Adult: 2 mg once daily. Elderly: Initially, 1 mg once daily, may increase to 2 mg once daily if necessary.
Renal Impairment
Severe (GFR <30 mL/min/1.73 m2): 1 mg once daily. Patient on dialysis: Contraindicated.
Hepatic Impairment
Severe (Child-Pugh Class C): Initially, 1 mg once daily, may increase to 2 mg once daily if necessary.
Administration
May be taken with or without food.
Contraindications
Intestinal obstruction or perforation, obstructive ileus, active severe inflammatory bowel conditions (e.g. Crohn’s disease, toxic megacolon/megarectum, and ulcerative colitis). Renal impairment requiring dialysis. Pregnancy and lactation.
Special Precautions
Patient w/ history of arrhythmias or ischaemic CV disease, severe and unstable concomitant disease (e.g. cancer, AIDS, neurological or psychiatric, pulmonary, IDDM or other endocrine disroders). Severe hepatic (Child-Pugh Class C) and renal (GFR <30 mL/min/1.73 m2) impairment. Elderly.
This drug may cause dizziness and fatigue, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor bowel movement frequency.
Drug Interactions
May decrease serum concentration of contraceptives (i.e. oestrogens, progestins). May enhance adverse effect of levosulpiride. Increased serum concentration w/ P-glycoprotein/ABCB1 inhibitors. Reduced effect w/ atropine-like substance.
Action
Description: Prucalopride is a selective 5-HT4 receptor agonist w/ prokinetic effect. It stimulates peristaltic reflex, intestinal secretions, and GI motility. Pharmacokinetics: Absorption: Rapidly absorbed from the GI tract. Absolute bioavailability: >90%. Time to peak plasma concentration: 2-3 hr. Distribution: Extensively distributed; enters breast milk. Volume of distribution: 567 L. Plasma protein binding: Approx 30%. Metabolism: Metabolised slowly in the liver. Excretion: Via urine (approx 60-65% as unchanged drug); faeces (approx 5% as unchanged drug). Terminal elimination half-life: Approx 24 hr.