Drug Information: Motegrity (prucalopride)
In December 2018, the Food and Drug Administration (FDA) approved Motegrity (prucalopride), a brand-name prescription drug, for treating chronic idiopathic constipation (CIC) in adults. This selective serotonin-4 (5-HT4) receptor agonist is designed to stimulate colonic motility, easing the symptoms of CIC.
However, while Motegrity seems to have an effect in some studies, its effectiveness compared to a placebo varies, and more research is needed to determine its long-term efficacy.
**Long-Term Effects and Considerations**
Common side effects of Motegrity include nausea, abdominal pain, headache, diarrhea, dizziness, vomiting, gas, and fatigue. These side effects are generally mild to moderate and often diminish with continued use. Persistent or severe side effects should prompt discontinuation and consultation with a healthcare provider.
Some serious but rare side effects reported include fast or irregular heartbeat, severe or persistent abdominal pain, bloody diarrhea, mood changes, and rectal bleeding. Monitoring for these symptoms during long-term therapy is important.
Comprehensive data on very long-term use (years) are limited, and routine monitoring by healthcare providers is advised, especially to check for cardiovascular or gastrointestinal issues. There is limited data on its use during pregnancy or lactation, and infants should be monitored for diarrhea if exposed through breastfeeding.
**Safety and Interactions**
Motegrity is metabolized by CYP3A4 to seven minor metabolites and is primarily eliminated by the kidneys. It is likely safe to take with over-the-counter (OTC) constipation medications, but it's important to consult a doctor before using it with other medications.
**Comparison with Amitiza**
Both Motegrity and Amitiza are FDA-approved to treat adults with CIC. Amitiza is also approved for opioid-induced constipation and chronic non-cancer pain in adults, and irritable bowel syndrome with constipation in adult females. They have different drug forms and administration methods, and can cause both similar and different side effects.
**Availability and Cost**
Motegrity doesn't have generic forms and is only available as a brand-name drug. The actual price depends on insurance, location, and pharmacy. It isn't currently available as an over-the-counter drug.
**Usage and Administration**
Motegrity comes as a tablet that is taken once per day, available in two strengths: 1 mg and 2 mg. If you miss a dose, take it as soon as you remember. But if it's almost time for your next dose, skip the missed dose. Take only the next dose at the regular time. Don't take extra medication to make up for the missed dose.
**Off-Label Uses**
Motegrity may be used off-label for other conditions such as gastroparesis, irritable bowel syndrome (IBS), and opioid-induced constipation. However, more research is needed to fully understand its effectiveness for these conditions.
**Weight Loss and Safety Concerns**
If you'd like to lose weight, talk with your doctor. Motegrity isn't FDA-approved for use as a weight-loss aid and using it for this purpose can cause serious side effects.
In conclusion, Motegrity is generally well tolerated for long-term use in adults with chronic idiopathic constipation, but patients should be vigilant about side effects and communicate regularly with their healthcare provider. Should side effects become severe or persistent, alternative treatments may need to be considered.
- The approval of Motegrity in 2018 was for treating chronic idiopathic constipation (CIC), a gastrointestinal medical-condition in adults.
- This prescription drug, though effective in some studies, varies in effectiveness compared to a placebo, and long-term studies are needed to ascertain its long-term efficacy.
- Common side effects of Motegrity include nausea, abdominal pain, headache, diarrhea, dizziness, vomiting, gas, and fatigue, which are generally mild to moderate and often diminish with continued use.
- While Motegrity is designed to help with digestive issues, it's important to consult a healthcare provider before using it with other drugs, as it interacts with certain enzymes and is primarily eliminated by the kidneys.
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