Journal of Diabetes Research / 2018 / Article / Tab 2

Review Article

Diabetic Enteropathy: From Molecule to Mechanism-Based Treatment

Table 2

Prokinetic for treatment of diabetic gastroparesis.

DrugMode of actionRecommended daily dose (formulation)Comment

Metoclopramide5-HT4 receptor agonist
D2-receptor antagonist
10 mg TID (tablet)Black box warnings for long-term use:
(i) FDA < 3 months
(ii) EMA ≤ 5 days
DomperidoneD2-receptor antagonist10 mg TID (tablet)
30 mg BID (suppository)
Should be avoided in the presence of prolonged QT interval
ErythromycinMotillin receptor agonist
Cholinergic receptor agonist
250 mg TID (tablet)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
Prucalopride5-HT4 receptor agonist2 mg (tablet)Currently under investigation for diabetic gastroparesis in phase III trials. May be used off-label in selected cases
Granisetron5-HT3 receptor agonist3.1 mg per 24 hours (patch)Evidence from controlled trials is lacking in diabetic gastroparesis

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