an underlying cause like bowel obstruction or medication side effects. CIC is estimated to affect up to 14% of the global population and disproportionately affects women and older adults.

Irritable Bowel Syndrome with Constipation (IBS-C)

IBS-C is a functional GI disorder in which constipation occurs along with recurring abdominal pain or discomfort. Unlike CIC, which is just constipation, IBS-C involves a significant pain or bloating component as well. IBS is estimated to affect 7–16% of the US population, with IBS-C being a common subtype. The American College of Gastroenterology (ACG) gives Trulance's drug class a strong recommendation for treating IBS-C based on high-quality clinical trial data.

How Is Trulance Taken?

Trulance is taken as one 3 mg tablet by mouth once daily. Unlike Linzess, which must be taken on an empty stomach at least 30 minutes before eating, Trulance can be taken with or without food at any time of the day. This flexibility is a practical advantage for many patients.

If you have trouble swallowing tablets:

• Crush the tablet and mix it with 1 teaspoon of applesauce
• Dissolve the tablet in 1 ounce (30 mL) of water and drink immediately
• It can also be administered through a nasogastric or gastric feeding tube when properly prepared

How Long Does Trulance Take to Work?

Many patients begin to see improvements in bowel movement frequency within the first week of treatment. In clinical studies, Trulance-treated patients showed statistically significant improvements in complete spontaneous bowel movements (CSBMs) early in the 12-week study period. However, full benefit may take several weeks, and your doctor may assess your response at 4–8 weeks.

Who Should NOT Take Trulance?

Trulance is contraindicated in:

• Children under 6 years of age: Trulance carries a boxed warning for serious risk of dehydration in young children. It is contraindicated in this age group.
• Patients with bowel obstruction: Trulance is contraindicated if you have a known or suspected mechanical blockage in your gut.
• Children and adolescents aged 6–17: Trulance should be avoided in this age group as safety and effectiveness have not been established.

Is Trulance a Controlled Substance?

No. Trulance is not a controlled substance. It has no DEA schedule, no addiction potential, and no special prescribing restrictions beyond a standard prescription. Any licensed prescriber can write for it.

How Much Does Trulance Cost?

Trulance has a retail price of approximately $749–$830 for a 30-tablet supply. With GoodRx, it can be as low as $620. With a SingleCare card, $552. Commercially insured patients using the Salix Savings Card can pay as little as $25 per fill. There is no generic version available as of 2026.

The Bottom Line

Trulance is an FDA-approved, non-controlled prescription medication for adults with IBS-C or CIC. It's taken once daily with or without food and works by increasing fluid in the intestines to make bowel movements easier and more regular. For a deeper dive into how it works, see our article on how Trulance works. And if your pharmacy doesn't have it in stock, medfinder can help you locate a pharmacy near you that does.