prucalopride succinate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
prucalopride succinate: clinical details
Prescribing considerations
- Confirm chronic constipation with inadequate relief from laxatives and exclude obstruction or another secondary cause requiring investigation.
- Consider renal function because prucalopride is predominantly eliminated unchanged in urine.
- Use caution in severe hepatic impairment and in severe, clinically unstable disease, particularly with previous arrhythmia or ischaemic cardiovascular disease.
- Reassess clinical benefit if ineffective and periodically during continuing treatment.
Contraindications and cautions
- Hypersensitivity to prucalopride or an excipient
- Renal impairment requiring dialysis
- Intestinal perforation or obstruction, including obstructive ileus
- Severe inflammatory intestinal disease, including Crohn's disease, ulcerative colitis, toxic megacolon or toxic megarectum
- For the selected lactose-containing product: rare hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption
Monitoring
- No routine medicine-specific laboratory schedule is stated in the SmPC.
- Review bowel symptoms, treatment benefit, diarrhoea, hydration and tolerability.
- Review new palpitations and reassess renal or hepatic function when clinically indicated.
Clinical pharmacology
A selective, high-affinity 5-HT4 receptor agonist that increases propulsive colonic motility. Oral bioavailability is high, food does not materially affect absorption, metabolism is limited and renal excretion of unchanged prucalopride is the main elimination route.
Formulation and product differences
- The selected product is a film-coated oral tablet containing lactose monohydrate.
- Excipients, tablet markings, packaging and storage instructions can differ between manufacturers; check the individual product information.
prucalopride succinate preparations and strengths
Tablet
Route: Oral
Strengths: 1 mg, 2 mg
prucalopride succinate interactions
Prucalopride has relatively low potential for pharmacokinetic interactions, but relevant medicines and circumstances include:
Oral contraceptive pills
There is no clinically important direct interaction, but severe diarrhoea may reduce contraceptive absorption; follow the pill leaflet's additional-contraception advice.
Erythromycin
Prucalopride increased erythromycin concentrations in a study; the mechanism and clinical significance are uncertain.
Potent P-glycoprotein inhibitors, including ketoconazole, verapamil, ciclosporin and quinidine
These may modestly increase exposure to prucalopride; the documented ketoconazole effect was considered too small to be clinically relevant.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.