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Selective Serotonin (5-HT₄) Receptor Agonist — Prokinetic

Prucalopride

Brand names: Constella, Resolor

Prucalopride is a prokinetic used for chronic constipation in adults when other laxatives have failed to provide adequate relief.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Prucalopride tablets can be taken with or without food. The recommended dosage by patient population is shown in Table 1. Table 1: Recommended Dosage Regimen and Dosage Adjustments by Population Population with CIC Recommended Oral Dose Regimen Adults 2 mg once daily Patients with severe renal impairment (creatinine clearance (CrCL) less than 30 mL/min) [ see Use in Specific Populations (8.5, 8.6 ) ] . 1 mg once daily Take with or without food. ( 2 ) Recommended dosage by patient population: Population with CIC Recommended Oral Dose Regimen Adults 2 mg once daily. ( 2 ) Patients with severe renal impairment (creatinine clearance (CrCL) less than 30 mL/min 1 mg once daily. ( 2 , 8.5 , 8.6 )

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-12-04. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is a selective, high-affinity serotonin 5-HT4 receptor agonist that stimulates colonic motility and accelerates gastrointestinal transit.

Prescribing in practice

  • Reduce the dose in severe renal impairment, as clearance is reduced.
  • Headache, nausea, diarrhoea and abdominal pain are common, particularly in the first few days of treatment, and often settle with continued use.
  • Review the response after the recommended trial period and stop if there is no adequate benefit.

Monitoring

No routine laboratory monitoring is required; assess symptomatic response at review and reduce the dose where renal function is significantly impaired.

Counselling the patient

  • Early side effects such as headache and nausea often ease after the first few days.
  • Tell your doctor if it has not improved your symptoms after the agreed trial, so it can be reviewed.

Evidence & guidelines

Recommended for chronic constipation after other laxatives fail (NICE TA211; NICE CKS).

Reference: NICE TA211 Prucalopride for Chronic Constipation; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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