Prucalopride

Prucalopride
Clinical data

Trade names	Resolor, Resotran
AHFS/Drugs.com	International Drug Names
License data	EU EMA: Resolor
Pregnancy category	AU: B1 Not recommended
Routes of administration	Oral
ATC code	A06AX05 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) ℞ (Prescription only)
Identifiers
IUPAC name 4-Amino-5-chloro-N-[1-(3-methoxypropyl)piperidin-4-yl]-2,3-dihydro-1-benzofuran-7-carboxamide
CAS Number	179474-81-8^Y
PubChem CID	3052762
IUPHAR/BPS	243
ChemSpider	2314539
UNII	0A09IUW5TP
Chemical and physical data
Formula	C₁₈H₂₆ClN₃O₃
Molar mass	367.870 g/mol
3D model (Jmol)	Interactive image
SMILES COCCCN1CCC(CC1)NC(=O)C2=CC(=C(C3=C2OCC3)N)Cl
InChI InChI=1S/C18H26ClN3O3/c1-24-9-2-6-22-7-3-12(4-8-22)21-18(23)14-11-15(19)16(20)13-5-10-25-17(13)14/h11-12H,2-10,20H2,1H3,(H,21,23) Key:ZPMNHBXQOOVQJL-UHFFFAOYSA-N

Prucalopride (brand name Resolor, developed by Johnson & Johnson and licensed to Movetis) is a drug acting as a selective, high affinity 5-HT₄ receptor agonist which targets the impaired motility associated with chronic constipation, thus normalizing bowel movements. Prucalopride was approved for use in Europe in 2009, in Canada (named Resotran) on December 7, 2011 and in Israel in 2014 but it has not been approved by the Food and Drug Administration for use in the United States. The drug has also been tested for the treatment of chronic intestinal pseudo-obstruction.

Prucalopride, a first in class dihydro-benzofuran-carboxamide, is a selective, high affinity serotonin (5-HT₄) receptor agonist with enterokinetic activities. Prucalopride alters colonic motility patterns via serotonin 5-HT₄ receptor stimulation: it stimulates colonic mass movements, which provide the main propulsive force for defecation.

The observed effects are exerted via highly selective action on 5-HT₄ receptors: prucalopride has >150-fold higher affinity for 5-HT₄ receptors than for other receptors. Prucalopride differs from other 5-HT₄ agonists such as tegaserod and cisapride, which at therapeutic concentrations also interact with other receptors (5-HT_1B/D and the cardiac human ether-a-go-go K⁺ or hERG channel respectively) and this may account for the adverse cardiovascular events that have resulted in the restricted availability of these drugs.Clinical trials evaluating the effect of prucalopride on QT interval and related adverse events have not demonstrated significant differences compared with placebo.

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