What are the functions and effects of Acotiamide?

Acotiamide (Acotiamide) is a new gastrointestinal motility regulation drug mainly used to treat functional dyspepsia (Functional Dyspepsia, FD). The drug was first developed in Japan and was approved for marketing in Japan in 2013. It was later promoted and used in Russia and other countries. Functional dyspepsia is a common gastrointestinal disorder with typical symptoms including upper abdominal fullness, early satiety, bloating after eating, and upper abdominal pain or discomfort. The original intention of developing acotiamide is to improve these non-organic digestive problems and improve gastric emptying and peristalsis functions by acting on neurotransmitter regulatory pathways.

The pharmacological mechanism of acotiamide is mainly based on its properties as a selective acetylcholinesterase (AChE) inhibitor. It increases the level of acetylcholine in the gastrointestinal tract by inhibiting the decomposition of acetylcholine, thereby enhancing the contraction ability of the smooth muscle of the gastric wall, promoting gastric emptying speed and improving gastric adaptive expansion. Unlike traditional prokinetic drugs, acotiamide has no significant effect on dopamine receptors or 5-HT receptors and is therefore less likely to cause extrapyramidal reactions or psychiatric symptoms. It is considered a safer and well-tolerated treatment option.

In patients with functional dyspepsia, long-term application of acotiamide can significantly relieve symptoms such as postprandial fullness, upper abdominal bloating, and eating discomfort, and improve the patient's quality of life. Overseas research also shows that acotiamide can not only regulate gastric motility, but also play a certain balancing role in the nerve reflexes of the gastric-brain axis, reducing gastric dysfunction caused by stress or anxiety. Due to the drug's good safety profile and durability of symptom improvement, more and more clinicians regard it as one of the first-line drugs for the treatment of FD.

At present, acotiamide has been widely used in Japan, Russia and other countries, but it has not yet been approved for marketing in mainland China. It represents a new direction in the drug treatment of functional dyspepsia and also brings new hope to patients with refractory gastric dysfunction.

Reference: https://www.rad-ar.or.jp/siori/english/search/result?n=33322