Levosulpiride in the management of functional dyspepsia and delayed gastric emptying

Levosulpiride is a sulpiride isomer that exerts its prokinetic action through a dual mechanism: 1) as a D-2 dopamine receptor antagonist and 2) as a serotonin 5HT(4) receptor agonist, conferring this drug with a cholinergic effect. At a dosage of 25 mg three times daily, levosulpiride accelerates gastric and gallbladder emptying. Clinical trials have shown that this agent is more effective than placebo in reducing the symptoms of dyspepsia, while comparative studies have demonstrated that its effect is similar or superior to that of other dopamine antagonists. The safety profile of levosulpiride is good and the frequency of adverse events is similar to that of other D2 dopamine antagonists. Therefore, this drug is a useful therapeutic option in the management of patients with functional dyspepsia, as well as in those with delayed gastric emptying. (C) 2010 Elsevier Espana, S.L. All rights reserved.