Effect of Pirenzepine on Oesophageal, Gastric, and Enteric Motor Function in Man

Abstract

The effect of pirenzepine on oesophageal, gastric, and enteric motor function was evaluated in six healthy volunteers. Each subject was studied before and after taking pirenzepine, 100 mg/day, for 3 days. Half and complete gastric emptying times of clear liquid, assessed by epigastric impedance, were significantly delayed by the drug: 6.16 +/- 1.74 min and 13.8 +/- 4.64 min versus 16.65 +/- 3.03 min and 25.1 +/- 8.2 min, respectively (p less than 0.05). Enteric motility was assessed by manometry, and variables studied were the duration of the various phases of the migratory motility complex, the frequency of contractions in phase III, and the amplitude of contractions in phases II, III, and in the postprandial period. Only phase I was affected and was significantly prolonged by the drug: 16.08 +/- 5.94 min versus 31.65 +/- 12.88 min (p less than 0.01). Oesophageal motility was assessed by manometry. Variables studied were amplitude and duration of contractions in the body of the oesophagus, and lower oesophageal sphincter pressure. Results were not significantly changed by the drug. We conclude that pirenzepine, given at a dose used for treatment of peptic ulcer disease, significantly delays the gastric emptying of liquids, has minimal effect on enteric motility, and has no effect on oesophageal motility. The effect on gastric emptying may be therapeutically useful by reducing the acid load on the duodenum in duodenal ulcer disease.

Model of rapid gastrointestinal transit in dogs: effects of muscarinic antagonists and a nitric oxide synthase inhibitor

“…In our study, no muscarinic antagonist slowed small bowel transit, although the very high doses of pirenzepine and AF-DX 116 delayed gastrointestinal transit in humans and dogs. 13,19 It is conceivable that a small treatment effect could have been missed in this small sample.…”

“…High doses of the M 1 blocker, pirenzepine (100 mg day −1 by mouth) prolonged phase 1 of the MMC and slowed gastric emptying in humans 19 . Intravenous administration of pirenzepine (300 µg kg −1 ) delayed the MMC cycle in dogs 20 .…”

“…[15][16][17][18] High doses of the M 1 blocker, pirenzepine (100 mg day )1 by mouth) prolonged phase 1 of the MMC and slowed gastric emptying in humans. 19 Intravenous administration of pirenzepine (300 lg kg )1 ) delayed the MMC cycle in dogs. 20 On the other hand, low doses of pirenzepine (50 mg day )1 by mouth) stimulated gastrointestinal motility, while 50 mg twice daily accelerated gastrointestinal transit 21,22 in humans.…”

Usefulness and safety of pirenzepine in double-contrast study of upper gastrointestinal tract: Comparison with scopolamine methylbromide

“…5. A possible advantage of pirenzepine in duodenal bulb studies can be seen in a slower recurrence of peristalsis which facilitates examination [4].…”

“…It is a hydrophilic compound and has prevalently peripheral effects [3]. The block of M1 muscarinic receptors inhibits gastric acid production and also induces a significant delay in the emptying of the stomach [4,5]. Conflicting findings are reported on esophageal, biliary, and enteric motility [6][7][8][9][10], even though pirenzepine is also used in treatment of irritable bowel syndrome [11,12].…”