Prucalopride: A Potential Medication Option for Constipation

As you know, medication options for chronic constipation are few and far between. One of the more promising medications, Zelnorm, was recently taken off the market. Luckily, those researchers are working hard! A new medication, prucalopride, is currently under investigation. Prucalopride, like Zelnorm, works by activating the 5-HT4 receptors for the neurotransmitter serotonin, as an increase in serotonin appears to increase the motility of the intestinal system.

A recent study assessed the effectiveness of prucalopride for the treatment of severe chronic constipation. The criterion for inclusion in the study was to have fewer than two spontaneous and complete bowel movements per week. The medication was considered to be effective if a patient experienced three or more spontaneous and complete bowel movements per week. A total of 620 patients received one of two different dosages of prucalopride or a placebo over a period of 12 weeks. The study also assessed for the presence of any cardiovascular changes as the risk of such side effects was the reason that Zelnorm is no longer available.

The results were promising. Approximately one third of the patients in the two prucalopride groups experienced the desired increase to three or more bowel movements. Almost half of the two prucalopride patients increased the number of bowel movements by one per week as compared to a quarter of the patients who were given a placebo. The prucalopride patients reported a higher degree of satisfaction with bowel movements and saw their constipation as a less severe problem. There was no evidence of cardiovascular problems.

Prucalopride is not currently available in the United States. Studies such as these will be presented to the FDA in order to have the drug approved. In the meantime, please see my article, “Prescription Medication for Constipation Predominant Irritable Bowel Syndrome.”

_Source:

Camilleri, M., Kerstens, R., Rykx, A. & Vandeplassche, L. “A Placebo-Controlled Trial of Prucalopride for Severe Chronic Constipation” New England Journal of Medicine 2008 358:2344-2354.