Mode of action
Itopride increases acetylcholine concentrations by inhibiting dopamine D2 receptors and acetylcholinesterase. Higher acetylcholine increases GI peristalsis, increases the lower esophageal sphincter pressure, stimulates gastric motility, accelerates gastric emptying, and improves gastro-duodenal coordination.
Clinical use and dosage
Typically, itopride is indicated in the treatment of GI symptoms caused by reduced GI motility:
dyspepsia of a non-ulcer type (gastric "fullness", discomfort, and possible pain)
anorexia
heartburn
regurgitation
bloating
nausea and vomiting
other possible gastric, prolactin, or dopamine related conditions
Typical adult dosage is usually 150mg/24hrs in 3 divided doses. The dose is usually taken on an empty stomach about an hour before meals. However, the dosage and details of administration may vary depending on the patient’s age, symptoms, and other factors.
Itopride was shown to significantly improve symptoms in patients with functional dyspepsia and motility disorders in placebo-controlled trials.
These studies concluded that the reduction in the severity of symptoms of functional dyspepsia after 8 weeks of treatment with itopride indicated that itopride was significantly superior to placebo and that itopride yielded a greater rate of response than placebo in significantly reducing pain and fullness.
Contraindications and precautions
Itopride is a relatively new drug and it is not currently approved for normal prescribed use nor OTC use in either the US nor the UK. However, this does not necessarily indicate that itopride is not effective or safe.
Patients taking itopride should report any side-effects to their treating physician.
Itopride is contraindicated in hypersensitivity to itopride or benzamides; lactation, GI hemorrhage, obstruction or perforation. Itopride may not be indicated for those suffering from Parkinson's disease or other conditions involving dopamine regulation issues. Itopride should be used with special caution in the young and the elderly. Little information is available at this time regarding the safe use of itopride during pregnancy.
Adverse drug reactions
Some common side-effects of itopride may include: rash, diarrhoea, giddiness, exhaustion, back or chest pain, increased salivation, constipation, abdominal pain, headache, sleeping disorders, dizziness, galactorrhea, and gynecomastia.
Other side-effects may also be present.
Leukopenia, a reduction in the normal level of white blood cells, can be a potentially life-threatening reaction to itopride.
Interactions
Anticholinergic agents reduce the action of itopride. It is worth noting that itopride is a relatively new drug and that it is therefore possible that other drugs may interact with itopride which are not currently known.
