From the Guidelines
Itopride is an efficacious treatment for functional dyspepsia (FD), particularly for patients who do not respond to first-line treatments, as recommended by the British Society of Gastroenterology guidelines 1. The uses of Itopride (N-[4-[2-(Dimethylamino)ethoxy]benzyl]-3,4-dimethoxybenzamide) include:
- Treatment of functional dyspepsia (FD) as a prokinetic agent
- Enhancement of gastric motility and emptying
- Increase of lower esophageal sphincter pressure
- Relief of symptoms such as early satiety, postprandial fullness, bloating, and nausea According to the guidelines, prokinetics like itopride may be an efficacious treatment for FD, although efficacy varies according to drug class, and many of these drugs are unavailable outside of Asia and the USA 1. The quality of evidence for itopride is low, but it is still considered a viable option for patients with FD who do not respond to other treatments 1. It is essential to note that itopride should be used cautiously in patients with severe hepatic or renal impairment and is contraindicated in those with gastrointestinal bleeding, obstruction, or perforation. Common side effects of itopride include mild headache, diarrhea, and abdominal pain, though it generally has fewer central nervous system effects than other prokinetics because it doesn't cross the blood-brain barrier significantly. The typical dosage of itopride is 50 mg three times daily before meals, though some patients may require up to 100 mg three times daily, and treatment duration usually ranges from 4-8 weeks, depending on symptom response.
From the Research
Uses of Itopride
Itopride, also known as N-[4-[2-(Dimethylamino)ethoxy]benzyl]-3,4-dimethoxybenzamide, is a prokinetic agent with a dual mode of action, acting as a dopamine D2 antagonist and an acetylcholinesterase inhibitor. The uses of Itopride include:
- Treatment of functional dyspepsia (FD) 2, 3, 4, 5
- Management of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) 5
- Treatment of mild gastro-esophageal reflux disease (GERD) 6
Efficacy in Functional Dyspepsia
Studies have shown that Itopride is effective in improving symptoms of functional dyspepsia, with response rates ranging from 57% to 75% 2, 3, 4. Itopride has also been shown to be well-tolerated, with a safety profile similar to that of placebo 2, 3, 4.
Efficacy in Postprandial Distress Syndrome and Epigastric Pain Syndrome
A study found that Itopride improved symptoms of postprandial distress syndrome, particularly in patients with overlapping PDS and EPS 5.
Efficacy in Gastro-esophageal Reflux Disease
A pilot study found that Itopride was effective in decreasing pathologic reflux in patients with mild GERD, with a significant decrease in total symptom score and esophageal acid exposure time 6.
Dosage and Administration
Itopride has been administered at doses ranging from 50mg to 300mg, three times daily, depending on the specific indication and study 2, 3, 4, 5, 6.