A Prokinetic Agent with a Dual Effect – Itopride – In the Treatment of Dysmotility

Abstract

A wide range of dyspeptic symptoms in clinical practice reflect the high prevalence of functional disorders of the gastrointestinal (GI) tract. Prokinetic agents are the current mainstay in the therapy of functional dyspepsia. One of these drugs is itopride. We evaluated therapeutic efficacy of itopride according to the literature review. The therapeutic potential of itopride is connected with a dual effect: influencing of enzyme acetylcholinesterase activity and blocking dopamine D2 receptors. After the itopride administration, the contractility of smooth muscle in the upper GI tract increases. Itopride is a drug with rapid absorption from the small bowel; its peak serum concentration occurs 35 minutes after oral administration. Itopride does not pass the blood-brain barrier and does not affect the heart rate by influencing the QT segment. Itopride is a safe prokinetic agent with positive influence on the symptoms of functional dyspepsia such as postprandial fullness, bloating, and gastric emptying. Itopride could also be used for the therapy of the mild form of gastro-oesophageal reflux.

Efficacy and safety of itopride SR for upper gastrointestinal symptoms in patients with diabetic gastroparesis: real-world evidence from Pakistan

“…Table 3 presents the distribution of severity scores before and after treatment, comparing data for weeks 0 and 4. The severity scores are categorized into five levels: very mild degree (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), mild degree of severity (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), moderate degree of severity (41-60), severe (61-80), and extremely severe (81-100). At week 0, out of a total of 988 participants, 37% had a very mild degree of severity; 24.6% had a mild symptoms, 29.3% had moderate symptoms, 8.8% had severe symptoms, and only 0.4% had extreme symptoms.…”

“…Itopride shows promise in managing gastroparesis symptoms by accelerating gastric emptying, improving gastric tension and sensitivity, and exerting antiemetic effects. 12 , 13 Human studies have demonstrated the positive effects of itopride on solid and liquid gastric emptying compared with placebo and pantoprazole. Two randomized controlled trials reported significant improvements in gastric emptying rates for itopride compared with control groups.…”