Mosapride

Mosapride.svg

Mosapride is a gastroprokinetic agent that is primarily used to treat gastroesophageal reflux disease (GERD) and other gastrointestinal disorders. It functions as a selective 5-HT4 receptor agonist, which enhances the release of acetylcholine in the enteric nervous system, thereby promoting gastrointestinal motility.

Mechanism of Action

Mosapride acts by stimulating the 5-HT4 receptors located in the gastrointestinal tract. This stimulation leads to an increase in the release of acetylcholine, a neurotransmitter that plays a crucial role in the contraction of smooth muscles in the gastrointestinal tract. By enhancing acetylcholine release, mosapride facilitates the movement of food and other contents through the stomach and intestines, thereby alleviating symptoms of gastrointestinal disorders.

Indications

Mosapride is indicated for the treatment of:

• Gastroesophageal reflux disease (GERD)
• Functional dyspepsia
• Irritable bowel syndrome (IBS) with predominant constipation
• Other conditions associated with delayed gastric emptying

Pharmacokinetics

After oral administration, mosapride is rapidly absorbed from the gastrointestinal tract. It undergoes extensive first-pass metabolism in the liver, primarily by the enzyme CYP3A4. The major metabolite, des-4-fluorobenzyl mosapride, also possesses pharmacological activity. The drug and its metabolites are excreted mainly via the urine.

Side Effects

Common side effects of mosapride include:

• Diarrhea
• Abdominal pain
• Nausea
• Headache

Less common but more severe side effects may include:

• Allergic reactions
• Cardiac arrhythmias

Contraindications

Mosapride is contraindicated in patients with:

• Known hypersensitivity to mosapride or any of its components
• Severe hepatic impairment
• History of cardiac arrhythmias

Drug Interactions

Mosapride may interact with other medications metabolized by the CYP3A4 enzyme, such as:

• Ketoconazole
• Erythromycin
• Ritonavir

Caution is advised when co-administering these drugs, as they may increase the plasma concentration of mosapride, leading to an increased risk of adverse effects.

Dosage and Administration

The typical dosage of mosapride for adults is 5 mg taken three times daily before meals. The dosage may be adjusted based on the patient's response and the severity of symptoms.

See Also

• Gastroprokinetic agent
• Gastroesophageal reflux disease
• Functional dyspepsia
• Irritable bowel syndrome