Prucalopride: what it treats, how to take it, side effects
Last updated September 3, 2026.
Prucalopride (brand name Motegrity) is a once-daily prescription tablet for chronic idiopathic constipation in adults. It is a highly selective 5-HT4 agonist that stimulates the bowel's own movement, used when laxatives alone have not been enough.
What does it treat?
It treats chronic idiopathic constipation: constipation lasting months with no clear underlying cause. Idiopathic matters here. Constipation from a blockage, severe gut inflammation, or another disease is a different problem, and prucalopride is not the answer for it.
How do you take it?
The adult dose is 2 mg by mouth once daily, with or without food, at about the same time each day. With severe kidney impairment (creatinine clearance under 30 mL/min), the dose drops to 1 mg once daily. If you miss a dose, take it when you remember unless the next dose is close, and never double up. If it has not helped after several weeks of daily use, that is a reason to revisit the plan with your prescriber, not to raise the dose yourself.
Side effects to know
- Common: headache, abdominal pain, nausea, diarrhea, bloating, dizziness, vomiting, gas, and fatigue; each occurred in at least 2% of patients in trials. These are often worst in the first days and then ease.
- Serious: the label carries a warning about suicidal thoughts and behavior, new or worsening depression, and self-injurious thinking. Stop the drug and contact your provider immediately if any unusual mood change appears.
Who should not take it?
Do not take prucalopride if you are allergic to it, or if you have an intestinal perforation or obstruction, obstructive ileus, or a severe inflammatory bowel condition such as Crohn's disease, ulcerative colitis, or toxic megacolon. Tell your prescriber if you have ever had depression, suicidal thoughts, or other mood problems, and whether you have kidney disease. Data in pregnancy are limited, so that decision belongs with your doctor.
When is it an emergency?
If you start having thoughts of harming or killing yourself while taking prucalopride, stop the medicine and call or text 988 (the Suicide and Crisis Lifeline in the US) right away, or call your local crisis line elsewhere. For severe abdominal pain with vomiting or a swollen hard belly, which can signal obstruction, call 911. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
How long does prucalopride take to work?
Many people have a bowel movement within the first few days of daily dosing, and some within hours of the first dose. It is built for steady daily use rather than as-needed rescue, so give it consistent weeks before judging it with your prescriber.
What is the warning about mood changes?
The Motegrity label warns about suicidal thoughts and behavior and new or worsening depression seen in clinical trials and postmarketing reports. If you notice any unusual change in mood or thinking, stop the drug and contact your healthcare provider immediately. Thoughts of self-harm are a reason to call or text 988 in the US right away.
Is prucalopride a laxative?
Not in the usual sense. Stimulant and osmotic laxatives act locally in the colon; prucalopride is a prokinetic, a prescription 5-HT4 agonist that restores coordinated bowel movement. It is typically considered after standard laxatives have not worked.
Can I take prucalopride with kidney disease?
Mild to moderate kidney problems usually need no change, but with severe renal impairment (creatinine clearance under 30 mL/min) the label lowers the dose to 1 mg once daily. Your prescriber uses your kidney numbers to set the dose.
Does prucalopride interact with antidepressants?
There is no blanket ban, but the mood-change warning makes your full psychiatric history relevant. Tell your prescriber about depression, past suicidal thinking, and every mental health medicine you take so they can weigh it and monitor you.
Do I take prucalopride forever?
It is approved for ongoing daily use in chronic constipation, and many people take it long term. Periodic reviews make sense: if your bowel habit normalizes, your prescriber may trial a break; if it never works, continuing it adds nothing.