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Drug Info

How long does Trulance stay in your system?

This medication can relieve constipation for up to one to two days with each dose
By | Mar. 11, 2025
clock next to prescription bottle - how long does Trulance stay in your system

Key takeaways

  • Trulance is a prescription medication that treats irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) in adults.

  • Trulance acts within the GI tract instead of being absorbed into the bloodstream, so it’s unknown exactly how long it stays in your system, but it’s estimated that its effects last a day or two.

  • Several factors influence how long it stays in your system, such as taking it with food, dosage, and body weight. For best results and to minimize side effects like diarrhea, take Trulance at the same time every day without food.

In this article:

Trulance (plecanatide) is a prescription medication used to treat irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) in adults. If you live with either of those health conditions, you know you don’t want symptoms coming back unexpectedly before your next dose. Understanding how it’s processed by your body can give you peace of mind and help you better manage your Trulance treatment plan. While it’s not precisely known how long Trulance stays in your system, it’s estimated to last a day or two. Read on for everything you need to know to ensure Trulance is working at its best for you.

How long does Trulance stay in your system?

“Trulance works by increasing the amount of fluid in your intestines, which results in changes in the consistency of your stool and helps to relieve constipation,” explains  Jacqueline Forman, MD, a board-certified gastroenterologist with Digestive Healthcare Associates in Great Neck, New York. Unlike many medications, which need to be processed by the liver or kidneys and absorbed by the body before they begin to work, Trulance stays in the intestines and does its work there. The fact that it isn’t absorbed into the bloodstream is the main reason why it’s hard to say quite how long it stays in your system. 

“When we refer to Trulance as being ‘in the system,’ we are referring to it being in the GI tract (whereas with most medications, we mean in the blood),” explains Aaron Emmel, Pharm.D., founder and program director at Pharmacy Tech Scholar, an online education service for pharmacists. For most drugs, we know how long it stays in the system based on the drug’s half-life, or how long it takes for its concentration in the bloodstream to be reduced by half. “Since there are negligible levels of Trulance to detect in the blood, there has not been an established half-life,” Dr. Emmel says. 

Experts estimate that Trulance stays in the system about the same amount of time it takes other substances to move through the digestive tract. “I would suggest, without any evidence to back it up, that for most people, it will be about one to two days by the time the drug and its byproducts are eliminated in the stool,” Dr. Emmel says.

Trulance is intended to be taken every day. This means that if each dose takes a day or two to move through your system, your next dose will already be active and working by the time the previous dose has run its course. It also means you can see results pretty fast. “Studies demonstrated a statistically significant improvement in the percentage of patients having complete spontaneous bowel movements in as little as 24 hours,” Dr. Forman says. Indeed, clinical studies confirm that people start to see the effects of Trulance to improve various types of constipation within the first week of taking it.

Factors that influence how long Trulance stays in your system

Like with any medication, there are factors that influence how long Trulance stays in your system and how quickly it works. Here are some of the biggest and what you might be able to do about them. 

Food intake

“Food intake is probably the biggest factor,” Dr. Emmel says. “In studies, patients who received a meal (either high fat, high calorie or low fat, low calorie) reported looser stools up to 24 hours after a single dose compared to patients who fasted.” Trulance can be taken with or without food, but if you can take it without food, you may see results faster.

Physical characteristics

“A person’s physical measurements such as height, weight, and body fat can affect how quickly a drug will work and how long it takes to excrete the drug,” Dr. Forman says. According to research in The Journal of Nutrition, being overweight or having obesity is typically associated with faster gastric emptying, which means that food and other substances move from the stomach and into the small intestine faster than they do in average-weight people. This could mean that Trulance would not be in your system and working for as long if you are overweight or have obesity.

Trulance dosage and frequency

“The dosage and frequency of Trulance can impact its duration of action in your body,” Dr. Forman explains. “For example, higher doses or more frequent administration may result in the drug remaining in your system for a longer period of time.” The standard FDA-approved dose for Trulance is 3 mg once daily. In studies comparing 3 mg Trulance to 6 mg Trulance, there was no additional treatment benefit with the higher dose, and there was a greater incidence of side effects. But if you were to take a higher dose, it might take longer to travel through your GI tract, thus staying in your system for longer.

Trulance side effects and risks

Given that it is a medication for treating digestive problems, the possible side effects of Trulance are mostly digestive in nature as well. Trulance may cause bloating, stomach tenderness, gas, nausea, dizziness, and mild to severe diarrhea. The most common side effects of Trulance, per the National Library of Medicine, include:

  • Bloating
  • Stomach tenderness, cramping, or abdominal pain
  • Gas
  • Nausea
  • Dizziness
  • Mild diarrhea

Do Trulance side effects go away?

Trulance side effects should go away once the body has time to adjust to the medication. If you continue to experience bothersome side effects, contact your healthcare provider. They may be able to recommend ways to manage or prevent side effects. 

Severe diarrhea, dehydration, or weight loss are considered serious side effects and can be signs of an overdose of Trulance. Stop taking Trulance and seek medical advice from a healthcare professional immediately if you experience these symptoms.  

Since Trulance works within the intestine, it doesn’t have any major interactions with prescription drugs. Still, it’s always best to share a list of all over-the-counter (OTC) medications and supplements you take with your provider and pharmacist before starting Trulance. Certain OTC treatments, like laxatives, can increase side effects when taken with this medication

The only people who should not take it, per the Food and Drug Administration (FDA), are children younger than 6 years of age (because they would be at risk of serious dehydration) and people who have or are suspected of having a physical blockage in their GI tract. 

“Trulance is designed to be a long-term solution for IBS-C and CIC,” notes Dr. Forman, so there is no harm or increased risk of side effects from taking it daily or long-term. If it’s working and you aren’t experiencing side effects, there’s no reason that should change.

Optimal use of Trulance

Trulance is meant to be taken once a day, every day, with or without food. “It may help to take your dose at the same time every day to maximize its performance potential,” Dr. Forman suggests. Unlike some other treatment options for constipation, Trulance is not an as-needed medication—it’s a long-term solution. If you forget a dose, you should just skip it as opposed to doubling up your next one, which will increase your risk of side effects like diarrhea.

Even though the FDA-recommended Trulance dosage is 3 mg, that amount might not be quite right for you, which is something you can determine with your healthcare provider. “If you are experiencing side effects such as extreme bouts of persistent diarrhea or dehydration, please notify your doctor right away as the dose may need to be adjusted to prevent these side effects from occurring,” Dr. Forman says.  

Trulance alternatives

“There are several other medications on the market designed to treat IBS-C and CIC,” Dr. Forman notes. So if Trulance isn’t working for you, a different drug might be better. “The variations between these drugs are primarily in their mechanism of action, active ingredient, frequency, convenience of dosing, and insurance coverage,” Dr. Forman adds. Alternatives to Trulance include:

At the end of the day, the medication that works best for you—whether it’s Trulance or something different—is a decision that should be made following a conversation with your healthcare provider. While you won’t experience any withdrawal or additional side effects if you stop taking Trulance on your own, your constipation may return, so it’s best to make that call only after chatting with your healthcare team.