Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Gastroenterology (Expert Forum)
Zelnorm
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Zelnorm
by Dr. Erik, Feb 15, 2003 12:00AM
Dear DR.
I am a 34 year old male. I have been suffering with reflux for two years and for the most part it has been resistant to PPI's. I saw a Physician's assisant at my Gastro's office yesterday and he gave me some samples of Zelnorm. He said it is a newer pro-motility drug originally for IBS in women but that he thinks it will be soon indicated for GERD. My question to you is: Is zelnorm safe and does it have any cardiovascular side effects as Propulsid did? I have had an episode of Atrial Fibrillation in the past and I have had PVC's and PAC's for years. I am afraid that Zelnorm might bring on an arrhythmia. On the other hand, if Zelnorm would work for me it would be a Godsend. I have already had three anti-reflux surgeries and want to avoid any more. Thanks!
I am a 34 year old male. I have been suffering with reflux for two years and for the most part it has been resistant to PPI's. I saw a Physician's assisant at my Gastro's office yesterday and he gave me some samples of Zelnorm. He said it is a newer pro-motility drug originally for IBS in women but that he thinks it will be soon indicated for GERD. My question to you is: Is zelnorm safe and does it have any cardiovascular side effects as Propulsid did? I have had an episode of Atrial Fibrillation in the past and I have had PVC's and PAC's for years. I am afraid that Zelnorm might bring on an arrhythmia. On the other hand, if Zelnorm would work for me it would be a Godsend. I have already had three anti-reflux surgeries and want to avoid any more. Thanks!
Doctor's Answer
by Kevin Pho, MD, Feb 15, 2003 12:00AM
, Feb 15, 2003 12:00AM
Hello - thanks for asking your question.
Zelnorm (Tegaserod) increases the action of serotonin (a body chemical) in the intestines. This speeds the movement of stools (bowel movements) through the bowels. Tegaserod is used to treat severe, chronic, irritable bowel syndrome (IBS) in women who have constipation (not enough or hard bowel movements) as their main bowel problem, (constipation-predominant). Tegaserod has not been shown to be helpful for men with irritable bowel syndrome.
This is from the Zelnorm.com site:
"Adverse events reported significantly more often with Zelnorm than with placebo were headache (15% vs 12%) and diarrhea (9% vs 4%). Zelnorm is contraindicated in those patients with severe renal impairment; moderate or severe hepatic impairment; a history of bowel obstruction, symptomatic gallbladder disease, suspected sphincter of Oddi dysfunction, or abdominal adhesions; or a known hypersensitivity to the drug or any of its excipients. Zelnorm should not be initiated in patients who are currently experiencing, or frequently experience, diarrhea. Zelnorm should be discontinued immediately in patients with new or sudden worsening of abdominal pain."
http://www.zelnorm.com/hcp/about/zelnorm/importsafety.jsp
Regarding cardiovascular effects specfically:
"Although the events reported occurred during treatment with Zelnorm, they were not necessarily caused by it:
Cardiovascular: hypotension, angina pectoris, syncope, arrhythmia, bundle branch block, supraventricular tachycardia"
http://www.zelnorm.com/hcp/about/zelnorm/tolerability.jsp
Zelnorm is not typically prescribed for GERD. Looking at Medline, there is one very small study that suggested that it *may* have a decrease in post-prandial acid secretion:
"Tegaserod in a dose of 1 mg/day causes a significant decrease in postprandial oesophageal acid exposure. The reduction in oesophageal acid exposure with tegaserod treatment may result from enhanced oesophageal acid clearance, improved gastric emptying, and/or reduced transient lower oesophageal sphincter relaxations."
Kahrilas PJ, Quigley EM, Castell DO, Spechler SJ. The effects of tegaserod (HTF 919) on oesophageal acid exposure in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2000 Nov;14(11):1503-9.
I would strongly suggest that you follow this up with your personal physician or gastroenterologist.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Links:
Zelnrom.com
http://www.zelnorm.com/index.jsp?checked=y
http://www.zelnorm.com/hcp/about/zelnorm/tolerability.jsp
Zelnorm (Tegaserod) increases the action of serotonin (a body chemical) in the intestines. This speeds the movement of stools (bowel movements) through the bowels. Tegaserod is used to treat severe, chronic, irritable bowel syndrome (IBS) in women who have constipation (not enough or hard bowel movements) as their main bowel problem, (constipation-predominant). Tegaserod has not been shown to be helpful for men with irritable bowel syndrome.
This is from the Zelnorm.com site:
"Adverse events reported significantly more often with Zelnorm than with placebo were headache (15% vs 12%) and diarrhea (9% vs 4%). Zelnorm is contraindicated in those patients with severe renal impairment; moderate or severe hepatic impairment; a history of bowel obstruction, symptomatic gallbladder disease, suspected sphincter of Oddi dysfunction, or abdominal adhesions; or a known hypersensitivity to the drug or any of its excipients. Zelnorm should not be initiated in patients who are currently experiencing, or frequently experience, diarrhea. Zelnorm should be discontinued immediately in patients with new or sudden worsening of abdominal pain."
http://www.zelnorm.com/hcp/about/zelnorm/importsafety.jsp
Regarding cardiovascular effects specfically:
"Although the events reported occurred during treatment with Zelnorm, they were not necessarily caused by it:
Cardiovascular: hypotension, angina pectoris, syncope, arrhythmia, bundle branch block, supraventricular tachycardia"
http://www.zelnorm.com/hcp/about/zelnorm/tolerability.jsp
Zelnorm is not typically prescribed for GERD. Looking at Medline, there is one very small study that suggested that it *may* have a decrease in post-prandial acid secretion:
"Tegaserod in a dose of 1 mg/day causes a significant decrease in postprandial oesophageal acid exposure. The reduction in oesophageal acid exposure with tegaserod treatment may result from enhanced oesophageal acid clearance, improved gastric emptying, and/or reduced transient lower oesophageal sphincter relaxations."
Kahrilas PJ, Quigley EM, Castell DO, Spechler SJ. The effects of tegaserod (HTF 919) on oesophageal acid exposure in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2000 Nov;14(11):1503-9.
I would strongly suggest that you follow this up with your personal physician or gastroenterologist.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Links:
Zelnrom.com
http://www.zelnorm.com/index.jsp?checked=y
http://www.zelnorm.com/hcp/about/zelnorm/tolerability.jsp
Member Comments
by 4gpact, Feb 16, 2003 12:00AM
I take Zelnorm due to motility problems throughout the digestive tract. It has helped me, and though I am a woman, I know men that it has helped as well. I think it is worth a shot. As far as reflux/GERD, etc. I think one reason people are diagnosed with this disorder (I was) is that they have poor stomach motility. The stomach does not empty properly, therefore there is a buildup of acid, etc. I take a medication called domperidone that I get from a pharmacy out of the country. It is not marketed here in the US, but is manufactured by a major drug company, and seems to be sold everywhere else in the world. In England, it is even an OTC medication. It works great for me. I would ask your doctor to do a gastric emptying scan. It makes sense that if the stomach emptied better, you would have less symptoms.
by mskathlene, May 04, 2008 04:29PM
A related discussion, zelnorm damage was started.
