Itopride

Itopride is a prokinetic benzamide derivative unlike metoclopramide or domperidone. These drugs have anti-dopaminergic actions at either D1 or D2-like dopamine receptors. Itopride is a unique prokinetic drug as it acts as a D2 antagonist and also as an acetylcholinesterase inhibitor. Due to these combined actions, itopride has been shown to be effective in the treatment of gastrointestinal symptoms associated with conditions such as chronic gastritis and functional dyspepsia.

Pharmacology

Itopride's actions are due to three main mechanisms. Firstly, it acts as a D2 antagonist, which means it inhibits the action of dopamine on the D2 receptors. This results in an increase in the release of acetylcholine in the gut, which in turn stimulates gut motility and accelerates gastric emptying. Secondly, itopride also acts as an acetylcholinesterase inhibitor. This means it prevents the breakdown of acetylcholine, thereby increasing the concentration of this neurotransmitter in the gut and further enhancing gut motility. Lastly, itopride may also have some antiemetic effects due to its D2 antagonist action in the chemoreceptor trigger zone.

Clinical use

Itopride is used for the treatment of functional dyspepsia and other gastrointestinal conditions. It is usually well tolerated with the most common side effects being dry mouth, abdominal pain and diarrhoea. Itopride is not currently approved for use in the United States, Canada or the United Kingdom but is available in other countries such as Japan and India.

See also

• Prokinetic agent
• Dopamine antagonist
• Acetylcholinesterase inhibitor

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