The preparation Alosetron acts on tissue hormones from the group of serotonins, which are mainly found in the human digestive tract and here control the transport of stool through the intestine. The active ingredient is only administered in the USA under strict conditions to patients with severe irritable bowel syndrome. The reason: Serious side effects are possible, which is why the preparation was withdrawn from the market for a few months.
What is alosetron?
The drug alosetron belongs to the group of setrons, although it differs from these in terms of its effect. While Setrone is commonly used during tumor chemotherapy or radiation therapy, as well as post-operative nausea and vomiting, alosetron is used in the United States to treat irritable bowel syndrome.
In some patients with fibromyalgia syndrome, pain can also be relieved to some extent. Alosetron was initially approved in the USA at the beginning of 2000, but was temporarily withdrawn from the market after nine months due to serious side effects. In mid-2002, the active ingredient was re-launched on the market under the trade name Lotronex with restricted approval.
Pharmacological effect
Alosetron is a selective inhibitor that acts on the serotonin receptors. These appear particularly frequently in the human organism in the gastrointestinal tract. Like all active ingredients from this group of substances, alosetron initially works against vomiting.
The preparation also causes the stool to move more slowly through the intestinal tract. Serotonin is a tissue hormone that occurs primarily in the central nervous system, in the cardiovascular system and in the intestinal nervous system. This hormone affects not only the gastrointestinal tract, but also blood pressure and the transmission of signals in the central nervous system.
The hormone has sensory and motor functions in the gastrointestinal tract. On the one hand, the intestine reacts directly to serotonin, on the other hand it takes on a function as a neurotransmitter. Serotonin, which is released in the intestinal mucosa, activates various neurons. These then play together, whereupon the wave of contraction and subsequent relaxation arises, which moves the stool through the intestine towards the anus.
In its sensory function, serotonin transmits complaints from the digestive system to the brain and can cause nausea and vomiting without a specific cause for these complaints being identified.
Medical application & use
Alosetron is given in the United States under certain conditions to women who have severe irritable bowel syndrome. One of the prerequisites is that you have had the symptoms - especially diarrhea - for at least six months and that you do not respond to other treatment methods.
In addition, their digestive tract must not have any biochemical or anatomical anomalies. Doctors who want to administer the preparation must register in a so-called prescribing register of the manufacturer and conclude a written agreement with their patient. Irritable bowel syndrome is a range of functional bowel diseases that can mimic symptoms of various other bowel diseases.
Because irritable bowel syndrome is inherently harmless, long-lasting diarrhea is the key symptom for prescribing Alosetron. The reason: Because the stool is too fluid in diarrhea, long-term diarrhea can lead to a large loss of fluids and electrolytes. This is dangerous for the affected patients because electrolytes such as sodium, magnesium, calcium or phosphate play an important role in the proper functioning of the cells in the body.
Risks & side effects
About a third of patients treated with Alosetron complain of constipation. So you can empty the bowel less than three times a week. Common side effects also include stomach pain, malaise, and nausea.
About two per thousand of all patients who complain of side effects lead to severe constipation, which makes surgical intervention necessary. Ischemic bowel inflammation is also possible. This term describes various inflammations in the colon or colon, which can be acute or chronic. These are often associated with slimy, bloody diarrhea and in extreme cases can even lead to death if this side effect is not treated as quickly as possible.
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