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Brand

Propulsid

Availability

Comes in tablets and suspension

Pharmacology

Structurally related to procainamide but pharmacologically different, cisapride is an oral prokinetic drug.

It both increases and promotes lower esophageal peristalsis and sphincter pressure, but does not increase gastric acid secretion. It speeds gastric emptying.

Cisapride is rapidly absorbed and well distributed.

Indications

Used in some cases of megacolon and chronic constipation.

Drug Interactions or Contraindications

Do not give in GI perforation and hemorrhage.

High dose can cause infertility in female rats, as well as embryotoxic and fetotoxicity.

Ketoconazole, miconazole, erythromycin, clarithromycin, troleandomycin, nefazodone, fluconazole, itraconazole, indinavir, and ritonavir, inhibit metabolism of cisapride and increase the risk of cardiac arrhythmias. Do not give together.

Adverse Reactions

Serious toxicity can develop with this agent, do not overdose.

CV:  ventricular tachycardia, torsades de pointes, and QT prolongation.

GI:  diarrhea, and abdominal pain.

Dosage Recommendations

0.2 mg/lb to 0.4 mg/lb (if using this dose range in lbs and changing to kg, it will be 0.4 mg/kg to 0.8 mg/kg). ^{3 4}

or

0.1 mg/kg to 0.5 mg/kg , PO , q12hrs  ¹

Considerations

• Not known to be effective in baby rats.
• Caution when giving other oral meds with cisapride, since it may affect their absorption due to its action of decreasing GI transit time.
• Administer on empty stomach at least 15 minutes before eating for consistent absorption.
• Store at room temperature and protect from light.
• May have difficulty obtaining drug as reports have it that it is being removed from the market in the U.S.A.

Posted on June 23, 2003, 16:22, Last updated on December 14, 2008, 11:49 | Miscellaneous