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A phase 2b trial found that naronapride, a dual-action prokinetic drug, significantly reduced core gastroparesis symptoms at 20 mg and 40 mg doses taken three times daily compared to placebo. Quality of life also improved meaningfully at those doses. The drug was generally well tolerated, with no cardiac or blood sugar safety concerns flagged.
Gastroparesis — a condition where the stomach empties too slowly, causing nausea, bloating, and abdominal pain — has long lacked effective treatment options. A new phase 2b trial is offering some hope: naronapride, an investigational drug that stimulates serotonin receptors to boost gut motility while blocking dopamine receptors to ease nausea, outperformed placebo in a 12-week study of 328 adults with idiopathic or diabetic gastroparesis.
Participants taking 20 mg or 40 mg three times daily saw significantly greater reductions in core symptom scores and meaningful improvements in quality of life — covering daily activities, diet, and psychological well-being. The 10 mg dose didn't hit statistical significance. Side effects were mostly gastrointestinal (diarrhea being the most common), and discontinuation rates were higher with naronapride than placebo (9.9% vs. 2.4%), though no cardiac or prolactin-related safety signals emerged.
By the Numbers:
Why it matters: Gastroparesis is notoriously difficult to treat, with few approved therapies. Naronapride's dual mechanism and clean safety profile — especially the absence of cardiac or glycemic concerns — make it a compelling candidate to watch as it moves toward later-stage trials.
