Clinical efficacy often diminishes after 2–4 weeks due to tachyphylaxia Prokinetic action likely a drug class effect and other macrolides with less toxicity may be used (azithromycin, clarithromycin), but evidence from controlled trials is lacking
Prucalopride
5-HT4 receptor agonist
2 mg (tablet)
Currently under investigation for diabetic gastroparesis in phase III trials. May be used off-label in selected cases
Granisetron
5-HT3 receptor agonist
3.1 mg per 24 hours (patch)
Evidence from controlled trials is lacking in diabetic gastroparesis