Tegaserod (Oral)

Generic name: tegaserod [ teg-a-SER-od ]
Brand name: Zelnorm
Drug class: Serotoninergic neuroenteric modulators

Uses for tegaserod

Tegaserod is used to treat irritable bowel syndrome with constipation (IBS-C) in women less than 65 years of age. Tegaserod increases the movement of stools (bowel movement) through the bowels. It also decreases pain and discomfort in the stomach area, bloating, and constipation. However, this medicine does not cure irritable bowel syndrome. If you stop using tegaserod, your symptoms may return in 1 to 2 weeks.

Tegaserod is also used to treat women younger than 55 years of age who have chronic constipation with an unknown cause.

This medicine was withdrawn from the U.S. market on March 30, 2007, due to an increased risk of heart attack, stroke, and worsening chest pain that can become a heart attack in patients treated with this medicine compared to placebo (sugar pills). On July 27, 2007, this medicine was made available under a restricted access program called treatment IND, however, as of April 2, 2008, this medicine is no longer available under a treatment IND, and is only available for use in emergency situations. For further information and to see if you qualify for treatment with tegaserod for emergency use, you should consult your doctor. Your doctor will then contact FDA's Division for Drug Information about the emergency IND process at druginfo@fda.hhs.gov.

This medicine is available only with your doctor's prescription and for use in emergency situations.

Before using tegaserod

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of tegaserod in the pediatric population. Safety and efficacy have not been established.

Geriatric

This medicine is not for use in women 65 years of age or older.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Abdominal adhesions (scar tissues that form on the organs in the stomach area), history of or
• Angina (chest pain), history of or
• Bowel blockage, history of or
• Gallbladder disease, history of or
• Heart attack, history of or
• Ischemic colitis (not enough blood flow to the bowels), history of or
• Kidney disease, severe (eg, end-stage kidney disease) or
• Liver disease, moderate or severe or
• Sphincter of Oddi dysfunction (muscle in the upper bowels that cannot contract and relax normally), suspected, history of or
• Stroke, including transient ischemic attack, history of—Should not be used in patients with these conditions.

• Depression or
• Heart disease—Use with caution. May make these conditions worse.

• Diabetes or
• Diarrhea, now or frequent or
• Hypertension (high blood pressure) or
• Hyperlipidemia (high amount of cholesterol in the blood) or
• Obesity—Use with caution. May increase risk for more side effects.

Proper use of tegaserod

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Take this medicine on an empty stomach, at least 30 minutes before meals.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For chronic constipation:
    • Adults—6 milligrams (mg) 2 times a day before meals. Your doctor will decide how long you should continue to take this medicine.
    • Children—Use and dose must be determined by your doctor.
  • For irritable bowel syndrome with constipation:
    • Adults 65 years of age and older—Should not be used in women within this age group.
    • Adults less than 65 years of age—6 milligrams (mg) 2 times a day before meals for 4 to 6 weeks.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using tegaserod

It is very important that your doctor check your progress at regular visits, especially during the first few weeks that you use this medicine, to make sure it is working properly. Blood and urine tests may be needed to check for unwanted effects.

Call your doctor if your symptoms do not improve or if they get worse.

This medicine may increase your risk of having a heart attack or stroke. Check with your doctor right away if you are having chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, trouble breathing, slurred speech, or weakness.

Check with your doctor right away if you have rectal bleeding, severe or bloody diarrhea, or new or worsening stomach pain. These may be symptoms of a serious condition called ischemic colitis (swelling and injury of the bowels caused by not enough blood flow to the bowels).

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

Do not take this medicine if you have diarrhea now or have diarrhea often.

Do not use this medicine if you are smoking.

Side Effects of tegaserod

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Diarrhea
• stomach pain

Less common

• Bleeding from the rectum
• bloody stools
• dizziness or lightheadedness
• feeling of constant movement of self or surroundings
• headache, severe and throbbing
• pale skin
• sensation of spinning
• troubled breathing with exertion
• unusual bleeding or bruising
• unusual tiredness or weakness

Rare

• Chest pain or discomfort
• confusion
• difficulty in speaking
• double vision
• headache
• inability to move the arms, legs, or facial muscles
• inability to speak
• nausea
• pain or discomfort in the arms, jaw, back, or neck
• slow speech
• sweating
• thoughts or attempts at killing oneself
• vomiting

Incidence not known

• Blurred vision
• confusion
• constipation
• cough
• dark urine
• difficulty swallowing
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast heartbeat
• hives, itching, skin rash
• indigestion
• light-colored stools
• new or worsening stomach pain
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• severe diarrhea
• severe nausea or vomiting
• stomach pain, usually after eating a meal
• stomach tenderness
• sweating
• tightness in the chest
• upper right abdominal pain
• yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Bloated, full feeling
• chills
• cold sweats
• confusion
• dizziness, faintness, or lightheadedness when getting up from lying or sitting position
• excess air or gas in the stomach or bowels
• headache
• passing gas

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Belching
• difficulty in moving
• heartburn
• increased appetite
• indigestion
• lack or loss of strength
• muscle pain or stiffness
• pain, swelling, or redness in the joints
• stomach discomfort or upset

Incidence not known

• Thinning or loss of hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Commonly used brand name(s)

In the U.S.

• Zelnorm

Available Dosage Forms:

• Tablet

Therapeutic Class: Gastrointestinal Agent

Pharmacologic Class: Serotonin Receptor Agonist, 5-HT4

Frequently asked questions

• Is Zelnorm back on the market?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer