Prucalopride

Once daily oral treatment for adults with chronic idiopathic constipation.

A selective serotonin-4 (5 HT4) receptor agonist that enhances colonic peristalsis to increase bowel motility.

Increases intracellular adenosine monophosphate to enhance release of as acetylcholine, major excitatory neurotransmitter in the G.I. tract.

In 6 studies 19-38% of patients who receive the drug responded compared with 10%-20% of those who received a placebo.

Common adverse reactions include: headache, abdominal pain, nausea, diarrhea, and abdominal distention.

The usual recommended dose is 2 mg daily in individual 65 years or younger and 1 mg daily in individuals older than 65 years.

It is eliminated exclusively through renal excretion.

It should be used only if standard laxatives fail for the management of constipation.