Which medications in the drug class Prokinetic Agents are used in the treatment of Constipation?

Updated: Jul 05, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Prokinetic Agents

Prokinetics are promotility agents proposed for use in patients with severe constipation-predominant symptoms.

Prucalopride (Motegrity)

Prucalopride, a selective 5-hydroxytryptamine (serotonin) type 4 receptor (5-HT4) agonist, is a gastrointestinal (GI) prokinetic agent that stimulates colonic peristalsis, thus increasing bowel motility. It is indicated for chronic idiopathic constipation.

Tegaserod (Zelnorm)

Tegaserod is available in the United States only by an emergency treatment investigational new drug (IND) protocol. This can be obtained from the FDA for irritable bowel syndrome (IBS) and IBS with constipation (IBS-C) or chronic idiopathic constipation (CIC) in women younger than 55 years who meet specific guidelines. The FDA Gastrointestinal Drugs Advisory Committee reviewed a supplemental new drug application (sNDA) for tegaserod in October 2018 with the proposed indication of treating women with IBS-C who do not have a history of cardiovascular (CV) ischemic disease. Their recommendation was to reintroduce tegaserod to the US market for women with IBS who are at low risk for CV ischemic disease.

Tegaserod is a serotonin type 4 (5-HT4) receptor partial agonist with no affinity for 5-HT3 receptors. It may trigger peristaltic reflex via 5-HT4 activation, which enhances basal motor activity and normalizes impaired GI motility.


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