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tegaserod

5HT4 partial agonist · Prokinetic agent

5HT4 partial agonistProkinetic agentATC A03AE02
CDSCO approvedATC A03AE02
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Tegaserod is an aminoguanidine indole that acts as a partial 5HT4 agonist. It stimulates motility and accelerates transit in the esophagus, stomach, small bowel, and ascending colon, and stimulates Cl– secretion.

Indications

Constipation-predominant IBS (in women under 65 who fail first-line therapies)IBS with mixed bowel habits (in female patients who fail other therapies)

Dosing

Adult
6 mg orally, twice a day and 30 min before meals. Discontinue if adequate symptom control not obtained in 4 to 6 weeks.

Pharmacokinetics

Peak effect
About 1 h
Half-life
5 to 8 h
Metabolism
Hydrolysis and direct glucuronidation
Excretion
Primarily in feces as unchanged drug; remainder in urine as metabolites

Contraindications

  • History of myocardial infarction
  • Stroke
  • Transient ischemic attacks
  • Angina
  • Ischemic colitis
  • Severe renal impairment
  • Moderate or severe hepatic impairment
  • Bowel obstruction
  • Gallbladder disease

Side effects

Common
DiarrheaHeadacheAbdominal painNauseaFlatulenceDyspepsiaDizziness
Serious
  • Volume depletion, hypotension, and syncope associated with diarrhea
  • Suicidal ideation (warning, based on clinical trials)
  • Ischemic colitis

Related guidelines

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Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team