Trial of Itopride 150mg Once a Day Versus Itopride 50 mg Thrice a Day; in Patients With Functional Dyspepsia

Inclusion Criteria:

1. Adult male and/or non-pregnant non-lactating female subjects aged above 18 years.

2. Subjects provided written informed consent and are willing to participate in thestudy.

3. Subjects with functional (non-ulcer) dyspepsia according to Rome IV criteriaincluding postprandial distress syndrome (PDS) and with or without EPS (epigastricpain syndrome) with one or more of the following:

• bothersome postprandial fullness,

• bothersome early satiation

• bothersome epigastric pain,

• bothersome epigastric burning for at least 12 weeks in the preceding 6 months

4. No evidence of organic, systemic, metabolic or structural disease likely to explainsymptoms - Subjects who have to undergone physical examination and lab tests (including white-cell and red-cell counts, measurement of fasting blood sugar andliver-function tests), abdominal ultrasonography, and upper GI endoscopy* in orderto rule out structural cause for symptoms of FD.

*history of upper GI endoscopy within 6 months prior to enrolment or at screening.

5. Baseline severity of at least moderate symptoms on LDQ (total score ≥ 9) atscreening.

6. H. pylori negative documented test report within 3 months prior to enrolment orduring screening.

Exclusion Criteria:

1. Known hypersensitivity to Itopride or any component of the formulation and to anyother related drug.

2. Subject with history or presence of clinically relevant evidence of cardiovascular,neurological, gastrointestinal/hepatic, renal, psychiatric, respiratory, urogenital,hematologic/immunologic, HEENT (head, ears, eyes, nose, throat), dermatological/connective tissue, musculoskeletal, metabolic/nutritional, drug hypersensitivity,allergy, endocrine, major surgery or other relevant disease as revealed by medicalhistory requiring treatment which at investigator's discretion might interfere withthe study.

3. Subjects who cannot be treated with Itopride in line with the prescribinginformation.

4. Subjects scheduled for surgery during the study.

5. Subjects with a history of difficulty in swallowing.

6. Subject requiring concomitant treatment with anticholinergic drugs, drugs withnarrow therapeutic index, sustained release or enteric-coated formulations.

7. Subjects taking Acid release inhibitors (e.g. histamine-2-receptor [H2]-antagonists, proton pump inhibitors [PPI], or potassium-competitive acid blockers),antacids (e.g. aluminium- or magnesium hydroxide, sodium bicarbonate), gastricmucosa protectors (e.g. sucralfate, rebamipide).

8. Subject with history of unusual bleeding and family history for bleeding disorders.

9. Subjects with only reflux-related symptoms or who have predominantly reflux-relatedsymptoms.

10. Subjects with esophagitis, Barrett's esophagus, erosions or peptic ulcer diseasewithin one year prior to the study or Zollinger-Ellison Syndrome.

11. Dyspepsia that is exclusively relieved by defecation or associated with a change instool frequency or stool form to exclude IBS.

12. Clinically significant ECG abnormalities.

13. Subjects treated with Itopride or any other gastroprokinetic within 4 weeks prior toscreening.

14. Subjects who took non-steroidal anti-inflammatory drugs for more than 2 weeks priorto screening

15. Subjects with refractory FD1 (defined as FD presenting symptoms continuing for atleast 6 months, unresponsive to at least two medical treatments such as PPIs,prokinetics, or H. pylori eradication) as per investigator's discretion

16. History of or known inflammatory bowel disease (IBD) or coeliac disease.

17. History of or known severe hepatic, renal, pancreatic, cardiac, metabolic,hematological or malignant disease or trimethylaminuria.

18. Subjects with changed smoking status within the last three months.

19. History of or known GI malignancy or ulcers associated to malignancy or any alarmfeatures for GI malignancy, e.g. GI bleeding.

20. Subjects who do not meet the criteria stated in concomitant medication section.

21. Subjects with history of severe depression, anxiety or other psychologicaldisorders.

22. Females with child-bearing potential must agree to use an acceptable method ofcontraception during the study.

23. Subjects in whom an increase in gastrointestinal motility could be harmful, e.g., (history of) gastrointestinal hemorrhage, mechanical obstruction or perforation.

24. Specific food intolerance which is relieved by diet modifications (e.g. lactoseintolerance, celiac disease).

25. Subjects with confirmed IBS as per Rome IV criteria.

26. Current alcohol or drug abuse.

27. History of abdominal surgery except appendectomy, cholecystectomy or hysterectomy,tubal ligations, bladder slings or vasectomies.

28. Hepatic cirrhosis or abnormal liver laboratory findings (defined as >3xULN of ALT orAST).

29. Subjects under hemodialysis therapy or having advanced chronic kidney disease (defined as eGFR <60 mL/min).

30. History of or known congestive heart failure NYHA class III and IV, or any otheruncontrolled chronic diseases, such as: uncontrolled hypertension (systolic/diastolic blood pressure ≥160/100 mmHg); uncontrolled diabetes (HbA1c >8%).

31. Subjects currently being known to be afflicted by serious infection(s), or any knownsevere illness(es) which are judged by the investigator could interfere withsubjects' safety and/or study evaluation.