tegaserod, Zelnorm

The serotonin 5-HT4 receptor is a receptor that prevents contractions when serotonin binds to it. Tegaserod blocks the 5-HT4 receptor and prevents serotonin from binding to it. As a result, contractions increase. The increased contractions speed the transit of digesting food and reverse the constipation. In addition, tegaserod reduces the sensitivity of the intestinal pain-sensing nerves and can thereby reduce the perception of pain. Tegaserod was approved by the FDA in July, 2002.



PREPARATIONS: White, round tablets of 2 and 6 mg.

STORAGE: Tegaserod tablets should be stored at room temperature, 59-86°F (15-30°C).

PRESCRIBED FOR: Tegaserod is used for the short-term treatment of women with IBS whose primary bowel symptom is constipation. It also is approved for the treatment of chronic, idiopathic constipation in men and women less than 65 years of age.

DOSING: The usual dose of tegaserod is 6 mg twice daily, most frequently for 4 to 12 weeks. Tegaserod can be taken with or without food. Older persons do not require lower doses than younger persons.

DRUG INTERACTIONS: There are no known drug interactions with tegaserod. Other drugs that increase intestinal contractions will likely lead to more diarrhea if used together with tegaserod.

PREGNANCY: No ill effects were seen in the fetuses of pregnant rats given 15 times the human dose and rabbits given 50 times the human dose of tegaserod (on a per-weight basis). Nevertheless, there are no adequate studies of tegaserod in pregnant women. Therefore, physicians must weight the potential benefit of giving tegaserod during pregnancy against the unknown risk.

NURSING MOTHERS: Tegaserod is secreted into the breast milk of nursing rats. Very high doses of tegaserod in mice cause tumors. Due to the demonstration of these tumors and the lack of safety data in children, physicians must weigh the potential benefit of giving tegaserod to nursing women against the unknown risk to the infant.

SIDE EFFECTS: Tegaserod is well tolerated in most patients. The most commonly reported side effects are headache (1 in 6 patients), abdominal pain (1 in 8), and diarrhea (1 in 11). Only diarrhea has been reported substantially more frequently than with placebo treatment (sugar pill). Rarely the diarrhea is severe, leading to hospitalization for dehydration and requiring intravenous fluids. Ischemic colitis has been seen rarely in patients taking tegaserod although it is not clear if there is a causal relationship. Patients who develop signs of ischemic colitis--worsening abdominal pain, bloody diarrhea--should stop taking tegaserod and contact their physicians.

Quick GuideIBS - Irritable Bowel Syndrome: Symptoms, Diet, Treatment

IBS - Irritable Bowel Syndrome: Symptoms, Diet, Treatment
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