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Ibsrela vs Trulance
Introduction
For patients with irritable bowel syndrome (IBS) characterized by constipation or chronic idiopathic constipation, certain drugs that alter the absorption and secretion of fluid in the intestines can help manage symptoms. Ibsrela and Trulance are two such drugs prescribed for this purpose. They each impact different mechanisms in the gut, but both have effects on easing constipation and improving bowel function.
Ibsrela is a sodium/hydrogen exchanger 3 (NHE3) inhibitor which works by increasing intestinal fluid secretion and motility, thereby aiding stool passage. On the other hand, Trulance is classified as a guanylate cyclase-C agonist. It increases cyclic Guanosine Monophosphate (cGMP) levels that result in increased chloride and bicarbonate secretion into the intestine lumen to increase fluid movement into it due to osmotic pressure differences - thus promoting regular bowel movements.
Ibsrela vs Trulance Side By Side
| Attribute | Ibsrela | Trulance |
|---|---|---|
| Brand Name | Ibsrela | Trulance |
| Contraindications | Known allergy to any components of the drug, history of blockage in your stomach or intestines, conditions that can cause an obstruction like Crohn's disease, Phenylketonuria (PKU) | Known allergy to any components of the drug, history of blockage in your stomach or intestines, or other conditions that can cause an obstruction like Crohn's disease |
| Cost | Around $1,000 for 30 tablets | Around $500 for 30 tablets |
| Generic Name | Tenapanor | Plecanatide |
| Most Serious Side Effect | Severe allergic reactions, severe diarrhea leading to dehydration, unusual bleeding or bruising, rapid heartbeat, pancreatitis | Severe allergic reactions, severe diarrhea, unusual bleeding or bruising, lightheadedness or fainting spells |
| Severe Drug Interactions | Not specifically mentioned, but it's crucial to inform healthcare providers about all medicines being taken to avoid negative interactions | Not specifically mentioned, but similar to Ibsrela, it's important to discuss all current medications with a healthcare provider |
| Typical Dose | 500–1000 mg twice daily, not to exceed 2000 mg/day | 3mg/day, taken once daily in the morning on an empty stomach |
What is Ibsrela?
Tenapanor (the generic name for Ibsrela) was a significant advancement in the class of drugs known as NHE3 inhibitors. These medications are used to treat irritable bowel syndrome with constipation (IBS-C). Approved by the FDA in 2019, Ibsrela works by reducing absorption of dietary sodium in the gut, which increases fluid in the small intestine and helps ease bowel movements. It is prescribed to adults suffering from this form of IBS.
On the other hand, Plecanatide (also known as Trulance) falls under a different class called guanylate cyclase-C agonists. This drug also treats IBS-C but operates differently than Tenapanor; it mimics an endogenous peptide found within your body that regulates fluid secretion and transit time through your intestines.
Both medicines have been found effective for their purposes but they function via different mechanisms and may carry varying side effects. For instance, common side effects related to Trulance include diarrhea while those associated with Ibsrela may include swelling or a feeling of fullness or pressure in your abdomen.
What conditions is Ibsrela approved to treat?
Ibsrela is approved for the treatment of certain specific conditions, which include:
- Irritable Bowel Syndrome with Constipation (IBS-C) in adults
- Chronic Idiopathic Constipation (CIC) in adults
On the other hand, Trulance has been FDA approved to treat:
- Chronic idiopathic constipation (CIC)
- Irritable bowel syndrome with constipation(IBS-C), in adults.
How does Ibsrela help with these illnesses?
Ibsrela helps to manage Irritable Bowel Syndrome with constipation (IBS-C) by increasing the amount of fluid in your intestines. It does this by blocking a protein called sodium/hydrogen exchanger 3, which helps balance fluids in your body. By inhibiting this protein, Ibsrela can increase fluid secretion in your gut, helping stool pass through more easily and reducing constipation symptoms. This mechanism is important for digestion, absorption of nutrients, and maintaining proper hydration levels among other things. Individuals with IBS-C often experience uncomfortable symptoms such as abdominal pain and bloating due to their irregular bowel movements or hard stools. Therefore, by increasing intestinal fluid secretion, Ibsrela can limit the negative effects of IBS-C and help patients manage their condition.
What is Trulance?
Trulance, a brand name for plecanatide, is a guanylate cyclase-C agonist that mimics the function of endogenous uroguanylin in your body. By doing so, it increases the secretion of chloride and bicarbonate into the intestinal lumen which results in increased intestinal fluid and accelerated transit. Trulance was first approved by the FDA in 2017. As Trulance doesn't work on serotonin receptors like some other medications for constipation-predominant irritable bowel syndrome (IBS-C), it does not present with side-effects such as sedation or sexual dysfunction often associated with SSRIs like Prozac. Its unique mechanism can be beneficial for those suffering from chronic idiopathic constipation and IBS-C, particularly patients who have failed to find relief with more conventional treatments.
What conditions is Trulance approved to treat?
Trulance is approved for the treatment of certain gastrointestinal disorders, including:
- Chronic idiopathic constipation (CIC)
- Irritable bowel syndrome with constipation (IBS-C)
The medication has been specifically designed to increase fluid in your gut and improve bowel movements.
How does Trulance help with these illnesses?
Trulance is a medication known for managing chronic idiopathic constipation and irritable bowel syndrome with constipation (IBS-C). It helps to increase the fluid in your intestines, which can facilitate smoother bowel movements. Guanylate cyclase-C is an enzyme found on the lining of your intestines that regulates fluid balance and aids in stool transit. Trulance works by stimulating this enzyme, thus increasing fluid secretion and motility in the intestines, thereby relieving symptoms of constipation. Its action may also play roles in alleviating abdominal pain associated with IBS-C. Unlike Ibsrela which specifically targets bile acid transporter inhibition to decrease bile acid secretion leading to increased water secretion into colon, Trulance has a more general effect on intestinal fluid management making it potentially more effective across a broader range of patients. Therefore, it might be preferred when a patient does not experience sufficient relief from medications like Ibsrela.
How effective are both Ibsrela and Trulance?
Both tenapanor (Ibsrela) and plecanatide (Trulance) are effective in treating patients with irritable bowel syndrome with constipation (IBS-C), albeit via different mechanisms of action. Ibsrela was approved by the FDA in 2019, while Trulance received its approval two years earlier, in 2017.
A direct comparison study between Ibsrela and Trulance has not yet been conducted; however, both drugs have shown significant efficacy in managing symptoms of IBS-C within their respective clinical trials. In these studies, both medications exhibited promising safety profiles.
The effectiveness of Ibsrela is based on its ability to inhibit sodium absorption from the gastrointestinal tract thereby increasing fluid secretion into the gut which helps soften stool and reduces constipation. It also decreases abdominal pain by reducing visceral hypersensitivity associated with IBS-C. The recommended dose for optimal efficacy is thought to be 50 mg twice daily.
On the other hand, Trulance works by stimulating secretion of chloride and bicarbonate into intestinal lumen which increases fluid volume leading to an increased rate of transit through small intestine and colon resulting improvement in bowel function like reduced straining during defecation etc., Its efficacy as a stand-alone treatment for chronic idiopathic constipation has been proven robustly via several large-scale randomized controlled trials.
As per a review published in American Journal Of Health System Pharmacy [1] , there were no head-to-head comparisons available between tenapanor(Ibsrela) or plecanatide(Trulance). Therefore it can't be definitively stated if one drug is superior over another when it comes to managing symptoms related to Chronic Idiopathic Constipation or Irritable Bowel Syndrome With Constipation.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287288/
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At what dose is Ibsrela typically prescribed?
Oral dosages of Ibsrela range from 500–1000 mg twice daily, but studies have suggested that 500 mg twice a day is adequate for managing irritable bowel syndrome (IBS) in most adults. Regarding Trulance, the standard dosage is one 3 mg tablet per day for both chronic idiopathic constipation and irritable bowel syndrome with constipation in adults. For either medication, your healthcare provider might consider a dose adjustment based on your response after several weeks of treatment. However, for Ibsrela specifically, it's crucial not to exceed the maximum dosage of 2000 mg/day.
At what dose is Trulance typically prescribed?
Trulance treatment for chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C) usually begins at a dosage of 3mg/day. The dose is taken once daily, in the morning, on an empty stomach, at least 30 minutes before the first meal of the day. It is crucial not to exceed this recommended dose as it may lead to severe diarrhea. Hence, Trulance therapy should be carefully monitored and adjusted if there's no noticeable improvement in symptoms after several weeks of treatment under medical supervision.
What are the most common side effects for Ibsrela?
Common side effects of Ibsrela include:
- Increased blood levels of liver enzymes (signs of potential liver injury)
- Abdominal pain or discomfort
- Bloating and gas
- Nausea and vomiting
- Diarrhea, including severe diarrhea with substantial loss of fluids
- Dizziness or lightheadedness due to dehydration from diarrhea
On the other hand, Trulance is associated with side effects like:
- Diarrhea, which can sometimes be severe
- Gas or bloating
- Stomach-area (abdomen) pain
-Nausea -Distention
As always, it's crucial to discuss these potential side effects with your healthcare provider before starting a new medication.
Are there any potential serious side effects for Ibsrela?
While comparing Ibsrela to Trulance, it's important to note that both medications are generally considered safe and effective for treating irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation. However, they can occasionally cause serious side effects such as:
- Severe allergic reactions: signs include hives, difficulty breathing or swallowing, swelling of the face or throat.
- Serious cases of diarrhea which may lead to severe dehydration symptoms like dizziness, fainting due to low blood pressure; feeling incredibly thirsty or producing less urine than usual.
- Unusual bleeding or bruising under the skin
- Rapid heartbeat
- Pancreatitis: severe stomach pain that might move towards your back along with nausea and vomiting.
Also keep in mind that these drugs should not be used if you have a blockage in your digestive tract. If you notice any of these side effects while taking either medication, seek immediate medical attention.
What are the most common side effects for Trulance?
The use of Trulance can lead to a range of potential side effects, including:
- Diarrhea
- Stomach discomfort or bloating
- Increased gas (flatulence)
- Headache
- Dizziness
- Abdominal cramping or pain These are the most common side effects and tend to be mild. However, severe diarrhea is a potential serious concern with Trulance that may require immediate medical attention.
Are there any potential serious side effects for Trulance?
While Trulance is generally well-tolerated, it can occasionally cause serious side effects. If you experience any of the following symptoms after taking Trulance, seek medical attention immediately:
- Signs of a severe allergic reaction such as hives, itching, rash, swelling in your face or throat and difficulty breathing.
- Severe diarrhea: This could be an indication that your body isn't adapting to the medication well.
- Unusual bleeding or bruising: This could be a sign of low platelets in your blood which requires immediate care.
- Lightheadedness or fainting spells: These could indicate low blood pressure caused by dehydration due to severe diarrhea.
Remember that these are potential side effects and they don't occur in everyone taking this medication. However, if you do experience any unusual symptoms while on Trulance therapy consult with your healthcare provider promptly.
Contraindications for Ibsrela and Trulance?
Both Ibsrela and Trulance are prescription medications used to treat irritable bowel syndrome with constipation (IBS-C) in adults. Some patients may experience worsening symptoms of gastrointestinal distress, such as severe diarrhea or abdominal pain. If these symptoms persist or worsen, please seek immediate medical attention.
Neither Ibsrela nor Trulance should be taken if you have a known allergy to any components of the drug, have a history of blockage in your stomach or intestines, or suffer from other conditions that can cause an obstruction like Crohn's disease. Always inform your healthcare provider about all the medicines you are taking; some drugs may interact negatively with either Ibsrela or Trulance.
Specifically for patients prescribed on Ibsrela, it is crucial not to take this medication if you have Phenylketonuria (PKU). The tablets contain phenylalanine which could be harmful for people with PKU.
How much do Ibsrela and Trulance cost?
For the brand name versions of these drugs:
- The price for a supply of 30 tablets of Ibsrela (289 mg) averages around $1,000 which works out to approximately $33–34/day based on typical dosage.
- The price of 30 tablets Trulance (3 mg) is about $500, working out to roughly $16 -17/day.
Thus, if you are taking these medications at their typical dose levels, then Trulance is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
At this time there are no generic versions available for either Ibsrela (tenapanor) or Trulance (plecanatide). As they become available and more widely used over time, it's expected that costs will decrease significantly.
Popularity of Ibsrela and Trulance
Tenapanor, under the brand name Ibsrela, is a newer medication for Irritable Bowel Syndrome (IBS) with constipation in adults. In 2020, its prescription numbers were still relatively low as it was only approved by the FDA in late 2019.
On the other hand, plecanatide or Trulance has been available since early 2017 and is used not only for IBS with constipation but also chronic idiopathic constipation. It had an estimated total of nearly one million prescriptions dispensed in 2020 alone. This accounts for just over 12% of prescriptions within this specific class of gastrointestinal medications.
While both medicines work to alleviate symptoms associated with IBS and related conditions, they do so through different mechanisms: Tenapanor reduces absorption of dietary sodium in the gut which increases water secretion into the intestinal lumen that softens stool and promotes bowel motility; Plecanatide works by mimicking a naturally occurring hormone in your body which triggers bowel movements. The choice between these two will often come down to individual patient factors and doctor recommendation.
Conclusion
Both Ibsrela (tenapanor) and Trulance (plecanatide) have been approved for the treatment of Irritable Bowel Syndrome with Constipation (IBS-C), backed by clinical trials showing their effectiveness compared to placebo treatments. The two drugs can be used independently, but this should be under careful consideration by a physician as they are also contraindicated with one another due to differing mechanisms of action. While Ibsrela works primarily by inhibiting the sodium/hydrogen exchanger 3 (NHE3), resulting in an increase in bowel movements and reduction in abdominal pain, Trulance activates guanylate cyclase-C receptors leading to increased fluid secretion into the intestine that softens stool and facilitates bowel movement.
As relatively new medications on the market, neither is available in generic form at present which may impact cost considerations especially for patients who must pay out of pocket. Both Ibsrela and Trulance require consistent usage for noticeable effects; they are not quick-fix solutions.
The side effect profile between these two drugs is similar, both generally well-tolerated but with common side effects including diarrhea, gas, bloating or distension. For both drugs, patients need to closely monitor their symptoms while starting treatment or adjusting dosage levels - any worsening conditions should warrant immediate medical attention.