Linzess vs. Trulance – What is the Difference?

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: July 15, 2022

Linzess and Trulance are brand-name medications. They are commonly used in the treatment of CIC (or chronic idiopathic constipation). They also treat IBS-C (or irritable bowel syndrome with constipation). Prescription of these medications is for adults diagnosed with these illnesses.

These medications have many similarities in how they treat the symptoms of CIC and IBS-C. 

Knowing their differences and side effects can impact which medication a doctor prescribes. It’s important to understand the ways that Linzess and Trulance affect the body, including side effects, interactions, and general effectiveness.

 

What is Linzess?

Linzess can relieve the symptoms associated with chronic idiopathic constipation (CIC). It is also effective in treating irritable bowel syndrome with constipation (IBS-C). This prescription medication can bring condition-associated relief from constipation and abdominal cramping.

Available in capsule form, Linzess can come in doses of 72 mcg, 145 mcg, or 290 mcg. If you miss a dose, take it right away or skip it if it is almost time for your next scheduled dose. If you are not sure, call your pharmacist.

When taken as prescribed, this medication increases the frequency and eases bowel movements. It creates increased chloride and water in the intestines. Constipation relief occurs because the body’s stool softens and stimulates a bowel movement.

Linzess relaxes the abdomen, decreases pain, and encourages bowel movements. This is done by increasing the level of fluids in the intestines.

Linzess is not a controlled medication. It is not intended for weight loss or gain. However, if the side effect of bloating occurs, weight gain is a possibility.

 

Linzess Side Effects

Linzess may cause some side effects. Always discuss concerns or unknown symptoms with your pharmacist or doctor. These can include such mild, short-lived side effects as:

  • Headache
  • Gas
  • Bloating
  • Diarrhea
  • Pain in the abdomen

Though rare, some serious side effects may occur. Linzess can cause severe diarrhea and allergic reaction. Allergies can result in itching, rash, or flushed skin.

If any of these symptoms occur, call your doctor or seek medical help immediately. For life-threatening reactions, call 911 or go to the closest emergency department.

Some of the warnings associated with Linzess include:

  • Not Suitable for Children: Linzess is approved for adults only and not recommended for children under 18. There are serious warnings against using this medication for anyone under the age of 6.
  • Intestinal Blockage: If you have an intestinal blockage, do not use Linzess to treat CIC or IBS-C.

There are no known negative drug side effects for pregnant or breastfeeding women. There is also no evidence to suggest the medication will be passed through the breast milk to the infant. If you’re concerned about taking this drug, talk with your doctor before your first dose.

 

What Is Trulance?

Trulance is a medication prescription available in a 3 mg oral tablet. It was approved in 2017 by the FDA for the treatment of CIC or IBS-C.

CIC (or chronic idiopathic constipation) is ongoing constipation with an unknown cause.

IBS-C (or irritable bowel syndrome with constipation) is a variation of IBS. It has constipation symptoms rather than diarrhea.

Available only as a brand name drug, Trulance does not have a generic version.

Trulance is not a laxative that stimulates the urge to go. Laxatives are designed to work in one of two ways. One, they can cause intestinal muscle spasms that move the stool along. Or two, they make the stool bigger which encourages a bowel movement.

Instead, Trulance attaches to a protein found in the digestive tract. It then works by increasing fluid absorbed by the intestines. This makes bowel movements easier and more productive, relieving constipation.

If you miss your scheduled dosage time, take one tablet. Or if it is close to the time for your next dose, skip the missed tablet and continue with the prescribed dosage.

 

Trulance Side Effects

There are some side effects associated with the use of Trulance. If you notice these symptoms, always consult with your doctor or pharmacist immediately. For any life-threatening side effects, call 911 or seek emergency medical help.

Some mild side effects are:

  • Bloating of the abdomen
  • Feeling dizzy
  • Nausea
  • Diarrhea
  • Infection

Though rare, there are also possible serious side effects from Trulance, such as:

  • Severe diarrhea
  • Evidence of allergic reaction (such as tongue swelling, itchiness, or trouble breathing)
  • Dehydration

The FDA has issued one warning about Trulance and the risk of severe dehydration in children. For this reason, it is not recommended that children under the age of 6 use this medication.

It is unknown if Trulance causes any problems for pregnant or breastfeeding women. The medication is not shown to pass through breast milk to the child. It is always best to ask your doctor if this will adversely affect you, your pregnancy, or your baby.

 

What makes Linzess and Trulance Different?

In many ways, Linzess and Trulance are quite similar. 

  • Both are recommended treatments for CIC and IBS-C.
  • They belong to the drug class guanylate cyclase-C agonists.
  • Also, both are intended prescriptions for adults and contraindicated for children.

There are several key ways that these two medications are different. They are: 

  • Pill Form: Though oral, these drugs differ. Trulance is taken in tablet form and Linzess as a capsule.
  • Active Drug: The active ingredient in these medications is different. Trulance contains plecanatide, while Linzess contains linaclotide.
  • How to Take: One difference is how to take them. Linzess should be taken in the morning at least 30 minutes before eating anything. Trulance may be taken whole with water or crushed and mixed with applesauce.
  • Rapidness of Results: Trulance brings relief within one week of the first dose. With Linzess, patients may see results in two weeks. 

 

Linzess vs. Trulance: Which Medication is More Effective?

Knowing the effectiveness of any medicine is important when it’s prescribed for your illness. In the case of Linzess and Trulance, both medications are nearly equal. They are similar in their ability to treat CIC and IBS-C.

  • Both work within a couple of weeks.
  • Both have mostly mild side effects.
  • Both control symptoms of CIC and IBS-C.

Talk to your doctor or pharmacist for more details on which of these two drugs is your best option.

 

Medication Interactions for Linzess and Trulance

When deciding your treatment, your doctor needs information to determine the best medications. This is for your safety and to ensure the effectiveness of your treatment.

Known interactions for Linzess include:

  • There are no known medications known to interact with Linzess.
  • This drug should only be taken on an empty stomach. It can cause moderate interaction with foods and cause side effects.
  • Two illnesses can also interact with Linzess, including intestinal blockages and diarrhea. If you have these conditions, consult with your doctor before taking this medication.

Known interactions for Trulance include:

  • There are no known drug interactions with Trulance.
  • There are also two disease interactions, including gastrointestinal obstruction and dehydration. Do not use Trulance if you have a bowel obstruction or if you are dehydrated.

 

The Rx Advocates Can Help You Pay for Both Linzess and Trulance

At The Rx Advocates, we understand the need for people with CIC and IBS-C to take drugs like Linzess or Trulance. We also understand how expensive these medications can be. The cost can be challenging even for those with health insurance. You may even be one of the many people currently struggling over the cost of your medicine.

Taking the proper medication shouldn’t mean choosing between cost and quality of life. We are here to help. Our prescription advocacy program is designed for patients just like you. By utilizing patient assistance programs, many people are eligible for financial help because of their yearly income.

Has your doctor prescribed either Linzess or Trulance to treat your medical condition? Are you finding the cost a burden? The Rx Advocates might be able to help. Please contact us today so we can check your eligibility for our program.

 

Sources:

  1. Ada. Chronic Idiopathic Constipation. November 12, 2021. Available at: ada.com.
  2. MayoClinic. Irritable Bowel Syndrome. December 1, 2021. Available at: mayoclinic.com.
  3. MedicalNewsToday.com. Trulance: Side effects, dosage, cost, uses, alternatives, and more. 2022. Available at: medicalnewstoday.com.
  4. Drugs.com. Linzess: Uses, Dosage, and Side Effects. May 11, 2022. Available at: drugs.com.
  5. MedicalNewsToday.com. Linzess: Side effects. 2022. Available at: medicalnewstoday.com.
  6. MedicalNewsToday.com. Trulance: Uses. 2022. Available at: medicalnewstoday.com.
  7. MedicalNewsToday.com. Trulance: Side Effects. 2022. Available at: medicalnewstoday.com.
  8. How to Discuss. Trulance vs. Linzess. October 2021. Available at: howtodiscuss.com.
  9. Drugs.com. Linzess Interactions Checklist. Available at: drugs.com.
  10. Drugs.com. Trulance Interactions Checklist. Available at: drugs.com.
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