[flux]

Following in Guy's brilliant footseps, here is another drug that can take the place of Lotronex. This drug, in fact, is a cousin of Lotronex and Cilanestron and is what brought about the development of them. It is regularly used in cancer chemotherapy patients to prevent nausea. I don't believe it has been associated with colonic ischemia.Title Reduction of rectal sensitivity and post-prandial motility by granisetron, a 5 HT3-receptor antagonist, in patients with irritable bowel syndrome. Author Prior A ; Read NW Address Centre for Human Nutrition, Northern General Hospital, Sheffield, UK. Source Aliment Pharmacol Ther, 7(2):175-80 1993 Apr Abstract The effect of granisetron, a specific 5-hydroxytryptamine 3-receptor antagonist, on the anorectal responses to rectal distension and a 1000-calorie meal was assessed in 12 patients with irritable bowel syndrome. Each patient was studied on three occasions, receiving intravenously either 40 mcg/kg granisetron, 160 mcg/kg granisetron or normal saline. Granisetron caused a dose-dependent reduction in rectal sensitivity, manifested by an increase in the threshold volumes at which the sensations of gas, desire to defecate, urgency and discomfort were perceived. This reached significance for all sensations at the higher dose level (P < 0.01). No significant changes in anal pressures, rectal compliance or distension-induced motor activity occurred following drug administration. A dose-dependent reduction in post-prandial motility was observed following intravenous granisetron and this was highly significant at 160 mcg/kg (P = 0.005). These results suggest that the 5 hydroxytryptamine receptor antagonists may have a therapeutic role in patients with irritable bowel syndrome.

 

[Brandi Guidry]

Flux,Thanks for posting this interesting info. I think that it's a shame that Lotronex has been pulled off the shelves. Apparently, the FDA, hasn't weighed the good this medicine has done. In this case, I think that the good has outwieghed the bad. That's ashame!Brandi

 

[John]

Flux!You're brilliant!

Despite the negativity that some of the others say about you. I must truly admit that you are much more of an asset to our group. My sincerest thanks to you for your unselfish dedication and contribution to our IBS Group! SincerelyJohn[This message has been edited by John754 (edited 11-29-2000).]

 

[JuliaNYC]

Thanks Flux. I would like a slight bit of additional information, since the article only discusses IV granisetron and it also comes in 1 mg. tablets. Do you know whether any research has been done on whether the tablets may be equally effective for IBS? It doesn't seem as if the method of administration would make a difference, but I'm not an expert in these matters.[This message has been edited by JuliaNYC (edited 11-29-2000).]

 

[Pat_H]

Is this available for IBS-D? We have to have an alternative for Lotronex!

 

[Bud]

Thanks Flux, for all you do.

 

[Guest]

and how about men and how we take it?also, what is IBS-D??? I'm new here.keith

 

[Pat_H]

Greenmtnsuneople who have IBS either have constipation © or diarrhea (D) or are both C & D.

 

[flux]

John and others: glad to be of service as always.

quote: Do you know whether any research has been done on whether the tablets may be equally effective for IBS?

The drug is given in tablet form for nausea, so that's how it would be taken. The study appeared to be done to test the real-time effects, so that's why they used IV administration.

quote:and how about men and how we take it?

Doctors can presribe this drug as they see fit. In this case, it would be for those, men and women, with diarrhea, not constipation. [This message has been edited by flux (edited 11-29-2000).]

 

[eric]

Bump!------------------ http://www.ibshealth.com/ www.ibsaudioprogram.com

 

[Throne King]

Thank you Flux, I have a question.Do you know if 5HT3 receptors are present elsewhere in the body? Or are they specific to the digestive tract? I noticed I had less of my usual chronic pain while taking Lotronex and have felt really well lately.

 

[flux]

quoteo you know if 5HT3 receptors are present elsewhere in the body? Or are they specific to the digestive tract? I noticed I had less of my usual chronic pain while taking Lotronex and have felt really well lately.

5HT3 is part of the visceral pain pathways so it not surprising to me if it were helpful for chronic pain.

 

[BQ]

Flux, Thanks very much for the info. Can you tell us who manufacturers this drug? And how long has this drug been on the market? Thanks again. BQ

 

[Guest]

: J Pain Symptom Manage 1999 Nov;18(5):382-5 The use of mirtazapine in a patient with chronic pain.Brannon GE, Stone KDDepartment of Psychiatry, Louisiana State University School of Medicine, Shreveport 71130, USA.Antidepressant drugs that act on serotonin and noradrenergic systems may be analgesic. The newer antidepressant mirtazapine (Remeron) has activity on noradrenergic and serotonergic transmission and is approved for the treatment of a Major Depressive Disorder. This paper describes a case that suggests that mirtazapine may also be useful in the treatment of chronic pain.--------------------------------------------Blockade of serotonin 5-HT2 and 5-HT3 receptors by mirtazapine is the likely mechanism by which chronic pain may be modulated.

 

[Guest]

I agree with John and the others Flux, thank you for all your help and advice. It's obvious that you do much research before you post. Just want you to know it IS appreciated

debbie

 

[flux]

quote: Can you tell us who manufacturers this drug? And how long has this drug been on the market?

It is now marketed as Kytril by Roche. I think it has been for at least several years.

 

[wanderingstar]

thanks for the info flux. Bookmarked incase the IBS flares up in the future!susan

 

[Joanie65]

Hi flux. I was just wondering if there were any side effects of this drug, like weight gain. I have been reading posts on Remeron and that is one side effect. When taking Lotronex, I did not experience any side effects at all and was really happy with having a life again. I did take Doxepin 5 years ago and gained 50 pounds and was a little depressed because of the weight gain, so I do not want to go there again. Thanks for your time!

 

[Guest]

Thanks Flux for all the information you share with us. I was just wondering why I have only recently heard about Granisetron and Remeron since Lotronex has been taken away. Are they new to the market? Also, it sounds like they may work as Lotronex did - (as I understand it anyway) that they work on the cause of the problem, not just the symptoms of IBS. Is this correct? Many thanks for your help. I'm still taking the Lotronex but not comfortably. It makes me feel so much better and I feel like I can function without bathroom location worries, urgency OR pain. The thoughts of going back to the pre-Lotronex days make me cringe but at the same time, I don't want to be doing further damange to my body. I sure wish this whole medication thing had some easy answers. Again, thanks for listening and sharing...

 

[flux]

quote:I was just wondering if there were any side effects of this drug, like weight gain.

AFAIK, not. The major side effect should be constipation.

quote:Are they new to the market?

Nope.

quote:Also, it sounds like they may work as Lotronex did - (as I understand it anyway) that they work on the cause of the problem, not just the symptoms of IBS. Is this correct?

The actual cause is unknown. But these drugs intercept at least one major mechanism.