Medication pills on table

Medications for Gastroparesis

Jennifer O.

Written by: Jennifer O.

Updated: January 5th, 2023

Gastroparesis is a debilitating stomach disease for which there is no cure. However, there are a few medications for gastroparesis that may help mask symptoms and make life more manageable.

Despite the debilitating nature of the disorder, gastroparesis is sorely lacking in available resources for patients in the way of education and awareness. So, we (successfully) petitioned to make August the official gastroparesis awareness month. In our efforts to raise both funds for research and awareness this month, we also wanted to develop some resources that we felt would be an asset to someone who is newly diagnosed.

CDHF worked together with gastroparesis patient and advocate; Jennifer Ouellette, to put together a list of medications for gastroparesis. This detailed and comprehensive list will walk you through each medication, its uses, the potential side effects, and risks, along with some insights from Jennifer herself.

If you’re newly diagnosed and would like a deeper look into what medications for gastroparesis might make an appearance in your treatment plan, feel free to take a read or share with your doctor.

This list of medications for gastroparesis is meant for general information only and is not intended to replace any advice you may have already received from your healthcare practitioner.

12 Medications for Gastroparesis:

Domperidone (motilium)

Is one of the most commonly prescribed medications for gastroparesis, and usually the first treatment option that is offered. It does pose cardiac risk so it is recommended to have an electrocardiogram before starting and to continue to have cardiac activity monitored while on the medication. It can be used long term but you should be monitored by a doctor while on the medication. It works as an antiemetic and as a gastric prokinetic. It is supposed to help with nausea and vomiting as well as help speed up the gastric emptying time. This is the drug that I was on for 4 times a day for almost 10 years before it stopped working. It kept a lot of my symptoms calm with an occasional flare-up happening every once in a while.

Common Side Effects 

Rare but more serious side effects:

Do not take domperidone if you:

Metoclopramide (also known as Maxeran or Reglan or Metonia)

Despite some troublesome side effects, Metoclopramide is also one of the more commonly prescribed medications for Gastroparesis. Like Domperidone, it is supposed to help relief nausea, vomiting and also help with speeding up gastric emptying times and also help with reflux. It poses a risk of developing serious side effects such as Tardive Dyskenesia and Neuroleptic malignant syndrome. I was on the liquid form of this medication and started developing neurological twitches that could have turned into Tardive Dyskensia and been permanent. Thankfully for me, they went away after stopping the medication but that is unfortunately not the case for everyone.

Common Side Effects

More serious side effects to watch for:

Do not take metoclopramide if you:

Erythromycin

The same antibiotic that we use to treat bacterial infections also has a use in treating Gastroparesis. It is typically used at a lower dosage, not the same dosing used for antibiotic treatment with the drug.  I was told it shouldn’t be used longer than 4 weeks without a break because of side effect risks. It works by helping to stimulate the receptors that assist in making GI contractions and that helps increase motility in the GI tract. This is one of the medications for gastroparesis that was not effective for me when I tried it but I have heard some people have success with it short term.

Common Side Effects:

Rare more serious side effects:

Erythromycin should not be taken by anyone who:

Cisapride (Propulsid)

This is one of the medications for gastroparesis that has been banned in many countries. It is still available to my knowledge in Canada through Health Canada Special Access program. It is severely restricted because of the risk of rare but serious cardiac events associated with the drug.  Cisapride works as a gastric prokinetic agent increasing the motility in the GI tract.

Common Side Effects

Rare serious Side effects

medications for gastroparesis

Prucalopride (Resotran, Resolor)

This is one of the medications for gastroparesis that was part of the clinical trials held in Calgary. It is primarily used as a drug to help treat chronic constipation in women. It has been used by a lot of people in our Facebook support group, including myself. Some people have responded very well to Resotran. It worked great for me for about 6-7 months and then it stopped working. It helped speed up emptying times for me but the trade-off was a great deal of diarrhea.

Most common side effects:

Rare but serious side effects:

Do not take this medication if you:

Ondasetron (Zofran)

This is probably one of the more common antiemetic medications for gastroparesis that is prescribed. It is a drug that is used most often to treat nausea and vomiting associated with chemo or radiation in cancer patients. Many Gastroparesis patients including myself (until they no longer worked) find that this drug works well to help with nausea.

Common Side effects

Rare more serious side effects

Do not take this medication if you:

Promethazine (Phenergan)

It is an antihistamine used to treat allergies, nausea, and trouble sleeping. They use this medication a lot to help women with morning sickness during pregnancy. I have used it a few times for nausea and it works decently.

Common Side Effects:

Rare severe Side effects:

Relamorelin

It is a new drug being trialed currently with diabetic Gastroparesis patients here in Canada. As I have idiopathic Gastroparesis I have not had a chance to trial this drug as of yet.

https://ucalgary.ca/motility/current-research/treatment-diabetic-gastroparesis-new-clinical-trial

I don’t have a list of side effects yet as they are still testing the drug. The studies have been promising. Showing so far that there have been no cardiac or neurological side effects which would mean it could potentially be a safer option than some of the other medications out there currently.

Botox injections – (not covered in every province)

This seems to be hit or miss among patients who have tried it. My specialist said for my personal case my Gastroparesis it is too severe and it wouldn’t be worth it.  As I am not incredibly familiar with how it all works, so here is the official description of its use in cases of gastroparesis:

“While the patient is sedated, the physician will advance a scope through the esophagus, stomach, and the pyloric sphincter. Botox is injected into the pyloric sphincter in an effort to relax that muscle, enabling food to empty from the stomach more easily. It takes approximately 15-30 minutes.

The effects of the botox may be felt immediately or may take some time to begin working. Complications from the procedure include nausea and vomiting from sedatives. Although rare, some report bleeding, perforation of the esophagus, fever, or severe vomiting.

Botox injections are not a permanent solution and usually last no more than 6 months. Repeat injections do not always produce the same results.”

Linaclotide (Constella)

It is used to treat IBS-C and to treat chronic (long-term) constipation. It seems to be commonly prescribed for Gastroparesis patients who experience chronic constipation as well. It is usually my go-to medication when I am having issues with constipation and while it causes a bit more pain and bloating it does help with relieving constipation.

Common Side Effects:

Rare Side effects: 

Nabilone (synthetic cannabinoids)

Used to treat severe nausea. I know some people in the group have tried this as they can get their insurance to cover the pill form of synthetic cannabinoids but no coverage for actual cannabis. I cannot speak personally about this one as I use actual Medical Cannabis to treat my symptoms.

More Common Side effects:

Rare more serious side effects: 

Medical Cannabis for Gastroparesis

Is one of the most effective medications for gastroparesis, as far as managing symptoms go. Everyone is going to be different and Cannabis may or may not work for everyone.  Finding strains that have proper terpenes to help digestive issues, like Limonene is important when trying to find the best strains to help. This study may be of interest as it is newer research. Hopefully, more research and some clinical trials can happen soon!

With the help of people like YOU, we can raise money and awareness for gastroparesis. Hopefully, in time, new, more effective medications for gastroparesis can be found. Perhaps even a cure!

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