Itopride

Itopride
Clinical data
Routes of; administration	Oral
Legal status
Legal status	In general: ℞ (Prescription only);
Identifiers
	IUPAC name N-[[4-(2-Dimethylaminoethoxy)phenyl]methyl]-3,4-dimethoxybenzamide;
CAS Number	122898-67-3;
PubChem CID	3792;
CompTox Dashboard (EPA)	DTXSID7048320 ;
ECHA InfoCard	100.222.888
Chemical and physical data
Formula	C20H26N2O4
Molar mass	358.43 g/mol g·mol−1
3D model (JSmol)	Interactive image;
	SMILES CN(C)CCOC1=CC=C(C=C1)CNC(=O)C2=CC(=C(C=C2)OC)OC;

Itopride (INN) is a benzamide derivative not unlike metoclopramide or domperidone. These drugs inhibit dopamine and have a gastrokinetic effect.^[1] Itopride is indicated for the treatment of functional dyspepsia and other gastrointestinal (GI) conditions.^[2] It has the tradename Ganaton and it is marketed by Abbott Laboratories.

Ganaton (itopride) is not currently approved by the FDA for use in the United States, nor is itopride yet approved in the United Kingdom. This may explain the apparent lack of patient information available in English compared to other similar classes of medication.

A blister package of Ganaton (Itopride) 50mg tablets for distribution in the Slovak Republic.

Mode of Action

Itopride increases acetylcholine concentrations by inhibiting dopamine D2 receptors and acetylcholinesterase. Higher acetylcholine increases GI peristalsis, increases the lower oesophageal 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.

Contraindications & 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 neccessarily 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 haemorrhage, 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 durring 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 relitively new drug and that it is therefore possible that other drugs may interact with itopride which are not currently known.

External Links

[1] www.cimsasia.com

References

^ Iwanaga Y, Miyashita N, Saito T, Morikawa K, Itoh Z (1996). "Gastroprokinetic effect of a new benzamide derivative itopride and its action mechanisms in conscious dogs". Jpn. J. Pharmacol. 71 (2): 129–37. PMID 8835639. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
^ Holtmann G, Talley NJ, Liebregts T, Adam B, Parow C (2006). "A placebo-controlled trial of itopride in functional dyspepsia". N. Engl. J. Med. 354 (8): 832–40. doi:10.1056/NEJMoa052639. PMID 16495395. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

[pmid8835639-1] Iwanaga Y, Miyashita N, Saito T, Morikawa K, Itoh Z (1996). "Gastroprokinetic effect of a new benzamide derivative itopride and its action mechanisms in conscious dogs". Jpn. J. Pharmacol. 71 (2): 129–37. PMID 8835639. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

[pmid16495395-2] Holtmann G, Talley NJ, Liebregts T, Adam B, Parow C (2006). "A placebo-controlled trial of itopride in functional dyspepsia". N. Engl. J. Med. 354 (8): 832–40. doi:10.1056/NEJMoa052639. PMID 16495395. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

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