Itopride is a prokinetic drug that improves gastrointestinal motility by increasing acetylcholine concentrations and inhibiting dopamine D2 receptors. Itopride has anticholinesterase (AchE) activity as well as dopamine D2 receptor antagonistic activity. Itopride prevents the degradation of acetylcholine (ACh) by inhibiting the enzyme acetylcholinesterase (AChE). This increases the concentration of ACh, which stimulates gastric motility, increases lower esophageal sphincter pressure, and accelerates gastric emptying.