Drug Action
A selective serotonin 5HT4-receptor agonist with prokinetic properties.
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Drug reference
A selective serotonin 5HT4-receptor agonist with prokinetic properties.
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Chronic constipation when other laxatives fail to provide an adequate response ▶BY MOUTH ▶Adult: 2 mg once daily, review treatment if no response after 4 weeks ▶Elderly: Initially 1 mg once daily, increased if necessary to 2 mg once daily, review treatment if no response after 4 weeks
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Crohn’s disease. intestinal obstruction. intestinal perforation. toxic megacolon. ulcerative colitis
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History of arrhythmias. history of ischaemic heart disease
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NICE decisions ▶Prucalopride for the treatment of chronic constipation in women (December 2010) NICE TA211 Prucalopride (Resolor ®) is recommended as an option for the treatment of chronic constipation in women for whom treatment with at least 2 laxatives from different classes, at the highest tolerated recommended doses for at least 6 months, has failed to provide adequate relief and invasive treatment for constipation is being considered. If treatment with prucalopride is not effective after 4 weeks, the patient should be re-examined and the benefit of continuing treatment reconsidered. Prucalopride should only be prescribed by a clinician with experience of treating chronic constipation, after careful review of the patient’s previous courses of laxative treatments. www.nice.org.uk/guidance/ta211 Scottish Medicines Consortium (SMC) decisions SMC No. 653/10 The Scottish Medicines Consortium has advised (July 2011) that prucalopride (Resolor ®) is not recommended for use within NHS Scotland for the symptomatic treatment of chronic constipation of women in whom laxatives fail to provide adequate relief.
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▶Common or very common Appetite decreased. diarrhoea. dizziness. fatigue. gastrointestinal discomfort. gastrointestinal disorders. headache. nausea. vomiting ▶Uncommon Anorectal haemorrhage. fever. malaise. palpitations. tremor. urinary frequency increased SIDE-EFFECTS, FURTHER INFORMATION Side-effects generally occur at the start of treatment and are usually transient.
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Manufacturer recommends effective contraception during treatment.
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Manufacturer advises avoid—limited data available.
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Manufacturer advises avoid—present in milk.
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Manufacturer advises caution in severe impairment (risk of increased exposure, limited information available). Dose adjustments Manufacturer advises initial dose of 1 mg once daily in severe impairment; if tolerated this may be increased to 2 mg once daily.
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Dose adjustments Manufacturer recommends a reduced dose of 1 mg daily if eGFR less than 30 mL/minute/1.73 m2.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Resolor (Shire Pharmaceuticals Ltd) Prucalopride (as Prucalopride succinate) 1 mg Resolor 1mg tablets | 28 tablet P £38.69 DT = £38.69 Prucalopride (as Prucalopride succinate) 2 mg Resolor 2mg tablets | 28 tablet P £59.52 DT = £59.52 LAXATIVES › SOFTENING LAXATIVES
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Driving and skilled tasks Manufacturer advises that dizziness and fatigue may initially affect ability to drive or operate machinery.
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2 mg once daily, review treatment if no response
First-line fragment. Read the complete Indications and Dose section above.
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Initially 1 mg once daily, increased if necessary
First-line fragment. Read the complete Indications and Dose section above.
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