Why is Trulance so hard to find? [Explained for 2026]

If you've ever stood at the pharmacy counter only to hear "we don't have that in stock," you're not alone. Trulance (plecanatide) is a prescription medication that many patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC) depend on — and yet it can sometimes be surprisingly difficult to find at your local pharmacy. Here's why that happens, and what you can do about it in 2026.

What Is Trulance and Who Uses It?

Trulance is the brand name for plecanatide, a guanylate cyclase-C (GC-C) agonist approved by the FDA in January 2017 for chronic idiopathic constipation (CIC) in adults, with a second approval for irritable bowel syndrome with constipation (IBS-C) following in 2018. It works by stimulating fluid secretion in the intestines, softening stool, and helping bowel movements happen more regularly.

It's taken as a single 3 mg tablet once daily, with or without food — a convenience advantage over its main competitor, Linzess, which must be taken on an empty stomach. It's manufactured by Salix Pharmaceuticals and is available only as a brand-name medication, with no generic version expected until at least 2034.

Is Trulance Currently in Shortage?

As of 2026, Trulance is not listed on the FDA's official drug shortage list. There is no widespread, declared national shortage of this medication. However, that doesn't mean it's easy to find everywhere. Many patients still report difficulty filling their prescriptions — and there are several real reasons why.

Why Trulance Can Be Hard to Find at Your Pharmacy

Even without a formal shortage, several factors can make Trulance unavailable at any given pharmacy at any given time:

1. It's a Brand-Only Medication With Limited Demand

Unlike generic drugs that are widely dispensed by virtually every pharmacy, Trulance is a brand-name-only drug with a relatively small patient population. Pharmacies manage their inventory based on local demand. If only a few patients in a given area use Trulance, a pharmacy may choose not to keep it on hand at all, or may only stock a limited quantity. This means that even routine refills can trigger a delay while the pharmacy orders more.

2. Its High Cost Limits Formulary Access

Trulance carries a retail price of approximately $749 to $830 for a 30-day supply. Because it has no generic and is priced as a specialty-tier drug on many insurance formularies, many plans require prior authorization before they'll cover it. Some plans also require step therapy — meaning patients must try and fail Linzess first. These hurdles can delay access even when the drug is physically available.

3. Smaller Pharmacies Often Don't Stock It

Independent pharmacies and smaller chain locations are less likely to stock Trulance as a routine inventory item compared to major chains like CVS, Walgreens, or Rite Aid. Even among major chains, individual store locations may not have it on hand, requiring a special order that can take 1-3 business days.

4. Insurance Prior Authorization Delays

Prior authorization requirements create a common bottleneck for Trulance patients. Even if the pharmacy has the drug, your insurance may not authorize it right away. Some insurers, including Federal Employee Program Blue Cross Blue Shield, specifically require patients to first try Linzess (the preferred agent in the same drug class) before they'll approve Trulance. This step therapy requirement can delay getting your prescription filled by days or even weeks.

What Can You Do If You Can't Find Trulance?

Here are the most effective strategies for patients who are struggling to locate Trulance:

• Call multiple pharmacies before giving up. Stock varies significantly between locations, even within the same chain. Calling ahead can save you a wasted trip.
• Use medfinder. medfinder calls pharmacies near you to check which ones can fill your Trulance prescription — saving you the hassle of making dozens of calls yourself.
• Ask your pharmacy to order it. Most pharmacies can place a special order for Trulance if they don't have it in stock. Ask how long it will take and if they can contact you when it arrives.
• Try mail-order pharmacy. Many insurance plans have a mail-order pharmacy option that can ship a 90-day supply to your home, and it often costs less than retail.
• Talk to your doctor about alternatives. If Trulance is genuinely unavailable or unaffordable, medications like Linzess (linaclotide), Amitiza (lubiprostone), or Motegrity (prucalopride) may be effective alternatives.

What About the Cost? Can I Save Money on Trulance?

Trulance's high retail price is a barrier for many patients. Salix Pharmaceuticals offers a savings card for commercially insured patients that can reduce out-of-pocket costs to as little as $25 per prescription for up to 12 fills per year. GoodRx and SingleCare coupons can reduce the price to $552–$620 per month for patients paying cash. For low-income or uninsured patients, Salix also has a patient assistance program. See our full guide to saving money on Trulance for more options.

The Bottom Line

Trulance isn't in a formal shortage, but it can still be hard to find because it's a brand-only drug with limited pharmacy stock, a high price tag, and insurance hurdles that slow down access. The good news is that the drug itself is available — it's just a matter of knowing where to look. Tools like medfinder can help you locate which pharmacies near you have Trulance in stock, saving you time and frustration. Check out our guide on how to find Trulance in stock near you for step-by-step tips.