Zelnorm
Drug Class and Mechanism of Action of Zelnorm
Zelnorm is an oral medication for the treatment of constipation and irritable bowel syndrome (IBS) of constipation-predominant, especially in women. IBS is a chronic gastrointestinal disorder which is generally characterized by recurrent abdominal pain or discomfort with altered bowel function (which may be either constipation or diarrhea predominent). It is estimated that as many as 20% of American adults may suffer from IBS.
Contractions of the intestinal muscles (mainly those of the colon), control the movement of food through the intestine. In constipated patients, there are fewer contractions than in normal persons without constipation and an important factor that controls the contractions is serotonin or also known as hydroxytryptamin (HT). Serotonin is a chemical manufactured by nerves in the intestine and also in many other body parts). Serotonin is a "neurotransmitter" (a chemical messenger), that is, a chemical that nerves use to communicate with each other. When serotonin binds to its receptors on the nerves that control contractions of the intestinal muscles, serotonin can either promote or prevent contractions depending on the type of receptor it binds to. Binding to some types of receptors causes contractions, and binding to other types of receptors blocks contractions (cause constipation).
If serotonin binds to 5-HT4 receptor it prevents contractions. Zelnorm blocks the 5-HT4 receptor and prevents serotonin from binding to it. As a result, contractions increase. The increased contractions speed the transit of food which is undergoing digestion and reverse the constipation. In addition, Zelnorm reduces the sensitivity of the intestinal pain-sensing nerves and can thereby reduce the perception of pain.
Therapeutic Uses of Zelnorm
Zelnorm is used for the short-term treatment of IBS (especially women) whose primary bowel symptom is constipation (constipation predominant IBS). It is also used (approved) for the treatment of chronic, idiopathic constipation in men and women less than 65 years of age.
Direction of use of Zelnorm
The normal dose of Zelnorm is 6 mg two times a day, generally for 4 to 12 weeks. Zelnorm can be taken with food or on empty stomach. Older persons do not require lower doses than younger persons.
If You Miss a Dose of Zelnorm
If you miss a dose of Zelnorm you should take it as soon as you remember it. If you do not remember until the next day or it is almost time for the next dose you should skip the missed dose of Zelnorm and keep taking it as regular dosing schedule. You should not take 2 doses at a time.
How to Store Zelnorm
Zelnorm should be stored at room temperature, 59-86 degrees F (15-30 degrees C) in an air-tight container. Do not store Zelnorm in your bathroom. Store it away from heat, moisture and light. Keep Zelnorm out of reach of children.
More Information About Zelnorm
If your symptoms do not improve or if they become worse, you should consult your doctor. Do not share Zelnorm with others for whom it was not prescribed. Do not use this medicine for other medical conditions. If using this medicine for an extended period of time, obtain refills before your supply runs out. If you have any doubt or question about Zelnorm, you should ask your doctor or other health care provider.
Precautions to be Taken While Taking Zelnorm
- Other drugs that increases intestinal contractions will likely lead to more diarrheas if used together with Zelnorm (tegaserod).
- Do not take Zelnorm if you are allergic to any of the ingredients used in this product or if you have had an allergic reaction to it.
- It may take up to 4 weeks for this medicine to work and you should not stop taking Zelnorm if you do not get any result after using it for a week or two.
- If you experience different or suddenly worsening stomach pain compared to your regular IBS symptoms, stop taking this medicine and get medical attention immediately.
- Do not take Zelnorm if you are pregnant. If you plan on becoming pregnant, discuss with your doctor about the benefits and risks of using this medicine during pregnancy. It is unknown if this medicine is excreted in breast milk, but do not breast-feed while taking this medicine.
- Do not take higher dose of Zelnorm or take more frequently, without consulting your doctor.
Possible Adverse Effects of Zelnorm
- Zelnorm is generally well tolerated by most of the patients. The most commonly reported side effects are headache (approximately 16% of patients), abdominal pain (approximately 12% of patients), and diarrhea (approximately 9% of patients). Only diarrhea has been reported substantially more frequently than with placebo treatment (sugar pill) and rarely the diarrhea may be severe, leading to hospitalization for dehydration and requiring intravenous fluids.
- Ischemic colitis has been seen rarely in patients taking Zelnorm (tegaserod) but it is not clear if the cause of it is Zelnorm. Patients who develop signs of ischemic colitis, worsening abdominal pain, bloody diarrhea etc. should stop taking Zelnorm and contact their physicians immediately.
