Cinitapride: Formula, Presentation, Indications, Mechanism of Action, Dosage, Side Effects and Interactions

It is a substituted benzamide, which is used for its prokinetic properties in the treatment of gastroparesis and gastroesophageal reflux disease.

It is prescribed for gastrointestinal disorders associated with impaired motility, such as gastroesophageal reflux disease, functional or non-ulcer dyspepsia, and delayed gastric emptying .

Cinitapride belongs to the pharmacological group agonist and antagonist in 5HT receptors, on the basis of its mechanism of action.

Chemical formula

  • C21H30N4O4.

Presentation

  • It comes in tablet form to be administered orally.

Indications

Cinitapride is indicated mainly in the treatment of gastrointestinal disorders related to motility such as indigestion or functional or non-ulcer dyspepsia (nausea, heaviness, stomach pain, burning and flatulence).

As well as gastroesophageal reflux diseases ( frequent persistent heartburn , bitter liquid flow in the mouth, difficulty swallowing and upper abdominal pain), delay in gastric emptying and vomiting.

Mechanism of action

Cinitapride is a substituted benzamide with serotonergic 5-HT2 receptor antagonist activity and 5-HT1 and 5-HT2 serotonergic receptor agonist.

It acts by indirectly stimulating the release of acetylcholine, which is a chemical messenger that can increase the motility of the intestine.

It works by increasing the movement of the esophagus (feeding tube), stomach and intestines during digestion.

It also increases the strength of the muscle between the esophagus and the stomach.

Dose

The usual daily dose of cinitapride recommended for adults, older than 20 years, is 1 mg orally three times a day, 15 minutes before meals, and should be administered on an empty stomach.

Side effects

Symptomatic adverse reactions produced by Cinitapride are more or less tolerable, but in the event that they become severe, they can be treated symptomatically.

Like many medications, cinatapride can cause adverse effects such as:

  • In the central nervous system: Adverse effects such as confusion, slight sedation, drowsiness, tardive dyskinesia such as involuntary, rapid and repeated muscle movements of the head, neck, tongue, trunk or extremities that may appear months after the treatment has been abandoned.
  • On the skin: Rashes on the skin, itching and edema of the skin, mucous membranes and submucosal tissues rarely occur, these are induced by allergy reactions to the medication. The edema of the lips and tongue may be of very little incidence but they are dangerous because they can affect the larynx.
  • In the gastrointestinal system: Diarrhea.

In rare cases serious or irreversible adverse effects are caused by the use of cinitapride, which lead to more complications, there have been cases of gynecomastiaor excessive development of the mammary glands.

When an acute overdose of cinitapride occurs, signs and symptoms that include drowsiness, confusion, and extrapyramidal effects occur.

Warnings and contraindications

Cinitapride is contraindicated in those conditions of hypersensitivity to the drug or hypersensitivity to any component of the product.

Caution should be exercised in the administration of cinitapride in patients with a history of gastrointestinal bleeding, obstruction or mechanical perforation, and movement disorder, where increases in gastrointestinal motility may be harmful.

Regarding age, the alert should be practiced in children and adolescents for not having experience in use in these age groups.

It should be used with caution especially in the elderly, as it improves the action of acetylcholine.

Avoid excessive doses of cinitapride.

During the administration of cinitapride should be avoided the consumption of alcohol, as it can occur in further sedation.

The drug should not be administered to pregnant, nursing or newborn mothers.

If the patient is pregnant or breast-feeding, thinks that she might be pregnant or intends to get pregnant, she should consult her doctor before using this medicine. Cinitapride should not be administered in the first trimester of pregnancy.

Because cinitapride in its side effects can cause drowsiness, it is advisable not to drive a car.

Neither operate machinery nor perform activities that require a state of alert, while taking this medication.

It should be used with caution in patients who have a history of neuroleptic-induced dyskinesia.

Interactions

It is known that anticholinergic agents such as atropine, scopolamide and others can interact with cinitapride and reduce the action of the latter.

Cinitapride can have a beneficial relationship with some medications such as those used in the treatment of diseases of the nervous system and for insomnia , improving its effect.

It interacts with other drugs such as digoxin since it alters its absorption, simulating gastric emptying.