Efficacy and Tolerability of Levosulipride, Domperidone and Metoclopramide in Patients with Non-Ulcer Functional Dyspepsia: A Comparative Analysis

Singh, Harminder; Bala, Ritu; Kaur, Kamalpreet

doi:10.7860/jcdr/2015/11613.5775

Cited by 21 publications

(14 citation statements)

References 24 publications

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“…This might explain the low number of publications on metoclopramide in FD (Table ). Four trials comparing the efficacy of metoclopramide with placebo or other drug therapies in FD showed a significant improvement of dyspepsia symptoms after metoclopramide . Furthermore, a recent meta‐analysis comparing metoclopramide, trimebutine, mosapride, domperidone, itopride and acotiamide, all prokinetic agents, in 4473 FD patients reported better therapeutic efficacy for metoclopramide compared to itopride and acotiamide.…”

Section: Current Treatment Options For Functional Dyspepsiamentioning

confidence: 99%

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Review article: treatment options for functional dyspepsia

Masuy

Oudenhove

Tack

2019

Aliment Pharmacol Ther

100

124

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Background: Functional dyspepsia, consisting of epigastric pain syndrome and postprandial distress syndrome, is a prevalent functional gastrointestinal disorder. To date, only limited treatment options are available and conflicting results in terms of efficacy have been reported. Consequently, nonpharmacological treatment options are increasingly being explored for functional dyspepsia. Aim: To provide an overview of current pharmacological and nonpharmacological treatment options for functional dyspepsia. Methods: A literature search was conducted on Pubmed and other sources to identify relevant studies.Results: Acid suppressive therapy reduced symptoms in 30%-70% of the patients, with higher benefit in epigastric pain syndrome and superior effectiveness for proton pump inhibitors compared to H 2 -antagonists. Prokinetic agents, primarily used to treat postprandial distress syndrome, showed variable efficiency: 59%-81% responder rate for dopamine receptor antagonists, 32%-91% for serotonin-4-receptor agonists and 31%-80% for muscarinic receptor antagonists. H Pylori eradication, recommended in infected patients, was effective in 24%-82%. Refractory symptoms are addressed with neuromodulators. However, their efficacy in functional dyspepsia remains incompletely elucidated, available data showing symptom reduction in 27%-71% of the patients. Regarding herbal agents, peppermint oil reduced symptoms in 66%-91%, rikkunshito in 29%-34% and iberogast in 20%-95%. Lastly, acupuncture, cognitive behavioural therapy and hypnotherapy may help to provide symptom control, but research on their efficacy remains sparse.Conclusions: None of the available therapies is effective in the majority of patients without being associated with major side effects. Developing new treatment options is challenging due to the heterogeneity of functional dyspepsia, the lack of readily identified target mechanisms and the poor association between pathophysiological disturbances and symptoms.

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Section: Current Treatment Options For Functional Dyspepsiamentioning

confidence: 99%

“…Furthermore, domperidone and metoclopramide were shown to have a similar efficacy. However, domperidone is less prone to induce side effects and therefore considered to be better tolerated than metoclopramide . Whether domperidone is more effective in one of both FD subgroups has not been investigated.…”

Section: Current Treatment Options For Functional Dyspepsiamentioning

confidence: 99%

Review article: treatment options for functional dyspepsia

Masuy

Oudenhove

Tack

2019

Aliment Pharmacol Ther

100

124

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“…30 Hence Levosulpiride has several attractive features for use in patients undergoing laparoscopic cholecystectomy and appears to be quite promising to manage PONV in these patients. In addition, it has a low propensity for drug interactions [24][25][26][27][28][29][30] hence it can be safely used in elderly as well as in patients with renal failure. Thus, the present study clearly demonstrates the efficacy of preoperative administration of injection levosulpiride (25 mg) in the prevention of PONV and significantly reducing the requirement of rescue anti-emetics, duration of hospital stay resulting in overall improvement in patient care in the post-operative phase .…”

Section: Section: Surgerymentioning

confidence: 99%

Efficacy of Levosulpride in minimizing Post-operative Nausea and Vomiting after Laparoscopic Cholecystectomy

Sharma¹,

Goyal²,

Wadhwa³

et al. 2019

IJCMR

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Introduction: Gallstone disease is a common problem in our country. Approximately, 80% of the gallstones are asymptomatic. The risk factors predisposing to gallstone formation has been female sex, obesity, pregnancy, rapid weight loss, gallbladder stasis, and increasing age. Current study aimed to evaluate the efficacy of levosulpiride in minimizing PONV in our patients. Material and Methods: The present study was conducted over a period of one year in the Department of Surgery from January 2018 to December2018. One hundred patients fulfilling the eligibility criteria for elective laparoscopic cholecystectomy were enrolled in the study and were randomly placed into 2 groups of fifty each. Result: Injection of 25 mg levosulpiride in the preoperative phase in patients undergoing elective laparoscopic cholecystectomy surgeries under general anesthesia significantly (P<0.001) reduces the incidence of nausea & vomiting in post-operative phase. Conclusion: levosulpride improved the quality of patient care in immediate post-operative phase and decreased the duration of hospital stay.

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“… 79 Levosulpiride, although usually considered to be an antipsychotic medication, also has prokinetic properties and has been shown to be of benefit in FD. 80 , 81 …”

Section: Managementmentioning

confidence: 99%

Insights into the evaluation and management of dyspepsia: recent developments and new guidelines

Black

Houghton

Ford

2018

Therap Adv Gastroenterol

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Dyspepsia is a very common gastrointestinal (GI) condition worldwide. We critically examine the recommendations of recently published guidelines for the management of dyspepsia, including those produced jointly by the American College of Gastroenterology and the Canadian Association of Gastroenterology, and those published by the UK National Institute for Health and Care Excellence. Dyspepsia is a symptom complex, characterized by a range of upper GI symptoms including epigastric pain or burning, early satiety, and post-prandial fullness. Although alarm features are used to help prioritize access to upper GI endoscopy, they are of limited utility in predicting endoscopic findings, and the majority of patients with dyspepsia will have no organic pathology identified at upper GI endoscopy. These patients are labelled as having functional dyspepsia (FD). The Rome IV criteria, which are used to define FD, further subclassify patients with FD as having either epigastric pain syndrome or post-prandial distress syndrome, depending on their predominant symptoms. Unfortunately, the Rome criteria perform poorly at identifying FD without the need for upper GI endoscopy. This has led to the investigation of alternative diagnostic approaches, including whether a capsaicin pill or combined serum biomarkers can accurately identify patients with FD. However, there is insufficient evidence to support either of these approaches at the present time. Patients with FD should be tested for H. pylori infection and be prescribed eradication therapy if they test positive. If they continue to have symptoms following this, then a trial of treatment with a proton pump inhibitor (PPI) should be given for up to 8 weeks. In cases where symptoms fail to adequately respond to PPI treatment, a tricyclic antidepressant may be of benefit, and should be continued for 6 to 12 months in patients who respond. Prokinetics demonstrate limited efficacy for treating FD, but could be considered if other strategies have failed. However, there are practical difficulties due to their limited availability in some countries and the risk of serious side effects. Patients with FD who fail to respond to drug treatments should be offered psychological therapy, where available. Overall, with the exception of recommendations relating to H. pylori testing and the prescription of PPIs, which are made on the basis of high-quality evidence, the evidence underpinning other elements of dyspepsia management is largely of low-quality. Consequently, there are still many aspects of the evaluation and management of dyspepsia that require further research.

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Efficacy and Tolerability of Levosulipride, Domperidone and Metoclopramide in Patients with Non-Ulcer Functional Dyspepsia: A Comparative Analysis

Cited by 21 publications

References 24 publications

Review article: treatment options for functional dyspepsia

Review article: treatment options for functional dyspepsia

Efficacy of Levosulpride in minimizing Post-operative Nausea and Vomiting after Laparoscopic Cholecystectomy

Insights into the evaluation and management of dyspepsia: recent developments and new guidelines

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