Peritop Tablet: A Prokinetic for Gastrointestinal Symptoms

Peritop tablet contains Itopride Hydrochloride, a medication indicated for the treatment of various gastrointestinal symptoms associated with chronic gastritis, such as feeling of an enlarged abdomen, upper abdominal pain, anorexia (loss of appetite), heartburn, nausea, and vomiting.

How Peritop Works (Pharmacology)

Itopride Hydrochloride functions as a potent dopamine-2 ($D$$2$​) antagonist and an acetylcholine esterase inhibitor. Its mechanism involves:

• Inhibiting dopamine $D$$2$​ receptors: This action leads to increased acetylcholine release.
• Inhibiting acetylcholinesterase: This enzyme normally breaks down acetylcholine, so its inhibition results in higher concentrations of acetylcholine.

The combined effect of increased acetylcholine concentrations leads to enhanced gastrointestinal (GI) motility. Specifically, Itopride:

• Increases GI peristalsis (wave-like contractions that move food).
• Increases the lower esophageal sphincter pressure, helping to prevent reflux.
• Stimulates gastric motility (stomach movement).
• Accelerates gastric emptying.
• Improves gastro-duodenal coordination.

Key Indications & Benefits

Peritop tablet is indicated for the symptomatic treatment of gastrointestinal symptoms in chronic gastritis, which include:

• Feeling of an enlarged abdomen
• Upper abdominal pain
• Anorexia (loss of appetite)
• Heartburn
• Nausea
• Vomiting

Dosage & Administration

Itopride Hydrochloride should be taken before meals. Always consult a registered physician for medication use.

• Usual adult dose for oral use: 50 mg of Itopride Hydrochloride administered orally three times daily.
• Dose adjustment: The dose may be reduced according to the patient’s age and symptoms.

Special Populations:

• Use in the elderly: Elderly patients often have physiological hypofunction and are prone to adverse reactions. They should be closely monitored. If adverse reactions are evident, appropriate measures such as reduction or cessation of the drug should be implemented.
• Use in pediatric population: The safety and efficacy of Itopride Hydrochloride in children and adolescents below 18 years of age have not been established. Therefore, its administration is not recommended in this age group.

Important Considerations & Warnings

It is crucial to discuss your full medical history with your doctor before taking Peritop.

Contraindications:

• Hypersensitivity to the active substance or to any of the excipients in this preparation.
• Patients in whom increased gastrointestinal motility could be harmful, such as those with gastrointestinal hemorrhage, mechanical obstruction, or perforation.

Side Effects:

• Shock and anaphylactoid reactions: These are serious and may occur. Close observation is needed. If symptoms like hypotension (low blood pressure), dyspnea (shortness of breath), larynx edema (swelling of larynx), urticaria (hives), pallor, and diaphoresis (excessive sweating) occur, the drug should be discontinued, and appropriate measures implemented immediately.
• Hepatic function disorder and Jaundice: These may occur, indicated by increased AST (GOT), ALT (GPT), and γ-GTP etc. Close observation is needed. If abnormalities occur, the drug should be discontinued, and appropriate therapeutic measures implemented.

Pregnancy & Lactation:

• Pregnancy: The safety of Itopride Hydrochloride in pregnancy has not been verified. Therefore, itopride can be used in pregnant women or women in whom pregnancy cannot be excluded only if therapeutic benefits considerably outweigh possible risks.
• Lactation: Data about excretion in breast milk is known only from animal studies. Due to lack of experience with the use of itopride during breastfeeding, itopride is not recommended for breastfeeding women.

Precautions & Warnings:

• Enhances Acetylcholine Action: Peritop should be used with caution since it enhances the action of acetylcholine.
• Continuous Use: Peritop should not be consumed continuously for an extended period when no improvement of gastrointestinal symptoms is observed.
• PTP Packaging: For drugs packaged in a press-through package (PTP), instruct the patient to remove the drug from the package prior to ingestion. Accidental ingestion of the PTP sheet can lead to serious complications like esophageal puncture, perforation, and mediastinal sinusitis.

Drug Interactions:

• Anticholinergic Drugs: Peritop should be administered with care when co-administered with anticholinergic drugs such as Tiquizium bromide, Scopolamine butyl bromide, Timepidium bromide, etc.
  • Sign: There is a possibility of reducing the activity of Peritop (which activates gastrointestinal motility).
  • Mechanism: The gastrointestinal motility inhibitory action of anticholinergic drugs pharmacologically decreases the activity of Itopride.

Overdose Effects:

• In case of excessive overdose, the usual measures of gastric lavage and symptomatic therapy should be applied.

Storage Conditions

Store below 30°C, in a cool and dry place. Keep away from light. Keep all the medicine out of the reach of children.