Erythromycin accelerates gastric emptying in gastroparesis patients by binding to motilin receptors. This binding mimics the action of motilin, a naturally occurring hormone that stimulates gastric motility. The resulting increased motility helps move food through the stomach more quickly, alleviating symptoms such as nausea, vomiting, and bloating.
Specific Receptor Interactions
It’s important to understand that erythromycin’s interaction with motilin receptors isn’t as potent as motilin itself. The drug acts as a partial agonist, meaning it stimulates the receptors to a lesser degree than the endogenous hormone. This partial agonism likely contributes to its generally well-tolerated side effect profile compared to other prokinetic agents.
Dosage Considerations and Clinical Relevance
Clinicians typically prescribe low doses of erythromycin for gastroparesis, precisely because higher doses could lead to increased side effects, such as diarrhea. The low dose strategy focuses on leveraging its motilin receptor-agonist properties without inducing excessive gastrointestinal distress. Individual patient responses vary, necessitating careful monitoring and dose adjustments.
