What type of diarrhea does Xermelo treat?
Xermelo (telotristat ethyl) is a tablet used to treat carcinoid syndrome diarrhea. It is taken in combination with somatostatin analog therapy, when this type of therapy by itself does not adequately control the diarrhea.
What is carcinoid syndrome?
Carcinoid syndrome is a syndrome that can develop in people with carcinoid tumors - a type of cancer - in their gastrointestinal (GI) tract. Some of these tumors release substances into the bloodstream which causes carcinoid syndrome. The symptoms of carcinoid syndrome include:
- Severe diarrhea
- Facial flushing
- Wheezing
- Rapid heartbeat
Stress, drinking alcohol and heavy exercise can make these symptoms worse.
Carcinoid syndrome diarrhea causes multiple watery, loose stools each day
People with carcinoid syndrome diarrhea may have considerable urgency associated with each loose stool.
Carcinoid syndrome diarrhea is primarily caused by excess serotonin secreted by carcinoid tumors. Serotonin is important for normal gut function, but in people with carcinoid syndrome diarrhea, excessive amounts of serotonin can cause the series of wave-like of contractions in the gut (peristalsis) to significantly increase, which reduces water and electrolyte absorption and leads to diarrhea.
How does Xermelo work to stop carcinoid syndrome diarrhea?
Xermelo is a tryptophan hydroxylase inhibitor. Tryptophan hydroxylase is an enzyme involved in the synthesis of serotonin. By inhibiting this enzyme the overproduction of serotonin is reduced, which helps to prevent the diarrhea.
References
- Food and Drug Administration (FDA). Xermelo. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208794s001lbl.pdf. [Accessed March 5, 2021].
- American Cancer Society. Signs and Symptoms of Gastrointestinal Carcinoid Tumors. September 24, 2018. Available from: https://www.cancer.org/cancer/gastrointestinal-carcinoid-tumor/detection-diagnosis-staging/signs-symptoms.html. [Accessed March 5, 2021].
- Naraev BG, Halland M, Halperin DM, Purvis AJ, OʼDorisio TM, Halfdanarson TR. Management of Diarrhea in Patients With Carcinoid Syndrome. Pancreas. 2019;48(8):961-972. doi:10.1097/MPA.0000000000001384.
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Drug information
Related support groups
- Telotristat (1 questions, 3 members)
- Xermelo (1 questions, 3 members)
- Carcinoid Syndrome Diarrhea (1 questions, 3 members)