Zelnorm

Generic Name: tegaserod (Oral route)

teg-a-SER-od

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

Uses For Zelnorm

Tegaserod is a medicine for short term treatment of women who have irritable bowel syndrome (IBS) with constipation (not enough or hard bowel movements) as their main bowel problem. Tegaserod is also used to treat women younger than 55 years of age who have chronic constipation with an unknown cause. Tegaserod increases the movement of stools (bowel movement) through the bowels. Tegaserod does not cure irritable bowel syndrome. Tegaserod decreases pain and discomfort in the abdominal area, bloating, and constipation. If you stop taking tegaserod your irritable bowel syndrome symptoms may return in one to two weeks.

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This medicine is available only for use in emergency situations.

This medicine was withdrawn from the U.S. market on March 30, 2007, due to a higher chance of heart attack, stroke, and worsening chest pain that can become a heart attack in patients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 .

Before Using Zelnorm

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

Studies on this medicine have been done only in adult patients and there is no specific information comparing the use of tegaserod in children and adolescents under the age of 18 with use in other age groups.

Geriatric

Many medicines have not been specifically studied in older people. Therefore it may not be known whether they work the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of tegaserod in older patients with use in other age groups for treatment of irritable bowel syndrome.

This medicine is not approved for patients 55 years of age or older .

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

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 or
  • Anxiety or
  • Bowel obstructions or intestinal blockage (or history of) or
  • Depression or
  • Diabetes or
  • Gallbladder disease or gallstones (or history of) or
  • Heart attack or stroke, history of or
  • High blood pressure or
  • Hyperlipidemia (high amount of cholesterol in the blood) or
  • Kidney disease or
  • Liver disease or
  • Obesity or
  • Sphincter of Oddi dysfunction (severe stomach pain with nausea and vomiting) or
  • Suicidal tendencies or
  • Unstable angina (chest pain at rest)—Tegaserod should not be used if you have any of these conditions .
  • Abdominal pain, new or sudden worsening of—Tegaserod should be stopped immediately.
  • Diarrhea—Serious side effects such as dizziness, lightheadedness, and dehydration can occur when using tegaserod. If you have any of these symptoms, notify your doctor immediately and stop taking this medicine. Tegaserod should not be used if you are currently experiencing or frequently experience diarrhea.

Proper Use of Zelnorm

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—Oral, 6 milligrams (mg) twice daily on an empty stomach shortly before you eat a meal. Your doctor will decide how long you should continue to take this medicine.
    • For irritable bowel syndrome:
      • Adults—Oral, 6 milligrams (mg) twice daily on an empty stomach shortly before you eat a meal. You will take tegaserod for 4 to 6 weeks. If you feel better your healthcare professional might want to continue the medicine for an additional 4 to 6 weeks.

Missed Dose

If you miss a dose of this medicine, 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 Zelnorm

Your doctor will want to check your progress at regular visits, especially during the first few weeks that you take this medicine.

It is important to check with your doctor or pharmacist if you are taking or plan to take any prescription or over-the-counter medicines while taking tegaserod.

Do not use this medicine if you are smoking .

It is very important to tell your healthcare professional immediately if you become pregnant.

You should consult your doctor if you experience severe diarrhea, or if the diarrhea is accompanied by severe cramping, abdominal pain, or dizziness. You should also consult your healthcare professional if you experience new or worsening abdominal pain.

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

This medicine may cause some people to become dizzy. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy.

Zelnorm Side Effects

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
  • Dizziness
  • feeling of warmth
  • itching skin
  • redness of the face, neck, arms and occasionally, upper chest
  • swelling or puffiness of face
Incidence not known
  • Black, tarry stools
  • bloody diarrhea
  • bloody stools
  • constipation
  • fainting
  • indigestion
  • nausea
  • new or worsening abdominal pain
  • rectal bleeding
  • severe stomach pain with nausea and vomiting
  • vomiting

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 stomach or intestines
  • 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 or rare
  • Back pain
  • disease or abnormality of the joint
  • headache, severe and throbbing
  • leg pain

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.

See also: Side effects (in more detail)

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