Itopride

Itopride (INN, trade name Ganaton) is a prokinetic benzamide derivative

unlike metoclopramide or domperidone. These drugs inhibit dopamine and have
a gastrokinetic effect.
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Itopride is indicated for the treatment of
functional dyspepsia and other gastrointestinal conditions.
Itopride is not currently approved by the U.S. Food and Drug Administration (FDA)
for use in the United States, nor is it 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.
Clinical use
A blister package of Ganaton (Itopride) 50 mg tablets intended for distribution in the Slovak Republic.
Typically, itopride is indicated in the treatment of GI symptoms caused by reduced GI
motility:
dyspepsia of a non-ulcer/dysmotility type (gastric "fullness", discomfort, and
possible pain)
Delayed gastric emptying
anorexia
heartburn
regurgitation
bloating
nausea and vomiting
other possible gastric, prolactin, or dopamine related conditions
Itopride is typically taken three times a day. 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 patients 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
The most common side-effects of itopride include mild to moderate abdominal pain
and diarrhoea. Some other side effects that may occur include: rash, giddiness,
exhaustion, back or chest pain, increased salivation, constipation, 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.
Central nervous system adverse effects do not tend to occur due to poor penetration
across the blood brain barrier, although a slight raising of prolactin levels may
occur. Raising of prolactin levels is more common with high dose regimes of itopride.
Mechanism 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.