Which medications in the drug class Prokinetic Agents are used in the treatment of Diabetic Neuropathy?

Updated: Jan 08, 2019
  • Author: Dianna Quan, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Prokinetic Agents

Medications for diabetic gastroparesis are erythromycin (E-Mycin, Erythrocin, Ery-Tab, E.E.S.), cisapride (Propulsid), and metoclopramide (Reglan, Maxolon, Clopra). However, in 2009 the FDA issued a black box warning that long-term use of metoclopramide has been linked to the development of tardive dyskinesia. [111]

Erythromycin (Ery-Tab)

Macrolide antibiotic that duplicates the action of motilin, which is responsible for the migrating motor complex activity. Binds to and activates motilin receptors. IV administration of this drug enhances the emptying rate of both liquids and solids. Effect can be seen with PO erythromycin. Substitution of the enteric-coated form may be tolerated better by the patient.

Metoclopramide (Reglan)

Dopamine antagonist that stimulates acetylcholine release in the myenteric plexus. Acts centrally on chemoreceptor triggers in the floor of the fourth ventricle, which provides important antiemetic activity; side effects and tachyphylaxis are problems.


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