Prucalopride for Chronic Constipation

Woman with irritable bowel syndrome. Credit: Credit: Peter Dazeley

Prucalopride is a medication designed to treat chronic constipation - a health problem characterized by infrequent and difficult passage of stools over a prolonged period, along with a range of other distressing symptoms such as abdominal bloating, flatulence, and even vomiting. Traditional treatment options for chronic constipation involve mostly diet and lifestyle changes and/or laxatives. 

Prucalopride is available in Europe and the USA, under the name brand name "Resolor" and in USA as "Motegrity". The European Medicines Agency (EMA) has approved the use of prucalopride (Resolor) only for the treatment of chronic constipation in adults who have not responded to the use of laxatives. The medicine can only be obtained with a prescription.

How Does Prucalopride Work?

Prucalopride is characterized as a 5-HT4 agonist. This means that it activates the 5-HT4 receptors for the neurotransmitter serotonin. This activation is thought to increase the motility of the intestinal system by increasing peristalsis, or the muscle movements of the intestines that propel stool out of the body, making stools easier to pass and resulting in more frequent bowel movements.

Prucalopride is of the same class of medications as Zelnorm. However, prucalopride has been designed to have a different action on the body so as to reduce the likelihood of the rare but serious cardiovascular symptoms that resulted in Zelnorm being pulled off of the market.

How Effective Is Prucalopride at Treating Chronic Constipation?

In clinical trials to date, prucalopride has been shown to be superior to placebo in the following areas:

  • Increasing the frequency of spontaneous and complete bowel movements.
  • Improving patient perception of quality of life.
  • Resulting in patient perception that constipation is less of a problem.

What Are the Side Effects of Prucalopride?

In studies to date, the following side effects have been experienced:

Who Shouldn't Take Prucalopide?

Certain people are at higher risk for developing dangerous side effects or complications from taking prucalopride. These include people:

  • Known hypersensitivity to the drug or any of its ingredients
  • Intestinal perforation or obstruction
  • Obstructive ileus
  • Crohn's disease or ulcerative colitis
  • Severe and clinically unstable concomitant diseases, in particular arrhythmias or ischaemic cardiovascular disease.
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Article Sources
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  1. Omer A, Quigley EMM. An update on prucalopride in the treatment of chronic constipation. Therap Adv Gastroenterol. 2017;10(11):877-887. doi:10.1177/1756283X17734809

  2. European Medicines Agency. Resolor.

  3. Food and Drug Administration. Zelnorm.

  4. Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011;60(2):209-18. doi:10.1136/gut.2010.227132.

  5. Quigley EM. Prucalopride: safety, efficacy and potential applications. Therap Adv Gastroenterol. 2012;5(1):23-30. doi:10.1177/1756283X11423706

  6. Takeda Pharmaceuticals. Motegrity.

Additional Reading