TRIMEBUTINE - MECHANISM OF ACTION, EFFECTS ON GASTROINTESTINAL FUNCTION AND CLINICAL-RESULTS

The actions of trimebutine [3,4,5-trimethoxybenzoic acid 2-(dimethylam ino)-2-phenylbutylester] on the gastro intestinal tract are mediated v ia (i) an agonist effect on peripheral mu, kappa and delta opiate rece ptors and (ii) release of gastrointestinal peptides such as motilin an d modulation of the release of other peptides, including vasoactive in testinal peptide, gastrin and glucagon, Trimebutine accelerates gastri c emptying, induces premature phase III of the migrating motor complex in the intestine and modulates the contractile activity of the colon, Recently, trimebutine has also been shown to decrease reflexes induce d by distension of the gut lumen in animals and it may therefore modul ate visceral sensitivity, Clinically, trimebutine has proved to be eff ective in the treatment of both acute and chronic abdominal pain in pa tients with functional bowel disorders, especially irritable bowel syn drome, at doses ranging from 300 to 600 mg/day. It is also effective i n children presenting with abdominal pain.