Prucalopride

• Tablets 1mg, 2mg (£13.21 = 2mg daily)

Indications

• Prucalopride is recommended in accordance with NICE TA211 (December 2010) as an option for the treatment of chronic constipation only in women for whom treatment with at least two laxatives from different classes, at the highest tolerated recommended doses for at least 6 months, has failed to provide adequate relief and invasive treatment for constipation is being considered.

Dose

• Adult over 18 years 2mg once daily; elderly over 65 years, initially 1mg once daily, increased if necessary to 2mg once daily

Notes

1. Prucalopride should be used in accordance with NICE TA211 (December 2010)
2. Prucalopride should be initiated in secondary care where the patient will be overseen for 4 weeks to assess the benefit of the treatment. If treatment with prucalopride is effective, then prescribing can be continued in primary care.
3. Review treatment if no response after 4 weeks

Linaclotide (Constella)

The routine commissioning of linaclotide (Constella) is not accepted in Devon for the treatment of irritable bowel syndrome with constipation (IBS-C) in adults (see Commissioning Policy for more details). The policy indicates that in exceptional circumstances the Trust-Managed Individual Patient Treatments process can be used for this indication.