EM574 [Motilide] is a non-peptide erythromycin-derived motilin receptor agonist used to stimulate gastric motility.
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EM574 (de(N-methyl)-N-isopropyl-8,9-anhydroerythromycin A 6,9-hemiacetal) is a semisynthetic macrolide derived from erythromycin that functions as a potent motilin receptor agonist. It directly stimulates smooth muscle contraction in the human and rabbit gastric antrum by binding to motilin receptors with nanomolar affinity. In vivo studies demonstrate that EM574 enhances antral motility and accelerates gastric emptying, including in gastroparesis models, via cholinergic pathways. EM574 serves as a prototypical motilide and is widely used as a pharmacological tool to study motilin receptor signaling and gastrointestinal prokinetic mechanisms.