Prucalopride

  Issues for Surgery

Risk of exacerbation of chronic constipation if omitted, which may be further exacerbated by administration of opioids.

  Advice in the Perioperative period

Elective Surgery
Continue.

Patients taking combined oral contraceptive

If pre-operative cessation of combined oral contraceptive is being considered see Further Information.

Post-operative Advice
Restart post-operatively once enteral intake resumed.

Review if patient develops reduced gastrointestinal motility (e.g. ileus) post-operatively^{1, 2}.

Patients undergoing Colorectal Surgery
Review the need for prucalopride post-operatively.

  Interaction(s) with Common Anaesthetic Agents

None^{1, 2, 3}.

  Interaction(s) with other Common Medicines used in the Perioperative Period

Erythromycin
Concurrent administration of prucalopride and erythromycin (but not other macrolides) has been associated with increases in erythromycin exposure^{1, 2, 3}.  The mechanism for this interaction is not known and the increase is unlikely to be clinically relevant³.  However, erythromycin, particularly if given intravenously, can cause QT-prolongation and concomitant administration of prucalopride may and further increase this risk³. 

  Further Information

Contraception
Women of childbearing potential should use effective contraception during treatment with prucalopride^{1, 2}.  Bear this in mind if cessation of combined oral contraceptive is being considered pre-operatively.

  References

1. Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 4^th March 2021]
2. Summary of Product Characteristics – Resolor® (prucalopride) 1mg film-coated tablets. Shire Pharmaceuticals Limited. Accessed via www.medicines.org.uk 04/03/2021 [date of revision of the text June 2020]
3.  Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 4^th March 2021]