Plecanatide
Laxatives
Laxatives
A uroguanylin-like peptide that stimulates guanylate cyclase C in the gut, adding fluid to stool. Used for chronic constipation and IBS-C in adults.
Quick facts
- Group
- Laxatives
- Target
- Guanylate cyclase C (GC-C) on intestinal epithelium
- Used for
- Chronic idiopathic constipation
- Key effects
- Diarrhoea · Bloating · Nausea
- Monitor
- Stool frequency and consistency · Signs of dehydration
- ATC
- A06AX07
No doses: the clinician sets them by the current guideline.
Mechanism of action
Plecanatide is a synthetic analogue of uroguanylin. It activates guanylate cyclase C on the luminal surface of intestinal cells, raising cyclic GMP. This drives chloride and bicarbonate secretion into the lumen (through CFTR), water follows, stool softens and transit speeds up.
- Plecanatide activates guanylate cyclase C
- Cyclic GMP rises in enterocytes
- Chloride and water move into the lumen
- Softer stool, faster transit
Indications
- Chronic idiopathic constipation in adults
- Irritable bowel syndrome with constipation in adults Irritable bowel syndrome →
Adverse effects
Common
- Diarrhoea, the most common effect
- Bloating, gas, abdominal tenderness
- Nausea, dizziness
Contraindications
- Children under 6 years
- Known or suspected mechanical GI obstruction
- Avoided in patients under 18
Key interactions
- Other laxatives or drugs that cause diarrhoea
- More diarrhoea and dehydration risk
What is monitored
- Stool frequency and consistency
- Signs of dehydration with severe diarrhoea
Administration and safety
- Oral tablet, with or without food; swallowed whole, or crushed and mixed only with water or applesauce if swallowing is hard, then taken at once.
- Kept away from children; accidental use by a child is an emergency risk.
Pregnancy and breastfeeding
Human data are limited; it is used in pregnancy only if the benefit justifies the risk.
Nursing care
- Confirm the patient is an adult and has no bowel obstruction.
- Teach to stop and call for severe diarrhoea.
- Teach to store it out of reach of children.
- Give and explain the medication guide.
Pharmacokinetics
- Absorption
- Acts on the luminal surface of the gut lining
Test yourself
Think of the answer, then tap the question to see it.
Which enzyme does plecanatide activate?
Guanylate cyclase C on intestinal epithelial cells.
Which natural peptide does it mimic?
Uroguanylin.
Why is it contraindicated in young children?
Risk of serious, life-threatening dehydration.
Connections
← Back to the class: Laxatives
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Plecanatide: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.