Which drugs have been investigated in the treatment of constipation?

Updated: Jul 04, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Other drugs that have been studied include the prokinetic agents cisapride and tegaserod. [33, 34, 35] Although significant promise had been shown with this new class of drugs, these two agents were withdrawn from the US market.

Since July 27, 2007, use of tegaserod has been permitted only via an emergency treatment investigational new drug (IND) protocol through the FDA. As of July 16, 2014, this treatment IND program is still active. [36] The treatment IND protocol allows tegaserod treatment of IBS-C or chronic idiopathic constipation (CIC) in women younger than 55 years who meet specific guidelines. Its use is further restricted to those in critical need who have no known or preexisting heart disease.

The FDA Gastrointestinal Drugs Advisory Committee reviewed a supplemental new drug application (sNDA) for tegaserod in October 2018 with the proposed indication of treating women with IBS-C who do not have a history of cardiovascular (CV) ischemic disease. Their recommendation was to reintroduce tegaserod to the US market for women with IBS who are at low risk for CV ischemic disease. [37]

Renzapride, a mixed 5-HT4 receptor agonist and 5-HT3 receptor antagonist, has been tested to assess its efficacy and safety in the treatment of chronic constipation. [38]

Neurotrophin-3 stimulates the development, growth, and function of the nervous system and has been used to treat functional constipation. Stem cells have been suggested as a means of repopulating dysfunctional neurons.


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