Irritable Bowel Syndrome (IBS)

Also known as: Irritable Bowel Syndrome(IBS) / Colon, Irritable / IBS / Irritable Bowel Syndrome / IBS - Irritable Bowel Syndrome / Irritable Colon / Colitis, Mucous / Irritable Bowel / Syndromes, Irritable Bowel / Colitis mucous / Mucous colitis / Irritable bowel syndrome NOS / Colon spastic / Spastic colon / Irritable colon syndrome / [X]Psychogenic IBS / Functional bowel syndrome

DrugDrug NameDrug Description
DB00321AmitriptylineAmitriptyline hydrochloride, also known as _Elavil_, is a tricyclic antidepressant (TCA) with analgesic properties, widely used to treat depression and neuropathic pain [A174658]. It was originally approved by the FDA in 1977 and manufactured by Sandoz [L5308].
DB00771ClidiniumClidinium is a synthetic anticholinergic agent which has been shown in experimental and clinical studies to have a pronounced antispasmodic and antisecretory effect on the gastrointestinal tract. It inhibits muscarinic actions of acetylcholine at postganglionic parasympathetic neuroeffector sites. It is used for the treatment of peptic ulcer disease and also to help relieve abdominal or stomach spasms or cramps due to colicky abdominal pain, diverticulitis, and irritable bowel syndrome.
DB01151DesipramineDesipramine hydrochloride is a dibenzazepine-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, desipramine does not affect mood or arousal, but may cause sedation. In depressed individuals, desipramine exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Secondary amine TCAs, such as desipramine and nortriptyline, are more potent inhibitors of norepinephrine reuptake than tertiary amine TCAs, such as amitriptyline and doxepine. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. See toxicity section below for a complete listing of side effects. Desipramine exerts less anticholinergic and sedative side effects compared to tertiary amine TCAs, such as amitriptyline and clomipramine. Desipramine may be used to treat depression, neuropathic pain (unlabeled use), agitation and insomnia (unlabeled use) and attention-deficit hyperactivity disorder (unlabeled use).
DB00804DicyclomineA muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms.
DB00424HyoscyamineHyoscyamine is a chemical compound, a tropane alkaloid it is the levo-isomer to atropine. It is a secondary metabolite of some plants, particularly henbane (Hyoscamus niger.) Hyoscyamine is used to provide symptomatic relief to various gastrointestinal disorders including spasms, peptic ulcers, irritable bowel syndrome, pancreatitis, colic and cystitis. It has also been used to relieve some heart problems, control some of the symptoms of Parkinson's disease, as well as for control of respiratory secretions in end of life care.
DB01046LubiprostoneLubiprostone is a medication used in the management of idiopathic chronic constipation. A prostaglandin E1 derivative, lubiprostone is a bicyclic fatty acid that activates ClC-2 chloride channels located on the apical side of the gastrointestinal epithelial cells. Activation of these channels promotes the secretion of a chloride-rich fluid that soften the stool, increase gastrointestinal motility, and induce spontaneous bowel movements (SBM).
DB00540NortriptylineNortriptyline hydrochloride, the N-demethylated active metabolite of amitriptyline, is a dibenzocycloheptene-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, nortriptyline does not affect mood or arousal, but may cause sedation. In depressed individuals, nortriptyline exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Secondary amine TCAs, such as nortriptyline, are more potent inhibitors of norepinephrine reuptake than tertiary amine TCAs, such as amitriptyline. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. Compared to other TCAs, nortriptyline is less toxic and displays less drug interactions [A6584]. As a more selective noadrenaline reuptake inhibitor, nortriptyline is less likely associated with the hypertensive ‘cheese reaction' [A6584]. Nortriptyline exerts less anticholinergic and sedative side effects compared to the tertiary amine TCAs, amitriptyline and clomipramine. Apart from its indication to treat depression, nortriptyline has been investigated in chronic neuropathic pain (unlabeled use), fibromyalgia [A31911], irritable bowel syndrome (unlabeled use), diabetic neuropathy (unlabeled use) [A31912], post-traumatic stress disorder (unlabeled use), and migraine prophylaxis (unlabeled use).
DB00715ParoxetineParoxetine hydrochloride and paroxetine mesylate belong to a class of antidepressant agents known as selective serotonin-reuptake inhibitors (SSRIs). Despite distinct structural differences between compounds in this class, SSRIs possess similar pharmacological activity. As with other antidepressant agents, several weeks of therapy may be required before a clinical effect is seen. SSRIs are potent inhibitors of neuronal serotonin reuptake. They have little to no effect on norepinephrine or dopamine reuptake and do not antagonize ⍺- or β-adrenergic, dopamine D2 or histamine H1 receptors. During acute use, SSRIs block serotonin reuptake and increase serotonin stimulation of somatodendritic 5-HT1A and terminal autoreceptors. Chronic use leads to desensitization of somatodendritic 5-HT1A and terminal autoreceptors. The overall clinical effect of increased mood and decreased anxiety is thought to be due to adaptive changes in neuronal function that leads to enhanced serotonergic neurotransmission. Side effects include dry mouth, nausea, dizziness, drowsiness, sexual dysfunction and headache (see Toxicity section below for a complete listing of side effects). Side effects generally occur during the first two weeks of therapy and are usually less severe and frequent than those observed with tricyclic antidepressants. Paroxetine hydrochloride and mesylate are considered therapeutic alternatives rather than generic equivalents by the US Food and Drug Administration (FDA); both agents contain the same active moiety (i.e. paroxetine), but are formulated as different salt forms. Clinical studies establishing the efficacy of paroxetine in various conditions were performed using paroxetine hydrochloride. Since both agents contain the same active moiety, the clinical efficacy of both agents is thought to be similar. Paroxetine may be used to treat major depressive disorder (MDD), panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), social anxiety disorder (social phobia), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and premenstrual dysphoric disorder (PMDD). Paroxetine has the most evidence supporting its use for anxiety-related disorders of the SSRIs. It has the greatest anticholinergic activity of the agents in this class and compared to other SSRIs, paroxetine may cause greater weight gain, sexual dysfunction, sedation and constipation.
DB09090PinaveriumPinaverium is a spasmolytic agent used for functional gastrointestinal disorders. It is a quaternary ammonium compound that acts as an atypical calcium antagonist to restore normal bowel function. It is shown to relieve GI spasm and pain, transit disturbances and other symptoms related to motility disorders [A19697] and may be considered as effective first-lline therapy for patients with irritable bowel syndrome (IBS) [A19702]. Pinaverium bromide is the common ingredient in formulations, mostly as oral tablets. Although it is not a currently approved drug by the FDA, pinaverium is available in over 60 countries including Canada.
DB01220RifaximinRifaximin is a semisynthetic, rifamycin-based non-systemic antibiotic, meaning that the drug will not pass the gastrointestinal wall into the circulation as is common for other types of orally administered antibiotics. It has multiple indications and is used in treatment of traveller's diarrhea caused by E. coli; reduction in risk of overt hepatic encephalopathy recurrence; as well as diarrhea-predominant irritable bowel syndrome (IBS-D) in adult women and men. It is marketed under the brand name Xifaxan by Salix Pharmaceuticals.
DB09089TrimebutineTrimebutine is a spasmolytic agent that regulates intestinal and colonic motility and relieves abdominal pain with antimuscarinic and weak mu opioid agonist effects. It is marketed for the treatment of irritable bowel syndrome (IBS) and lower gastrointestinal tract motility disorders, with IBS being one of the most common multifactorial GI disorders [A19691]. It is used to restore normal bowel function and is commonly present in pharmaceutical mixtures as trimebutine maleate salt form. Trimebutine is not a FDA-approved drug, but it is available in Canada and several other international countries.
DrugDrug NameTargetType
DB00321AmitriptylineSodium-dependent serotonin transportertarget
DB00321AmitriptylineSodium-dependent noradrenaline transportertarget
DB00321AmitriptylinePotassium voltage-gated channel subfamily KQT member 2target
DB00321AmitriptylineAlpha-2A adrenergic receptortarget
DB00321AmitriptylineCytochrome P450 1A2enzyme
DB00321AmitriptylineCytochrome P450 2C19enzyme
DB00321AmitriptylineCytochrome P450 2D6enzyme
DB00321AmitriptylineSerum albumincarrier
DB00321AmitriptylineAlpha-1-acid glycoprotein 1carrier
DB00321AmitriptylineHistamine H1 receptortarget
DB00321Amitriptyline5-hydroxytryptamine receptor 2Atarget
DB00321Amitriptyline5-hydroxytryptamine receptor 1Atarget
DB00321AmitriptylineAlpha-1A adrenergic receptortarget
DB00321AmitriptylineCytochrome P450 3A4enzyme
DB00321AmitriptylineCytochrome P450 3A5enzyme
DB00321AmitriptylinePotassium voltage-gated channel subfamily A member 1target
DB00321AmitriptylineAlpha-1D adrenergic receptortarget
DB00321AmitriptylineDelta-type opioid receptortarget
DB00321AmitriptylineKappa-type opioid receptortarget
DB00321AmitriptylineHigh affinity nerve growth factor receptortarget
DB00321AmitriptylineBDNF/NT-3 growth factors receptortarget
DB00321AmitriptylineCytochrome P450 2C9enzyme
DB00321AmitriptylineCytochrome P450 2B6enzyme
DB00321AmitriptylineCytochrome P450 2C8enzyme
DB00321AmitriptylineHistamine H2 receptortarget
DB00321AmitriptylineHistamine H4 receptortarget
DB00321AmitriptylineSigma non-opioid intracellular receptor 1target
DB00321Amitriptyline5-hydroxytryptamine receptor 2Ctarget
DB00321AmitriptylineAlpha-1B adrenergic receptortarget
DB00321Amitriptyline5-hydroxytryptamine receptor 7target
DB00321Amitriptyline5-hydroxytryptamine receptor 1Dtarget
DB00321AmitriptylineMu-type opioid receptortarget
DB00321Amitriptyline5-hydroxytryptamine receptor 1Btarget
DB00321Amitriptyline5-hydroxytryptamine receptor 6target
DB00321AmitriptylinePotassium voltage-gated channel subfamily KQT member 3target
DB00321AmitriptylineUDP-glucuronosyltransferase 1-1enzyme
DB00321Amitriptyline5-hydroxytryptamine receptor 1Ctarget
DB00321AmitriptylineMuscarinic acetylcholine receptortarget
DB00321AmitriptylineHERG human cardiac K+ channeltarget
DB00321AmitriptylineMultidrug resistance protein 1transporter
DB00771ClidiniumMuscarinic acetylcholine receptor M1target
DB01151DesipramineMuscarinic acetylcholine receptor M1target
DB01151DesipramineSodium-dependent noradrenaline transportertarget
DB01151DesipramineBeta-2 adrenergic receptortarget
DB01151DesipramineMuscarinic acetylcholine receptor M2target
DB01151DesipramineSodium-dependent serotonin transportertarget
DB01151DesipramineHistamine H1 receptortarget
DB01151DesipramineBeta-1 adrenergic receptortarget
DB01151DesipramineCytochrome P450 2D6enzyme
DB01151DesipramineMuscarinic acetylcholine receptor M3target
DB01151DesipramineMuscarinic acetylcholine receptor M4target
DB01151DesipramineMuscarinic acetylcholine receptor M5target
DB01151DesipramineAlpha-1 adrenergic receptorstarget
DB01151Desipramine5-hydroxytryptamine receptor 2Atarget
DB01151DesipramineAlpha-1-acid glycoprotein 1carrier
DB01151DesipramineCytochrome P450 2B6enzyme
DB01151DesipramineCytochrome P450 3A4enzyme
DB01151DesipramineSolute carrier family 22 member 2transporter
DB01151DesipramineSolute carrier family 22 member 1transporter
DB01151DesipramineSolute carrier family 22 member 3transporter
DB01151DesipramineSolute carrier family 22 member 5transporter
DB01151DesipramineMultidrug resistance protein 1transporter
DB01151DesipramineSolute carrier family 22 member 4transporter
DB01151DesipramineCytochrome P450 1A2enzyme
DB01151DesipramineCytochrome P450 2A6enzyme
DB01151DesipramineCytochrome P450 2C18enzyme
DB01151DesipramineCytochrome P450 2C19enzyme
DB01151DesipramineCytochrome P450 2E1enzyme
DB01151DesipramineSphingomyelin phosphodiesterasetarget
DB01151Desipramine5-hydroxytryptamine receptor 1Atarget
DB01151Desipramine5-hydroxytryptamine receptor 2Ctarget
DB01151DesipramineD(2) dopamine receptortarget
DB01151DesipramineAlpha-2 adrenergic receptorstarget
DB00804DicyclomineMuscarinic acetylcholine receptor M1target
DB00804DicyclomineMuscarinic acetylcholine receptor M2target
DB00804DicyclomineCytochrome P450 1A1enzyme
DB00424HyoscyamineMuscarinic acetylcholine receptor M1target
DB00424HyoscyamineMuscarinic acetylcholine receptor M2target
DB00424HyoscyamineMuscarinic acetylcholine receptor M3target
DB00424HyoscyamineMuscarinic acetylcholine receptor M4target
DB01046LubiprostoneChloride channel protein 2target
DB01046LubiprostoneCarbonyl reductase [NADPH] 1enzyme
DB00540NortriptylineSodium-dependent serotonin transportertarget
DB00540NortriptylineSodium-dependent noradrenaline transportertarget
DB00540NortriptylineCytochrome P450 1A2enzyme
DB00540NortriptylineCytochrome P450 2D6enzyme
DB00540NortriptylineSerum albumincarrier
DB00540NortriptylineAlpha-1-acid glycoprotein 1carrier
DB00540NortriptylineHistamine H1 receptortarget
DB00540NortriptylineMuscarinic acetylcholine receptor M1target
DB00540NortriptylineMuscarinic acetylcholine receptor M2target
DB00540NortriptylineMuscarinic acetylcholine receptor M3target
DB00540NortriptylineMuscarinic acetylcholine receptor M4target
DB00540NortriptylineMuscarinic acetylcholine receptor M5target
DB00540Nortriptyline5-hydroxytryptamine receptor 2Atarget
DB00540NortriptylineAlpha-1A adrenergic receptortarget
DB00540Nortriptyline5-hydroxytryptamine receptor 1Atarget
DB00540NortriptylineCytochrome P450 3A4enzyme
DB00540NortriptylineCytochrome P450 3A5enzyme
DB00540NortriptylineAlpha-1D adrenergic receptortarget
DB00540NortriptylineCytochrome P450 2C19enzyme
DB00540NortriptylineProstaglandin G/H synthase 1enzyme
DB00540NortriptylineCytochrome P450 2E1enzyme
DB00540Nortriptyline5-hydroxytryptamine receptor 2Ctarget
DB00540Nortriptyline5-hydroxytryptamine receptor 6target
DB00540NortriptylineAlpha-1B adrenergic receptortarget
DB00540NortriptylineAlpha-2 adrenergic receptorstarget
DB00540NortriptylineBeta adrenergic receptortarget
DB00540NortriptylineD(2) dopamine receptortarget
DB00540NortriptylineSigma receptortarget
DB00540Nortriptyline5-hydroxytryptamine receptor 1Ctarget
DB00715ParoxetineSodium-dependent serotonin transportertarget
DB00715ParoxetineSodium-dependent noradrenaline transportertarget
DB00715Paroxetine5-hydroxytryptamine receptor 2Atarget
DB00715ParoxetineCytochrome P450 2D6enzyme
DB00715ParoxetineMuscarinic acetylcholine receptor M1target
DB00715ParoxetineMuscarinic acetylcholine receptor M2target
DB00715ParoxetineMuscarinic acetylcholine receptor M3target
DB00715ParoxetineMuscarinic acetylcholine receptor M4target
DB00715ParoxetineMuscarinic acetylcholine receptor M5target
DB00715ParoxetineCytochrome P450 2C9enzyme
DB00715ParoxetineMultidrug resistance protein 1transporter
DB00715ParoxetineCytochrome P450 2B6enzyme
DB00715ParoxetineCytochrome P450 2C8enzyme
DB00715ParoxetineCytochrome P450 1A2enzyme
DB00715ParoxetineCytochrome P450 3A4enzyme
DB09090PinaveriumVoltage-dependent L-type calcium channel subunit alpha-1Starget
DB09090PinaveriumCytochrome P450 3A4enzyme
DB01220RifaximinDNA-directed RNA polymerase subunit betatarget
DB01220RifaximinNuclear receptor subfamily 1 group I member 2target
DB01220RifaximinCytochrome P450 3A4enzyme
DB01220RifaximinCytochrome P450 2C19enzyme
DB01220RifaximinCytochrome P450 2C8enzyme
DB01220RifaximinCytochrome P450 2D6enzyme
DB09089TrimebutineMu-type opioid receptortarget
DB09089TrimebutineVoltage-dependent L-type calcium channeltarget
DB09089TrimebutineCalcium-activated potassium channeltarget
DB09089TrimebutineVoltage-dependent T-type calcium channeltarget
DB09089TrimebutineMuscarinic acetylcholine receptor M1target
DB09089TrimebutineMuscarinic acetylcholine receptor M2target
DB09089TrimebutineMuscarinic acetylcholine receptor M3target
DB09089TrimebutineMuscarinic acetylcholine receptor M4target
DB09089TrimebutineCytochrome P450 3A4enzyme
DrugDrug NamePhaseStatusCount
DB12853DA-68861Unknown Status1
DB12467TU-1001 / 2Completed1
DB05269Activated charcoal2Completed1
DB09278Activated charcoal2Completed1
DB11082Coal tar2Recruiting1
DB11074Dimethicone2Not Yet Recruiting1
DB00540Nortriptyline2Not Yet Recruiting1
DB11058Petrolatum2Not Yet Recruiting1
DB01323St. John's Wort2Completed1
DB05049DDP7332 / 3Unknown Status1
DB04465Lactose2 / 3Completed1
DB00244Mesalazine2 / 3Completed1
DB00141N-Acetylglucosamine2 / 3Recruiting1
DB01220Rifaximin2 / 3Recruiting2
DB09089Trimebutine2 / 3Completed1
DB00173Adenine4Unknown Status1
DB14222Bifidobacterium longum infantis4Completed1
DB13147Pancrelipase lipase4Completed1
DB00806Pentoxifylline4Unknown Status1
DB01220Rifaximin4Not Yet Recruiting1
DB00321AmitriptylineNot AvailableNot Yet Recruiting1
DB11121ChloroxylenolNot AvailableRecruiting1
DB01151DesipramineNot AvailableActive Not Recruiting1
DB00424HyoscyamineNot AvailableRecruiting1
DB08890LinaclotideNot AvailableEnrolling by Invitation1
DB01046LubiprostoneNot AvailableCompleted1
DB09567Olive oilNot AvailableCompleted1
DB02959OxitriptanNot AvailableCompleted1
DB09090PinaveriumNot AvailableActive Not Recruiting1
DB09090PinaveriumNot AvailableUnknown Status1
DB01220RifaximinNot AvailableCompleted2