GI motility regulator, peripheral opioid receptor agonist
ATC code: A03AA05 (Trimebutine)
An agonist of peripheral enkephalinergic μ, κ, and δ receptors within the enteric nervous system. Modulates motility according to baseline state: increases it in hypokinesia and decreases it in hyperkinesia. No central opioid effect – does not cross the blood-brain barrier and produces no dependence or analgesia.
Second line
Used in irritable bowel syndrome with mixed or variable bowel pattern. Evidence is modest: the 2011 Cochrane meta-analysis showed moderate benefit over placebo for symptom relief (RR 1.32, 95% CI 1.07–1.64), with low-quality studies. International guidelines ( 2021, 2022) do not include it; it is used mostly in Spain, France, and Eastern Europe.
Second line
In functional dyspepsia, trimebutine did not show benefit over placebo in large trials. Used as an add-on when dyspepsia coexists with motility disturbance.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Limited pregnancy data. Avoid in T1 where possible.
Milk excretion data are limited. Prefer alternatives with more data when feasible.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Trimebutine is evaluated for the following indications with varying evidence strength: Irritable bowel syndrome (evidence tier C), Functional dyspepsia (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Trimebutine (≥ 1 in 100): Dry mouth, Nausea, Hearing disturbances (rare), Skin rash. See the Safety section for uncommon and serious reactions.
FDA category C. Limited pregnancy data. Avoid in T1 where possible.
Milk excretion data are limited. Prefer alternatives with more data when feasible.
Trimebutine is contraindicated in: Trimebutine hypersensitivity; Age under 3 years (tablets). Full list in the Safety section.