2 The technology
2.1 Prucalopride (Resolor, Movetis) is a selective serotonin (5-HT4) receptor agonist that predominantly stimulates colonic motility. Prucalopride has a UK marketing authorisation for the 'symptomatic treatment of chronic constipation in women in whom laxatives fail to provide adequate relief'.
2.2 Prucalopride is administered orally. The summary of product characteristics (SPC) states that the recommended dose of prucalopride is 2 mg once daily for adult women (up to 65 years old) and 1 mg once daily for older women (over 65 years). The dose for older women can be increased to 2 mg once daily if needed. If once-daily prucalopride is not effective after 4 weeks, the patient should be re-examined and the benefit of continuing treatment reconsidered.
2.3 The SPC reports that the most common adverse effects that may be associated with prucalopride treatment include headache and gastrointestinal symptoms (abdominal pain, nausea or diarrhoea). Most adverse effects occur at the start of treatment and usually subside within a few days of continued treatment. For full details of side effects and contraindications, see the SPC.
2.4 Prucalopride is available in 1-mg and 2-mg tablets. The acquisition cost of prucalopride 1 mg is £38.69 for a pack of 28 tablets. The acquisition cost of prucalopride 2 mg is £59.52 for a pack of 28 tablets (excluding VAT; 'British National Formulary' [BNF], 60th edition). The manufacturer estimated that the annual cost of treatment with prucalopride is £622 for adult women and £403 for older women (excluding any monitoring costs), assuming that each woman receives treatment for an average of 220 days each year. Costs may vary in different settings because of negotiated procurement discounts.