How does this medication work? What will it do for me?

Plecanatide belongs to the class of medications called guanylate cyclase-C agonists.

It is used to treat adults with irritable bowel syndrome with constipation (IBS-C). Plecanatide works by increasing fluid in the digestive tract. This causes softening of the stools, increased speed of food and waste travelling through the digestive system, and increased frequency of bowel movements. It also helps reduce the discomfort that often occurs with long-term constipation by reducing the sensitivity of the pain-sensing nerves in the digestive system.

Some people notice an improvement in symptoms within 24 hours, while most begin to see improvement within a week of starting to take this medication.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each white-to-off-white, plain, round tablet, debossed with "SP" on one side and "3" on the other side, contains 3 mg of plecanatide. Nonmedicinal ingredients: microcrystalline cellulose and magnesium stearate.

How should I use this medication?

The recommended dose of this medication is 3 mg (one tablet) taken by mouth once a day. It may be taken with food or on an empty stomach. If you take plecanatide with food and then have diarrhea or abdominal cramping, you should avoid high-fat, high-calorie meals near the time you take plecanatide.

If you have trouble swallowing, the tablet may be crushed and sprinkled on a tablespoonful of applesauce or water. If you are using applesauce, sprinkle the contents of one capsule onto one teaspoon of applesauce and consume the tablet-applesauce mixture immediately. Do not store for later use.

If you are using water, put the tablet into a clean cup and add approximately 30 ml of room temperature water. Gently swirl the tablet and water for at least 10 seconds. The tablet will fall apart in the water. Swallow the mixture immediately. If you see any part of the tablet left in the cup, add another 30 mL of water to the cup, swirl again for at least 10 seconds and swallow immediately. Do not store the mixture for later use.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take plecanatide if you:

  • are allergic to plecanatide or any ingredients of the medication
  • have or may have a blockage in the digestive tract

Do not give this medication to children less than 6 years of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • common cold (e.g., stuffy or runny nose, sore throat)
  • diarrhea (loose, watery stools)
  • dizziness
  • headache
  • nausea

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • symptoms of influenza (e.g., sudden fever, chills, body aches, cough, sore throat)
  • symptoms of an upper respiratory tract infection (e.g., cough, sneezing, sore throat, runny nose, fever, fatigue)
  • symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • severe diarrhea

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Dehydration: Plecanatide may cause an increased amount of fluid to be removed from the body, resulting in dehydration. If you experience symptoms of dehydration, such as thirst, decreased urine or tear production, dizziness, or headaches, contact your doctor.

Diarrhea: The most common side effect of this medication is diarrhea. If you develop severe, watery diarrhea, it may lead to dehydration, which can become a medical emergency. If you experience severe diarrhea, stop taking this medication and contact your doctor as soon as possible.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if plecanatide passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children between 6 years and 18 years of age. Children may be more likely to develop diarrhea and its potentially serious effects. Plecanatide should not be given to children under the age of 6 years.

What other drugs could interact with this medication?

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

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