Prucon is indicated for the symptomatic management of chronic constipation in adults who do not respond adequately to conventional laxatives.
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Prucalopride is a highly selective 5-HT4 receptor agonist, with no significant interaction with hERG channels or 5-HT1 receptors—reducing cardiovascular risks associated with older drugs of this class.
5-HT4 receptors are distributed throughout the GI tract, particularly in smooth muscle cells, enterochromaffin cells, and the myenteric plexus.
Their stimulation enhances acetylcholine release, the primary excitatory neurotransmitter of the gut.
This action increases colonic motility by promoting contraction of longitudinal muscle and relaxation of circular muscle, facilitating forward propulsion of intestinal contents.
Adults: 2 mg once daily, with or without food, at any time of day. Doses above 2 mg do not enhance efficacy.
Elderly: Start with 1 mg once daily; may increase to 2 mg if required.
Children & Adolescents (<18 years): Not recommended.
Minimal interaction potential; prucalopride does not significantly affect CYP-mediated drug metabolism.
May be a weak substrate of P-glycoprotein (P-gp) but is not an inhibitor at therapeutic doses.
Ketoconazole (200 mg b.i.d.) increases systemic exposure by ~40% (not clinically relevant). Similar effects may occur with strong P-gp inhibitors (e.g., verapamil, cyclosporine A, quinidine).
No significant interactions reported with warfarin, digoxin, alcohol, paroxetine, or oral contraceptives.
Headache (~18%)
Gastrointestinal symptoms: abdominal pain, nausea, diarrhea
These effects are usually mild-to-moderate, occur early in therapy, and often resolve within a few days.
Rare: other mild adverse reactions.
Pregnancy: Not recommended. Effective contraception should be used during treatment. Animal studies show no direct harmful effects, but human data are lacking.
Breastfeeding: Avoid use due to insufficient safety data.
Renal excretion is the main elimination pathway.
Severe renal impairment (GFR <30 ml/min/1.73 m²): 1 mg once daily.
Hepatic impairment:
Severe (Child-Pugh C): Start with 1 mg once daily, may increase to 2 mg if tolerated.
Mild-to-moderate: No dose adjustment needed.
Severe diarrhea may reduce oral contraceptive effectiveness—advise additional contraception.
Contains lactose → contraindicated in patients with galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption.
Known hypersensitivity to prucalopride or excipients.
Severe renal impairment requiring dialysis.
Store below 30°C, in original packaging with desiccant.
Keep away from moisture and out of children’s reach.
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