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Alosetron

Alosetron is a 5-HT3 antagonist used for the management of severe diarrhoea-predominant irritable bowel syndrome (IBS) in women only. It was withdrawn from the market in 2000 owing to the occurrence of serious life-threatening gastrointestinal adverse effects, but was reintroduced in 2002 with availability and use restricted. It is currently marketed by GlaxoSmithKline under the trade name Lotronex. more...

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Mode of action

Alosetron, while being a 5-HT3 antagonist like ondansetron, is not an antiemetic. Alosetron has an antagonist action on the 5-HT3 receptors of the enteric nervous system of the gastrointestinal tract.

Serious adverse effects

Alosetron was withdrawn in 2000 following the association of alosetron with serious life-threatening gastrointestinal adverse effects.

The cumulative incidence of ischaemic colitis was 2 in 1000, while serious complications arising from constipation (obstruction, perforation, impaction, toxic megacolon, secondary colonic ischaemia, death) was 1 in 1000 (GlaxoSmithKline, 2002).

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Pediatric Use for Alosetron to Be Studied - Brief Article - Statistical Data Included
From Family Pratice News, 1/1/00

Glaxo Wellcome plans to study alosetron in children and adolescents with irritable bowel syndrome.

At the advisory committee hearing, Dr. George Dukes of Glaxo Wellcome said that the company had submitted a proposal to the Food and Drug Administration to study alosetron in children aged 611 and in adolescents, and hopes to begin studies in early 2000.

Dr. George D. Ferry, the pediatric gastroenterologist on the FDA's GI drugs advisory panel, said that there "will be a real interest in using this drug in children." Pediatric gastroenterologists struggle with how to treat young patients with IBS, he said at the hearing.

"It's not a very common problem in pediatrics, but it's definitely there," said Dr. Ferry of Texas Children's Hospital, Houston. The incidence of IBS in the pediatric population is much lower than in adults and varies by age, but is most clearly defined in those aged 13 and older.

The implications and severity of IBS "are very much the same" in children as in adults, he added.

The potential for using new drugs in children is often raised now at FDA hearings dealing with drugs that are used to treat adults, as part of an initiative to improve pediatric labeling of drugs.

The Food and Drug Administration Modernization Act, which went into effect in November 1998, created a powerful financial incentive for manufacturers to study their products in children: Companies receive a 6-month extension on the drug's patent if they provide acceptable pediatric data on the product.

COPYRIGHT 2000 International Medical News Group
COPYRIGHT 2001 Gale Group

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