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Prucalopride

Prokinetic · Laxative

ProkineticLaxativeATC A06AX05
CDSCO approvedATC A06AX05
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

A selective serotonin 5HT4-receptor agonist with prokinetic properties.

Indications

Chronic constipation in adults when other laxatives have failed to provide an adequate response. For chronic constipation, use should be considered in women only if at least two laxatives from different classes have been tried at the highest tolerated recommended doses for at least 6 months.Severe chronic constipation (in adults where laxatives fail)

Dosing

Adult
2 mg once daily, review treatment if no response after 4 weeks
Geriatric
Initially 1 mg once daily, increased if necessary to 2 mg once daily, review treatment if no response after 4 weeks
Max dose
2 mg once daily

Pharmacokinetics

Peak effect
2 to 3 h
Half-life
24 h
Excretion
Primarily in the urine as unchanged drug

Contraindications

  • Intestinal perforation
  • Intestinal obstruction
  • Obstructive ileus
  • Inflammatory conditions of the GI tract (Crohn's disease, ulcerative colitis, toxic megacolon/megarectum)

Side effects

Common
HeadacheAbdominal painNauseaDiarrhea
Serious
  • Suicidal ideation (warning, though no causal association established)

Drug interactions

Amiodarone
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Source: DDInter

Clarithromycin
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Cyclosporine
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Source: DDInter

Erythromycin
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Ketoconazole
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Source: DDInter

Quinidine
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Source: DDInter

Ritonavir
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Source: DDInter

Verapamil
Moderate
Database

Increased plasma concentrations of prucalopride, potentially leading to an increased incidence or severity of prucalopride-related adverse effects (e.g., headache, nausea, diarrhea, abdominal pain).

Monitor for increased adverse effects of prucalopride. A dose reduction of prucalopride may be considered if adverse effects become bothersome or severe, especially in patients with renal impairment.

Source: DDInter

4 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Prokinetic drugs

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Sources: Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team