Plecanatide

Indications

Plecanatide is used for: Chronic Idiopathic Constipation, Irritable Bowel Syndrome

Adult Dose

Oral Chronic Idiopathic Constipation Indicated for chronic idiopathic constipation in adults 3 mg PO qDay Irritable Bowel Syndrome Indicated for irritable bowel syndrome with constipation (IBS-C) in adults 3 mg PO qDay

Child Dose

<18 years: Safety and efficacy not established

Renal Dose

Administration

May take with or without food

Contra Indications

Children <6 yr Avoid use in children 6 yr to <18 yr Known or suspected mechanical gastrointestinal obstruction

Precautions

Diarrhea may occur; however, severe diarrhea is infrequent; if severe diarrhea occurs, suspend dosing and rehydrate the patient Risk of serious dehydration in pediatric patients

Pregnancy-Lactation

Pregnancy Data are insufficient to assess drug-associated risks for major birth defects and miscarriage in humans Plecanatide and its active metabolite are negligibly absorbed systemically, and maternal use is not expected to result in fetal exposure to the drug Lactation Unknown if distributed in human breast milk Plecanatide and its active metabolite are negligibly absorbed systemically, and maternal use is not expected to result in fetal exposure to the drug Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition

Interactions

Adverse Effects

Side effects of Plecanatide : 1-10% Diarrhea 5%

Mechanism of Action

Guanylate cyclase C (GC-C) agonist Plecanatide and its active metabolite bind to GC-C and act locally on the luminal surface of intestinal epithelial cells; GC-C activation leads to increased cyclic guanosine monophosphate (cGMP), which, in turn, stimulates secretion of chloride and bicarbonate into the intestinal lumen, mainly by activation of the cystic fibrosis transmembrane conductance regulator (CFTR) ion channel, resulting in increased intestinal fluid and accelerated transit