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Use of metoclopramide, domperidone, and cisapride in the management of diabetic gastroparesis.
Clin Pharm 1990; 9(5):357-65CP

Abstract

The pathophysiology, diagnosis, and treatment of diabetic gastroparesis are reviewed, and the mechanisms of action, pharmacokinetics, clinical efficacy, adverse effects, and dosage of metoclopramide, domperidone, and cisapride are described. Diabetic gastroparesis is a state of delayed gastric emptying that reportedly affects 20-30% of diabetic patients. Symptoms include nausea, early satiety, postprandial bloating and fullness, and vomiting. Diabetic gastroparesis has been managed most successfully with drugs that stimulate gastric emptying. Of the three agents studied--metoclopramide, domperidone, and cisapride--only metoclopramide is commercially available in the United States. The clinical efficacy of metoclopramide, domperidone, and cisapride has been well documented in several placebo-controlled trials. Metoclopramide effectively decreases mean gastric emptying time, although tolerance to this stimulation of gastric emptying may develop with long-term therapy. However, symptomatic relief persists with long-term therapy because of metoclopramide's antiemetic properties. Domperidone, which has also been shown to stimulate gastric motility and to possess antiemetic properties, improves symptoms in patients suffering from diabetic gastroparesis. Cisapride appears to have continued beneficial effects on gastric motility with long-term therapy. All three agents have favorable adverse-effect profiles. Although metoclopramide is currently the first-line agent for the management of gastroparesis, domperidone and cisapride both possess properties that may make them useful alternatives in patients who are unresponsive to or cannot tolerate metoclopramide therapy.

Authors+Show Affiliations

University of Michigan Hospitals, Ann Arbor.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

2190745

Citation

Brown, C K., and U Khanderia. "Use of Metoclopramide, Domperidone, and Cisapride in the Management of Diabetic Gastroparesis." Clinical Pharmacy, vol. 9, no. 5, 1990, pp. 357-65.
Brown CK, Khanderia U. Use of metoclopramide, domperidone, and cisapride in the management of diabetic gastroparesis. Clin Pharm. 1990;9(5):357-65.
Brown, C. K., & Khanderia, U. (1990). Use of metoclopramide, domperidone, and cisapride in the management of diabetic gastroparesis. Clinical Pharmacy, 9(5), pp. 357-65.
Brown CK, Khanderia U. Use of Metoclopramide, Domperidone, and Cisapride in the Management of Diabetic Gastroparesis. Clin Pharm. 1990;9(5):357-65. PubMed PMID: 2190745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of metoclopramide, domperidone, and cisapride in the management of diabetic gastroparesis. AU - Brown,C K, AU - Khanderia,U, PY - 1990/5/1/pubmed PY - 1990/5/1/medline PY - 1990/5/1/entrez SP - 357 EP - 65 JF - Clinical pharmacy JO - Clin Pharm VL - 9 IS - 5 N2 - The pathophysiology, diagnosis, and treatment of diabetic gastroparesis are reviewed, and the mechanisms of action, pharmacokinetics, clinical efficacy, adverse effects, and dosage of metoclopramide, domperidone, and cisapride are described. Diabetic gastroparesis is a state of delayed gastric emptying that reportedly affects 20-30% of diabetic patients. Symptoms include nausea, early satiety, postprandial bloating and fullness, and vomiting. Diabetic gastroparesis has been managed most successfully with drugs that stimulate gastric emptying. Of the three agents studied--metoclopramide, domperidone, and cisapride--only metoclopramide is commercially available in the United States. The clinical efficacy of metoclopramide, domperidone, and cisapride has been well documented in several placebo-controlled trials. Metoclopramide effectively decreases mean gastric emptying time, although tolerance to this stimulation of gastric emptying may develop with long-term therapy. However, symptomatic relief persists with long-term therapy because of metoclopramide's antiemetic properties. Domperidone, which has also been shown to stimulate gastric motility and to possess antiemetic properties, improves symptoms in patients suffering from diabetic gastroparesis. Cisapride appears to have continued beneficial effects on gastric motility with long-term therapy. All three agents have favorable adverse-effect profiles. Although metoclopramide is currently the first-line agent for the management of gastroparesis, domperidone and cisapride both possess properties that may make them useful alternatives in patients who are unresponsive to or cannot tolerate metoclopramide therapy. SN - 0278-2677 UR - https://www.unboundmedicine.com/medline/citation/2190745/Use_of_metoclopramide_domperidone_and_cisapride_in_the_management_of_diabetic_gastroparesis_ L2 - http://www.diseaseinfosearch.org/result/2998 DB - PRIME DP - Unbound Medicine ER -