What is Prucalopride: Uses, Dosage, Side Effects and More

Prucalopride is a prescription medication that helps treat chronic constipation by making your intestines move more effectively. It's specifically designed for people who haven't found relief with other treatments like fiber supplements or over-the-counter laxatives.

This medicine belongs to a class of drugs called serotonin receptor agonists, which work by targeting specific receptors in your digestive system. Think of it as giving your gut muscles a gentle but effective nudge to get things moving again naturally.

What is Prucalopride?

Prucalopride is a targeted medication that stimulates the movement of your large intestine to help relieve chronic constipation. Unlike general laxatives that work throughout your digestive system, this medicine focuses specifically on the colon where most constipation problems occur.

The medication was developed after years of research into how our digestive system communicates with itself. It works by activating serotonin receptors in your gut, which are like switches that tell your intestinal muscles when to contract and move waste along.

You might know this medication by its brand name Motegrity in the United States, or Resolor in other countries. It's been used safely in Europe for over a decade before becoming available in the US in 2018.

What is Prucalopride Used For?

Prucalopride is primarily prescribed for chronic idiopathic constipation in adults. This means long-term constipation that doesn't have an obvious underlying cause like medication side effects or other medical conditions.

Your doctor might recommend prucalopride if you've been dealing with constipation for months or years, especially if you've tried other treatments without success. The medication is particularly helpful for people who have fewer than three bowel movements per week or struggle with hard, difficult-to-pass stools.

It's also used when your constipation significantly impacts your quality of life, causing discomfort, bloating, or interfering with daily activities. The medicine can be especially beneficial for older adults who often experience slower digestive transit as they age.

How Does Prucalopride Work?

Prucalopride works by activating specific serotonin receptors called 5-HT4 receptors in your large intestine. These receptors act like biological switches that control how your gut muscles contract and relax.

When you take prucalopride, it binds to these receptors and sends signals that encourage your colon muscles to contract in a coordinated wave-like pattern. This natural rhythm, called peristalsis, helps move waste through your digestive system more efficiently.

The medication is considered moderately strong compared to over-the-counter options but gentler than some prescription alternatives. It typically starts working within hours, though you might not notice the full effects for a few days as your digestive system adjusts to the improved movement.

How Should I Take Prucalopride?

Take prucalopride exactly as your doctor prescribes, usually once daily in the morning. You can take it with or without food, though some people find taking it with breakfast helps establish a routine and may reduce any stomach upset.

Swallow the tablet whole with a glass of water. Don't crush, break, or chew the tablet, as this can affect how the medication is absorbed and released in your system.

If you're just starting prucalopride, it's helpful to stay near a bathroom for the first few days as your body adjusts to the medication. The effects can be quite noticeable initially, but this usually settles down as your digestive system adapts.

Try to take your dose at the same time each day to maintain consistent levels in your system. Setting a phone reminder can help you remember, especially during the first few weeks of treatment.

How Long Should I Take Prucalopride For?

The duration of prucalopride treatment varies depending on your individual response and underlying condition. Many people need to take it continuously to maintain regular bowel movements, as chronic constipation often returns when the medication is stopped.

Your doctor will likely want to see you after the first few weeks to assess how well the medication is working. If you're seeing good results with manageable side effects, you might continue taking it long-term under medical supervision.

Some people can eventually reduce their dose or take breaks from the medication, especially if they make lifestyle changes like increasing fiber intake, exercising more, or addressing underlying health issues. However, never stop or change your dose without discussing it with your healthcare provider first.

What Are the Side Effects of Prucalopride?

Like all medications, prucalopride can cause side effects, though not everyone experiences them. The most common side effects are related to your digestive system and usually improve as your body adjusts to the medication.

Here are the most frequently reported side effects that affect many people when starting prucalopride:

• Headache, which often lessens after the first week
• Nausea or stomach discomfort, especially in the first few days
• Diarrhea or loose stools as your system adjusts
• Abdominal pain or cramping
• Fatigue or feeling tired
• Dizziness, particularly when standing up quickly

These common side effects typically fade within a few days to weeks as your digestive system adapts to the medication's effects.

Less common but more serious side effects require immediate medical attention and include:

• Severe or persistent diarrhea that leads to dehydration
• Severe abdominal pain that doesn't improve
• Signs of allergic reaction like rash, itching, or swelling
• Unusual changes in mood or behavior
• Rapid or irregular heartbeat

If you experience any of these more serious symptoms, contact your healthcare provider right away or seek emergency medical care if symptoms are severe.

Who Should Not Take Prucalopride?

Prucalopride isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. The medication is not recommended for people with certain digestive conditions or those taking specific medications.

You should not take prucalopride if you have any of these conditions:

• Intestinal blockage or severe inflammatory bowel disease
• Severe kidney disease requiring dialysis
• Known allergy to prucalopride or its ingredients
• Crohn's disease or ulcerative colitis in an active flare
• Toxic megacolon or intestinal perforation

Your doctor will also be cautious about prescribing prucalopride if you have moderate kidney problems, are over 65 years old, or take medications that can affect your heart rhythm.

Women who are pregnant or breastfeeding should discuss the risks and benefits with their healthcare provider, as there's limited safety data for these situations. The medication may pass into breast milk, so alternative treatments might be considered.

Prucalopride Brand Names

Prucalopride is available under different brand names depending on where you live. In the United States, it's sold as Motegrity, which is the most commonly recognized brand name for American patients.

In other countries, you might find it under the brand name Resolor, which was the original commercial name when it was first approved in Europe. Both medications contain the same active ingredient and work identically.

Some countries may have generic versions available, which contain the same active ingredient but may be less expensive. Always check with your pharmacist to ensure you're getting the correct medication, regardless of the brand name.

Prucalopride Alternatives

If prucalopride doesn't work well for you or causes troublesome side effects, several alternative medications can help with chronic constipation. Your doctor can help you find the right option based on your specific needs and medical history.

Other prescription medications that work similarly include:

• Lubiprostone (Amitiza), which increases fluid in your intestines
• Linaclotide (Linzess), which helps with both constipation and abdominal pain
• Plecanatide (Trulance), which works by increasing intestinal fluid
• Lactulose, a prescription laxative that's gentler for long-term use

Non-prescription options your doctor might recommend include fiber supplements, stool softeners, or osmotic laxatives like polyethylene glycol. Sometimes a combination approach works better than relying on a single medication.

Is Prucalopride Better Than Lubiprostone?

Both prucalopride and lubiprostone are effective for chronic constipation, but they work through different mechanisms and may be better suited for different people. Prucalopride stimulates gut movement directly, while lubiprostone increases fluid in your intestines to soften stool.

Prucalopride often works faster and may be more effective for people whose main problem is slow intestinal transit. It's typically taken once daily, which many people find more convenient than lubiprostone's twice-daily dosing.

However, lubiprostone might be better tolerated by some people, especially those who experience significant nausea with prucalopride. It's also been available longer and has more long-term safety data.

Your doctor will consider factors like your specific symptoms, other medications you take, and your medical history to determine which option might work best for you. Sometimes it takes trying different medications to find the right fit.