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Zelnorm
Zelnorm (tegaserod) is a prokinetic agent used primarily for the treatment of irritable bowel syndrome with constipation (IBS-C) in women under 65 years of age. It belongs to a class of drugs known as serotonin receptor agonists, specifically targeting the 5-HT4 receptor to stimulate bowel movements and reduce symptoms such as bloating and abdominal pain.
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Frequently Asked Questions
How long does it take for Zelnorm to start working?
Some patients may begin to notice relief of symptoms within the first week of treatment, but it may take longer for others. Your doctor will evaluate your response to the medication after a few weeks.
Can men take Zelnorm?
Zelnorm is approved only for use in women under 65 for the treatment of IBS-C. Its effectiveness and safety in men have not been well established.
Why was Zelnorm taken off the market?
Zelnorm was temporarily withdrawn due to concerns over increased risks of cardiovascular events like heart attacks and strokes. It has since been reapproved for use in a specific population under careful monitoring.
Can Zelnorm be taken long-term?
Zelnorm is generally intended for short-term use, and patients should be periodically evaluated by their healthcare provider to assess the continued need for the medication.
What should I do if I miss a dose of Zelnorm?
If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. Do not take a double dose to make up for the missed one.
Comprehensive Drug Guide
How Does Zelnorm Work?
Zelnorm works by activating 5-HT4 receptors in the gastrointestinal tract, which enhances the release of certain neurotransmitters. This action increases intestinal motility (the movement of the intestines), helping to relieve constipation, reduce bloating, and alleviate abdominal discomfort in patients with IBS-C.
Common Dosages
- 6 mg tablets
Typical Dosing
- The typical dose for Zelnorm is 6 mg taken twice daily, 30 minutes before meals. It is recommended for short-term treatment, and its use should be periodically reassessed by a healthcare provider, especially for long-term management.
Typical Dosing
FDA Approved Indications
- Irritable bowel syndrome with constipation (IBS-C) in women under the age of 65
Who Shouldn't Take Zelnorm?
- A history of heart attack, stroke, or unstable angina
- Severe renal impairment or hepatic impairment
- A history of intestinal ischemia or bowel obstruction
Advice From The Pharmacist
- Zelnorm should be taken 30 minutes before meals, twice a day.
- If you miss a dose, take it as soon as you remember, but do not double the dose.
- Notify your healthcare provider if you experience severe abdominal pain, bloody stools, or sudden changes in your health, particularly related to your cardiovascular system.
- Avoid taking Zelnorm if you have a history of heart issues without consulting your doctor.
Side Effects of Zelnorm
Common Side Effects
- Diarrhea
- Abdominal pain
- Flatulence
- Headache
Uncommon/Severe Side Effects
- Cardiovascular events (e.g., heart attack, stroke)
- Intestinal blockage or bowel ischemia
- Severe diarrhea leading to dehydration
Risks and Warnings of Zelnorm
- Cardiovascular Risk: Zelnorm was temporarily withdrawn from the market due to concerns about an increased risk of heart attack and stroke. It has since been reapproved for use in a specific patient population (women under 65 without a history of cardiovascular disease), but caution is still advised.
- Gastrointestinal Issues: Zelnorm should not be used in patients with a history of bowel obstruction or other severe gastrointestinal disorders.
Interactions with Zelnorm
Common Drug Interactions
- Antidepressants (SSRIs, SNRIs): These drugs also act on serotonin receptors, so using them in combination with Zelnorm may increase the risk of serotonin syndrome, a rare but serious condition.
- Other prokinetic agents: Combining Zelnorm with other drugs that stimulate bowel movements could lead to excessive intestinal activity and diarrhea.
Alternatives to Zelnorm
- Linaclotide (Linzess): Another medication used to treat IBS-C that works by increasing fluid in the intestines to help with bowel movements.
- Lubiprostone (Amitiza): A chloride channel activator that helps increase fluid secretion in the intestines, also used for IBS-C.
- Plecanatide (Trulance): Another drug used to treat chronic idiopathic constipation and IBS-C by stimulating intestinal fluid secretion.
