Acotiamide HCl, an oral first-in-class prokinetic drug. The drug modulates upper gastrointestinal motility to alleviate abdominal symptoms resulting from hypomotility and delayed gastric emptying. It exerts its activity in the stomach via muscarinic receptor inhibition, resulting in enhanced acetylcholine release and inhibition of acetylcholinesterase activity[1]. Acotiamide enhances the effect of acetylcholine in the enteric nervous system, enhances gastric contractility, and accelerates delayed gastric emptying. Acotiamide prolongs gastric accommodation and improves stress-induced impaired gastric accommodation[2]. Adding acotiamide to gastric acid inhibitors can improve symptoms in patients with refractory NERD (non-erosive reflux disease) [3]. Acotiamide is associated with lower antral pressures after nutrient intake, whereas it has no effect on fundic pressures, GE (gastric emptying) rate and symptom perceptions in HVs[4].
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