Prucalopride (Motegrity, Resolor): Uses, Dose, MOA, Side effects

Motegrity is a medication made by Shire Pharmaceuticals that activates serotonin-4 (5-HT4) receptors.

It is mainly used to treat chronic constipation that has no apparent medical cause. It is not recommended for children or young children with idiopathic constipation.

Motegrity works differently from other medications like Linzess, Lubiprostone, and Placanatide.

Uses of Prucalopride (Motegrity)

Motegrity for constipation

Motegrity is utilized for the therapy of chronic constipation, particularly when there is no underlying medical cause. It is prescribed when other treatments, such as laxatives, have failed to relieve constipation.

The medicine works by increasing your gut motility. This makes it easier for your stomach and intestines to move food through your bowels during digestion.

Motegrity for gastroparesis

Even though it does not have FDA approval, Motegrity can be used off-label to treat gastroparesis, a condition in which the stomach empties food too slowly.

Symptoms of gastroparesis include:

• nausea,
• feeling abnormally full after eating, and
• vomiting.

Motegrity for IBS

Motegrity is also used as an off-label medication to treat Irritable Bowel Syndrome (IBS) with predominant constipation symptoms.

Motegrity for opioid-induced constipation

Motegrity is not approved by the FDA to treat constipation caused by opioids (OIC). However, doctors may prescribe it for this condition even though it is off-label.

In small clinical studies, it was examined whether Motegrity could reduce constipation caused by opioids.

After 4 weeks, 40.3% of those who took 4 mg of Motegrity once daily showed improvement. They had at least one more bowel movement per week than before they began taking the medication. [Ref]

Motegrity for weight loss (not recommended for use)

Motegrity may have weight loss effects like other serotonin agonists used in the past. However, no research has been conducted on this aspect of Motegrity yet.

It is not approved by the FDA for treating obesity or for aiding in weight loss. You should only take Motegrity as instructed by your doctor. If you use it for weight loss, it can have harmful side effects.

Taking weight-loss medications for constipation can lead to the following side effects:

• Electrolyte imbalances can cause problems with the heart, kidneys, and muscles.
• Dehydration
• Diarrhea

Dosages of Motegrity

Motegrity is a tablet that you can take by mouth. There are two different strengths available: 1 mg and 2 mg. Most people take a 2 mg tablet once a day, with or without food.

To make sure you use this medication safely, read the Patient Information Leaflet from your pharmacist before you start taking it or whenever you refill your prescription. If you have any questions, ask your doctor or pharmacist.

Dosage Information:

Your doctor will determine the right dose for you based on your age, health, and how you respond to the medication.

To get the best results, take it at the same time every day so you remember to take it. If you have any concerns or questions, talk to your doctor or pharmacist right away.

Side effects of Motegrity (Prucalopride):

Adverse effects are common during the first one to two days of taking Motegrity. These may include nausea, stomach pain, diarrhea, or headache.

Some people may also feel dizzy or tired. If any of these symptoms persist or worsen, inform your doctor or pharmacist right away.

However, most people who take Motegrity do not experience significant negative effects.

In rare cases, serious adverse effects may occur. If you experience severe or prolonged stomach discomfort, bloody diarrhea, rectal bleeding, or mental or emotional disorders such as depression, thoughts of suicide, or self-harm, stop taking Motegrity and seek medical attention immediately.

There is also a very low risk of a serious allergic reaction. Seek medical treatment right away if you develop symptoms such as a rash, itching or swelling, extreme dizziness, or breathing problems.

Here’s a table that summarizes the side effects:

Table demonstrating a summary of the Side effects of Motegrity system-wise:

Mechanism of action of Motegrity (Prucalopride):

Motegrity works differently from other medicines that have similar effects, as it targets specific receptors in the body without affecting others that can cause side effects.

Motegrity stimulates the 5-HT4 receptors found in the gut’s smooth muscle cells, enterochromaffin cells, and myenteric plexus.

This triggers the release of acetylcholine, a neurotransmitter that helps the gut contract and moves.

As a result, Motegrity boosts gut motility by selectively targeting these receptors, which increases colon contractions and allows for the easier movement of gut contents. This way, it helps to ease constipation.

Motegrity has a lower risk of cardiovascular side effects because it does not interact with other receptors, such as hERG channels or 5-HT1 receptors.

Motegrity Warnings and Precautions:

Before taking prucalopride, tell your doctor or pharmacist if you are allergic to it or any other substances.

There may be inactive ingredients in the medication that can cause allergic reactions or other problems. Talk to your pharmacist for more information.

It’s important to inform your doctor or pharmacist about all your medical conditions, particularly if you have:

• diabetes,
• heart disease,
• kidney disease,
• liver disease,
• mental or mood disorders, or
• stomach or abdominal issues like Crohn’s disease, ulcerative colitis, intestinal perforation, or obstruction.