# Any news of a new "Zelnorm" drug? 5-HT4?



## Nojokeibs (Apr 14, 2014)

Hello, I'm new and have been recently looking for alternatives to Zelnorm in the USA. I've been scouring the PubMed, the forums, both here and elsewhere, and I'm not really sure what if anything is available that has the same or similar mode of action.

Background: When Zelnorm came out, my GI doc was excited because he could finally treat me properly not with some silly laxative. He was like "This is new, so tell me what you think." Well, it fixed it totally, instantly and forever... until the horrid FDA pulled it off the market. I went to see my doctor... he said "Unfortunately, there aren't any similar alternatives." Oh great.

So for 8 wonderful months, I was pain free, constipation free, and everything was ducky. There was no diarrhea, no headaches, no side effects of any kind at all for me. It was the perfect solution for my case. And I've been constipated since I was a child probably because I had major abdominal surgery when I was a kid and am full of adhesions.

My gyno and I talked about surgery to remove adhesions... laparoscopy... etc... but in the end, I was back to laxatives and stool softeners. Junk science. And don't get me started on the fraud of fiber. Nothing plugs me up faster.

I've been fighting back with natural therapies, exercise, hot tubs (not a bad therapy really), swimming, sunshine, citrus peels, ginger, even nicotine gum (admittedly not natural, but at least it's not smoking and it works for me). I've changed my diet until you'd have to be a rocket scientist to hold the details all in your mind at once - but it works... mostly. Still, nobody should have to cut out quite this much of the normal diet just to poop normally. It's one thing to give up wheat and dairy...it's another to add to that high fodmap foods, anything processed or packaged, anything fried or even browned, concentrated starch of any sort (forget having tapioca, rice and potato bread, I can't digest it), and individual problem foods...

With Zelnorm I felt like part of the human race. Now I feel like a pathetic whiner always bellyaching, because I am in pain if I eat almost anything.

So I know one of the possible alternatives to Zelnorm was killed by the FDA because they couldn't be bothered to take a look at the paperwork fast enough... they kept delaying until all the finances of the company dried up... but have any others cropped up since then? Is it worth going to the GI doctor? Or is it still stool softeners and laxatives? I'd really like something that is 5-HT4 based or at least 5-HT3.

I did try LInzess, and it worked for a week at the 290 dose. It was my GP who gave it to me. Afterward though, I couldn't squeeze anything out. So unless a GI doctor has something wonderful to tell me about Linzess that I didn't know (like, it only works if you take B6, or you must combine it with drug X to make it really work...), I'm not really beating a path to his door yet.

Please please tell me there is a new alternative to Zelnorm out there. Even if it's only for Europeans, I'd like to know about it. Thanks!


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## annie7 (Aug 16, 2002)

have you heard of prucalopride--resolor. it is a selective high affinity 5-HT4 receptor agonist. it has been approved in the UK, europe, australia and other countries and also in canada (in canada it's called restoran). it works much like zelnorm but with a better safety profile. google it for more info.

i have read success stories from people who have tried it. if your doc will write you a script for it you can get it from canadadrugs.com. they carry it and will ship the usa. of course as they say one should always be careful when ordering from a foreign online pharm but the people i know who have ordered from them are very please with the service. i plan to ask my gastro about a script next time i see him.

https://www.canadadrugs.com/products/resolor/2mg/31821


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## Nojokeibs (Apr 14, 2014)

Wow, that's so awesome, is there a petition I could sign to get the FDA to get off it's duff?

At 4.95/pill, even with the exchange rate... pretend it's $4/pill x 30, that's $120/month + shipping. Ouch.

I've paid that much for drugs, but not often. Anyway, this kind of thing shouldn't be just for the rich. We should pull together on this and get the FDA to approve it for all of us.

Thanks for the info, annie7


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## annie7 (Aug 16, 2002)

also--you can still get zelnorm--the real thing made by novartis--in mexico. online it's available from medsmex.com. in mexico it's sold under the name zelmac.

http://www.medsmex.com/store/product.php?productid=4363&cat=&page=1

hopefully the link went through--otherwise just search their site for zelnorm.

BUT --a big but--be very careful when ordering from medsmex. years ago when the FDA yanked zelnorm some of us here on the board started ordering it from medsmex. and medsmex hacked into our credit card numbers and we were all hit with fraudulent charges. so we started ordering from them using safer methods of payment like visa gift cards--with a set amount on them-- or in my case, my bank of amercia credit card has a special "shop safe" program.

i haven't ordered zelnorm from medsmex in several years although i do know of a few people who still do. if you live close to the border you could just try going over there and seeing if other mexican pharms carry it.


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## kc99 (Jun 7, 2007)

I am not sufficiently aware of what's going on to know if the prucalopride delay is due to FDA or other issues. However, just as an FYI on the FDA side, they do have this webpage that invites patient engagement:

http://patientnetwork.fda.gov/

...just in case that's of interest to anyone.


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## Nojokeibs (Apr 14, 2014)

Hmm, wasn't working until I removed the www... I did write to them, and thanks for the heads up! Maybe we should all write.

My letter... so that others may model their own letter based on it...

Obviously, you should put your own medical history in there and not just copy paste exactly. But it's a start:

To: *patientnetwork (at) fda.hhs.gov*

===============================

I have suffered from IBS-C (severe constipation) all of my
life. Literally, since I was a small child, before I could speak, my parents were forced
to give me suppositories and I would wake in the night with agonizing abdominal pain that
often led to humiliating enemas which were not always effective. In the end, it was discovered I had a physical malformity in my abdomen that was easy to fix, but had to be done surgically. Thus, at
age 3 and 1/2, I had open abdominal surgery. I am alive today because of that surgery, but during a later surgery, a laparoscopy, it was discovered that I had adhesions. They were lysed.

After the adhesions were removed, the IBS-C went into remission for a long time. However,
surgery for adhesions is not an approved proceedure because it can simply be an endless
cycle of surgery. That's fine. However, when Zelnorm was approved, I was one of the
first that my doctor thought of for it. It worked and for the first time, I had normal
bowel movements. Not diarrhea, just perfectly normal. I felt human, I could eat
normally, not a franken-diet, I could exercise without agony, I could just be normal. To
say nothing of the effect it has on my mental well being to not have something so annoying
hanging over me. You can say that people should "grin and bear it" but seriously... can
you do that for decades? Without your outlook becoming sour? Without ever being
irritable? So for the first time, on Zelnorm, I was honestly cheerful, not faking it.

Then Zelnorm was removed, even though I had had no side effects at all, and had not heard
of anyone having any either. If anyone did have any side effects, it wasn't made public.
I believe it was some kind of political move and a wasteful one.

Like anyone without other options, I went back to supplements. They work just fine.
Finding the studies is harder because we in the USA don't believe that they should be
studied, so we wait for other countries to study them. Japan and India help out a lot
there, even Mexico. Lately, China has entered the game of verifying the effectiveness of
supplements. I've found a few 5-HT, but not necessarily 5-HT4 agonists among the
supplements. They help.

However, I'd much rather have something I can trust to be pure and not adulterated. I'm
very much aware of the risk of contamination and adulteration among supplements. I have no
other options right now. Until you approve something effective, I am stuck with risky but
effective options only.

This is why I implore you to approve prucalopride with all due speed. Americans deserve
the best health care, not the most backward, or the most paranoid. I have no heart
issues, but if this continues, who knows? One of these supplements might affect me badly
any day now. But, not having regular bowel movements, for decades on end, is not an option for me or anyone in my condition. As you can see, this isn't an attempt to "lose weight" by fooling a doctor
into giving me diarrhea. This is a medical problem that I've dealt with all my life.

Please approve prucalopride with all due speed. My very well being is at stake.

Thank you / Sincerely,

==============================


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## kc99 (Jun 7, 2007)

Likewise, thanks for the heads up on the bad link -- I tried editing that post, and I think the link is working OK now.

FYI, it also might be relevant to consult the Shire website:

http://www.shire.com/shireplc/en/rd/pipeline

.


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## annie7 (Aug 16, 2002)

thanks, kc for the shire link. been awhile since i've looked there. maybe there's hope yet







.

i've done the FDA thing several times in the last few years. they do send you a nice form letter back--lol...


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## Nojokeibs (Apr 14, 2014)

annie7 said:


> thanks, kc for the shire link. been awhile since i've looked there. maybe there's hope yet
> 
> 
> 
> ...


No form letter yet. Oh well.


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## annie7 (Aug 16, 2002)

...maybe they don't do that anymore...


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## KewlJewlSs (Apr 24, 2014)

Hello I'm new to this board but not new to IBS-C/A. I too, I was doing absolulately perfect on Zelmorm. I loved it and my Tummy Loved It. Everything just worked right. No side effects at all, my life was Finally in some order. I also felt like part of the human race again. I was a true believer as nothing up to that medication had worked and once I tried it, no adjusting, no messing around with timing it just right. I took it and It Worked. I was So Happy they had Finally Figured something out. I was one of the last in my area to get it filled and when I told my Dr they just took it away we were both just devastated.

Scratching his head he read the reasons and warnings called me asked if I had experienced Antthing like that, that he may not aware of, I told him no that this was the real deal. He offered to file an application that the FDA offered a short time after they pulled it, but after 6 months, countless amounts of hoops and paperwork we both gave up.

Of course I jumped online and did what others were doing. Finding it anywhere possible I could and ordering from Mexico and India later. But sadly in my opinion those didn't have the quality I needed, I don't know if it was changed but I eventually stopped ordering and yes I too, had been hacked several times and tried all means to get the Zelmorm but eventually I just couldn't find it anymore.

I've struggled again with same issues of low or no motility and went back into trying this and taking that. Of corse, Amtiza was a joke for me as well as fiber supplements that was just torture. I tried miralax I tried Linzess but seriously they do nothing other than cause horrible bloating and pain. And on Linzess I battled a Headache that made me just want to well I guess dig my eyes out of my head. Sadly that also just quick working and eventually once again I have up trying to tolerate the horrible stuff they have thrown at us since they took away Zelnorm!!

I am generally a happy girl, not a downer at all, but when your tummy hurts and it's feels like you're going to die even trying to just empty I have really questioned the FDA, our health care system. I mean can't take applications of those who truly suffer from no Motility fill out a form, follow up with our Dr to get this medication that really helped me and I'm sure countless others feel well again, to feel like we are in the real world, instead of being afraid to eat, afraid of the bathroom and the pain I'm going to endure when I walk in there? What is next? Will we ever have the chance to feel normal again? I'm so lost and this daily battle has consumed my world in so many different ways, they do not have a clue and honestly it doesn't feel like they care.

Thanks for Reading my story, it's great to be able to share with people that truly understand what it feels like to be sick and not have any solution to this really complicated but yet simple ordeal.

Just Bring Back Zelnorm and let me sign a waiver saying I swear this is what I need to survive and I hold no one responsible for anything bad, have my Dr and I both sign this and let me get back to feeling Normal and move on!!!

I up for any suggestions to getting similar results as I did on Zelnorm, if anyone has anything else to suggest!!


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## Nojokeibs (Apr 14, 2014)

Hi KewlJewlSs, welcome to the forum! I hear you, I wish the FDA heard us. I've spent hours and hours reading Pubmed trying to find something that is a 5-HT4 agonist. No dice, but there are much less selective herbs out there as supplements which I imagine are being researched for more specific components. At this time, I have tried Ginger Root, which seems to help a bit, but only in large doses as a supplement, if I try to drink ginger tea from the fresh root, I just sweat and that's not helpful, though the tea it makes is yummy. Naringin is something I'm trying now, but I can't say if it's effective yet since I've only just started trying it. I am extreme enough to fast periodically if that's what it takes to get my gut to quiet down.

I'm not sure why the FDA thinks that it's "protecting" us by doing this. We have no other options. it's not like there were 10 of these drugs out there, and one of them was removed. There was EXACTLY ONE drug of this type, and it was removed. It makes no sense. Look at the extremes people go to. Fasting, overuse of laxatives, buying from sketchy websites... and on and on, not to mention that supplements aren't drugs and shouldn't be depended upon like this.

If there is another drug, besides Linzess and Amitiza for IBS-C, I don't know of it. Amitiza isn't an answer. If that worked, then taking inulin would work too (that works by drawing water into the gut also), and so would miralax. There's no need for Amitiza or any other "increases water in the gut" type of drug. Nobody needs these drugs because if it's water you want, then you can get more in your gut with docusate sodium, magnesium citrate, miralax or vitamin C. Linzess works only temporarily for many people, according to my doctor, and I'm one of the lucky ones for whom it only works for a week.

Ref: http://www.ncbi.nlm.nih.gov/pubmed/17296458

We need a MOTILITY drug. Yet the FDA already let one slip by... despite all this guff about "fast track" for new drugs, our one and only hope drug was delayed over and over until it died in its infancy:

Here is the entire timeline of ARYx, a company that really tried to get us a new zelnorm:

http://thenumbers.marketplace.org/publicradio/quote/news?Limit=30&Symbol=365%3A3382415

I think the real reason why the drug was pulled and no action was taken on the second one and probably prucalopride will continue to be delayed is because it THREATENS THE BUSINESS INTEREST OF THE SSRI AND MAOI DRUGS. But once again it's short sighted. As the following reference shows, something cool happens when you give someone both a 5-HT4 agonist and an SSRI:

http://www.ncbi.nlm.nih.gov/pubmed/24287720

Since many people with chronic constipation are also candidates for SSRI's, this seems like the perfect time for the industry to come to terms with this new class of drugs.

I also believe that Zelnorm itself needs to be brought back, and this is why: the industry has been seeking a "more highly selective" 5-HT4 agonist for "safety" reasons. But adverse events are MORE COMMON with the more highly selective ones!!!!!! Here's the proof:

http://www.ncbi.nlm.nih.gov/pubmed/24308797

So why are they making such a fuss? They're making my life more dangerous, not less.


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## KewlJewlSs (Apr 24, 2014)

Wow thank you for the quick response Nokokeibs, I really appreciate your input as well as all your hard work in looking through so much information trying to figure out some type of relief from this whole issue. And I have to say Everything you posted, studied and suggested u find very true down to the letter of each word. Sadly Zelnorm has been my one and only true Love to get me through my hell and when I say I have tried it all, I literally have Tried It All. Sadly I am Not a candidate for SSRI, SNRI, MAOI or Anything else in That Over Pushed and Mis Understood conception that I'm depressed therefore I can't empty. Ugh that gets me every time. Now course I jumped on the Mineral band wagon, trying 5 HPT, Triptophan and numerous other supplements, Enzymes and Minerals to No Avail. I was myself on Zelnorm and today I'm Not, it's Simple, Yet very Easy to see that Big Pharma, The FDA and any other form of our Big Government in the Medical Community Does Not Want Us Well, They Want Us Sick, spend lots of $$ on lame meds and countless Dr Appts. So at this point and Time I continue to struggle daily and keep looking in Hopes .One Day I will stumble upon some thing that may remotely comes close to the comfort I once had with Zelnorm. Thank You for your links, and post. I will comb through everything you have posted, and see if I can find something for me!!!

Good Luck to you as well, you have obviously done your due diligence in your own world trying to find some of Feeling like A Human Being
And I am grateful for your Reply!!! 

KewlJewlSs


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## annie7 (Aug 16, 2002)

Theravance has a couple meds in the pipeline: selective 5-HT (4) receptor agonist Velusetrag (TD-5108) --in the pipeline both for both chronic idiopathic constipation and also for gastroparesis---and TD 8954. here's a few links--google for more:

http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/GastrointestinalDrugsAdvisoryCommittee/UCM281534.pdf

http://en.wikipedia.org/wiki/Velusetrag

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2982.2009.01378.x/pdf


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## Nojokeibs (Apr 14, 2014)

Thank you for posting that, annie7







I looked up hERG and it led to a better understanding of why regulators are so in fear of these drugs.

http://en.wikipedia.org/wiki/HERG#Drug_interactions

I knew about the long QT thing, but not the hERG connection. I think that goes a long way toward making it more understandable, even if it isn't something I agree with. I still think they're over-theorizing and should be looking at what is actually happening, which is that zelnorm was a safe drug. Maybe cisapride wasn't so safe, but I have no memory of it, so I can't say.

It does look like some activity is happening. Let's hope it pans out!


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## annie7 (Aug 16, 2002)

i never got the chance to try cisapride but one of my cats is on it. it's considered safe for veterinary use. it's a compounded med and very expensive.she has constipation problems too--like mother like daughter---lol--and cisapride coupled with lactulose have thankfully kept her going and have kept her from developing megacolon.

there have been times when i've been tempted to poach some of her cisapride for myself--lol..from what i've read though apparently that's what some pet owners do which has lead to some veterinary compounding pharmacies not making it anymore. at times it's been hard to get for her.


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## Nojokeibs (Apr 14, 2014)

annie7 said:


> i never got the chance to try cisapride but one of my cats is on it. it's considered safe for veterinary use. it's a compounded med and very expensive.she has constipation problems too--like mother like daughter---lol--and cisapride coupled with lactulose have thankfully kept her going and have kept her from developing megacolon.
> 
> there have been times when i've been tempted to poach some of her cisapride for myself--lol..from what i've read though apparently that's what some pet owners do which has lead to some veterinary compounding pharmacies not making it anymore. at times it's been hard to get for her.


Aww, poor kitty! But how cute!  Sounds like she is well taken care of. Our kitties are feral so they get all kinds of treats housecats don't... like raw fish twice a week, human grade canned sardines, sprinkles of Parmesan cheese on their food sometimes, tiny shrimp when I can find them, and human vitamins crushed up and mixed into one of those Fancy Feast Appetizer things. Horrendously spoiled! At first they had to have some kind of Flora probiotic for a few weeks because they had some kind of intestinal problem, but it cleared up. They came to us riddled with every type of parasite, but they're fine now. I think you're right, it's because I'm so focused on my diet, I also take super good care of my cats.

I'll have to look into lactulose, it keeps coming up in various places. Is it a fermentable sugar?


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## annie7 (Aug 16, 2002)

i don't really know--maybe. what i do know is it can cause gas. doesn't seem to bother sweetie but i don't want to even try it myself--- people have complained about the gas..

your kitties do sound well taken care of! they do so love to be spoiled don't they.


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## Rose (Mar 25, 1999)

I haven't posted in a while, but had to answer this post. After trying everything under the sun to help with my constipation, including having my sigmoid colon removed, nothing has helped me except Zelnorm. I have always ordered it from Medsmex.com, but recently found a better place called mymexican pharmacy.org. Their prices are lower that Medsmex and they are very nice to deal with. Waiting for shipment to the U.S. takes a few weeks, so always order it a few weeks befor I run out. I recently found another site in London that also ships it to the U.S. and even less expensive. That site is called www.greaterlondonpharmacy.com. I haven't ordered from them yet, but might try them next time.
Hope this helpful to those who need Zelnorm.


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## annie7 (Aug 16, 2002)

Hi Rose thanks for your information. I've been wondering how you were doing. sounds like you've been through a lot. so sorry that having your sigmoid colon removed hasn't helped.

glad zelnorm is still working for you and that you have found some better suppliers. take care, annie


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## Rose (Mar 25, 1999)

Hi Annie, yes, I have been through a lot. What was going to be laproscopic surgery to remove my sigmoid colon and correct severe rectal decent, turned into major open surgery 10 weeks ago, and I'm still not fully recovered. I found out I have a redundant colon, which accounts for my slow transit time and also accounted for why the surgery could not be done laproscopically. A fiber /senna combo used to help me go, but since the surgery the fiber/senna doesn't work anymore. Linzess gives me horrible gas pain, so I can't take that either. Zelnorm seems to be the only thing that gives me some relief. I think I remember you saying you have slow transit time also. Do you take anything on a daily basis that helps?


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## annie7 (Aug 16, 2002)

Hi Rose

oh so sorry your surgery got so complicated. any colon surgery is major surgery. it takes a long time to fully recover and get your strength back. june 2013 i had an emergency right hemicolectomy due to a cecal volvulus. the surgery was open abdominal. i ended up in hospital 18 days due to many complications and it took me a good three months to get my strength back and even longer of course to feel fully recovered. please do take good care of yourself, don't rush things, and take it easy.

yes i have slow transit (colonic inertia) . and i had a redundant twisted colon but i lost about 22 inches of that with the surgery. i also have pelvic floor dysfunction, rectal hyposensitivity and megarectum. and now adhesions. with all that going on, it's probably a miracle i can go at all. zelnorm never really helped me much. it only worked for me if i took 12 mg every two days or so. seems i build up a tolerance to serotonin rather quickly. linzess and amitiza helped even less. and yes, i got the horrible gas pain with linzess, too.

my surgeons and my gastro docs have all told me to take whatever i need to go and for me that is laxatives. duclolax and milk of magnesia.(i don't take these at the same time--that causes cramping--i take them a few hours apart) . this laxative cocktail doesn't always work completely and often leaves me feeling a bit nauseated and bloated but at least i can go daily with it. works better for me than zelnorm. i'm glad zelnorm is helping you.


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## Rose (Mar 25, 1999)

Thanks, Annie. Do you get any cramping after using Ducolax? I haven't tried Ducolax yet, but most laxatives will help me go, but I pay for it with cramping for hours afterward. Almost not worth it.


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## annie7 (Aug 16, 2002)

no, I don't , the one thing with dulcolax is you don't want to take it within an hour of any antacids or milk products or you may get cramping. something to do with these things eroding the protective coating on dulcolax . don't know if other laxatives are the same way or not but that's what it says on the dulcolax box.


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## Rose (Mar 25, 1999)

Do you take it at bedtime? If so, does it work the next morning. I might try it. I know I have some in the house.


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## annie7 (Aug 16, 2002)

I take 15 mg--3 pills. no i don't take it at bedtime because it takes a good 12 hours to work on me, but then, i'm a tough case. YMMV. I take it around 5:30 pm or so. i take milk of mag at bedtime. i need both to go.


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## Rose (Mar 25, 1999)

Ok, thanks. I'll let you know if I try it.


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## annie7 (Aug 16, 2002)

good luck!







fingers crossed it works well for you..


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## Rose (Mar 25, 1999)

Thanks, just checked , the box I have expired in May, 2013. Do you think they are still good? Or should I throw them out and buy a new box?


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## annie7 (Aug 16, 2002)

I don't know--some meds are still good well beyond the expiration date so it might still work but if it were me, i'd buy a new box because that way it's a fair trial. otherwise, if you used the old stuff and it didn't work, you wouldn't have any way of knowing if it failed because it was old or because it doesn't work for you..

I know there is supposed to be no difference between generic otc meds and brand names but for me, I find the brand name dulcolax works better than the generic ones.

good luck


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## Rose (Mar 25, 1999)

Thanks. That's what I thought too.


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## balancedgrub (Jul 13, 2014)

I take Resolor and I live in Thailand as an expat. I love it! It's worked great for me but it's not a one stop fixes all, you have to keep up with the low FODMAP diet, exercise everyday, drink at least 2 litters of water per day and understand how fibre works in the body http://www.balancedgrub.com/digestion/soluble-insoluble-fibre-for-constipation. All of this beats taking laxatives. I still get tummy aches now and then but it usually if I slip up on my diet.

You can follow my review and journey on Resolor here.

Good Luck with your petition,

Balanced Grub


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## annie7 (Aug 16, 2002)

oh yes, thanks, good advice for everyone and you've got a very helpful website, too.









I do all that--FODMAP, proper fiber amount and type for my body, exercise, water--been doing it for years...I just need to try resolor --lol...hopefully resolor will be the missing link for me although not even sure of that since zelnorm never worked too well for me. but still, i'd love to give it a shot. fingers crossed it gets approved here in the usa...


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## balancedgrub (Jul 13, 2014)

Hi, I'm currently on Resolor with prospects of coming off of it soon. If you can't get Zelorum You could try a diet high in tryptophan, Instead you could try a high tryptophan diet. Tryptophan is an essential amino acid which can not be produced by the body but instead we must get it from our diet. By eating a high foods high in tryptophan, our body can then synthesise serotonin (a hormone that makes us happy and creates the wave like motions in the bowel to speed up transit time) from tryptophan and then be converted to melatonin (the hormone that makes you sleep).

I posted an article on high tryptophan diet for constipation, it may help:

High Tryptophan Foods For Serotonin Related Constipation

I hope you find success soon 

Take care

BalancedGrub


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## annie7 (Aug 16, 2002)

Balanced Grub--yes, thanks--i tried the high tryptophan diet years ago when i first read about tryp and serotonin and the role it can play in speeding up peristalsis but it didn't help. and i still do eat most of the foods on the list.

personally, i think my C problems, especially at this point, are a bit too complicated for serotonin to fix. even zelnorm didn't help me too much. so i don't think i have serotonin related C. but thanks for posting your information. i'm sure it will be helpful for many people. certainly an excellent thing for everyone to try







. your website is full of good, helpful advice.


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## Jane Westfall (Feb 2, 2016)

Please - help. I am in the same situation as 'NoJokeIBS' and can't find Tegaserod online without going the Mexico route. Resolor...doe it's really work? I trust Canada pharmacy a bit more than Mexico. Mainly I want NON expired valid meds and I don't think Mexico is going to provide these. (I ordered from another pharma in mexico and they were sugar pills).

@nojokeibs - what are you taking now and how did you get it? thanks. JW in San francisco.


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## Nuffa (Sep 12, 2014)

resolor 2mg , which is the higher dose helps me but not enough.


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## tiredd (Mar 10, 2016)

I emailed Novartis in Mexico and they confirm that Novartis sells Zelnorm ( called Zelmac) in Mexico.

Jane Westfall, which pharma in Mexico sold you sugar pills?

thanks


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