Cisapride

Cisapride is a prescription medication used for treating gastrointestinal dysmotility.

• Cisapride  is available under the following different brand names: Propulsid

Adult and pediatric dosage

• Available through an investigational limited access program

Gastrointestinal Dysmotility

Adult dosage

• 5-10 mg orally every 6 hours for at least 15 minutes post meals during bedtime
• May need to increase to 20 mg in some patients

Pediatric dosage

• 0.15-0.3 mg/kg/dose orally every 6-8b hours; not to exceed 10 mg/dose

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of the Cisapride include:

• abdominal pain,
• nausea,
• diarrhea,
• increased frequency of urination,
• constipation,
• gas,
• indigestion,
• runny or stuffy nose,
• cough,
• viral infection,
• upper respiratory tract infection,
• pain,
• fever,
• urinary tract infection,
• insomnia,
• anxiety,
• nervousness,
• rash,
• itching,
• joint pain,
• vision problems,
• headache,
• vaginal infection,
• dizziness,
• vomiting,
• sore throat,
• chest pain,
• fatigue,
• back pain,
• depression,
• dehydration, and
• muscle pain.

Serious side effects of the Cisapride include:

• none.

Rare side effects of the Cisapride include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Cisapride has severe interactions with the following drugs:
  • albuterol
  • alfuzosin
  • apomorphine
  • arformoterol
  • aripiprazole
  • artemether
  • atomoxetine
  • ceritinib
  • clarithromycin
  • dofetilide
  • escitalopram
  • levoketoconazole
  • mifepristone
• Cisapride has serious interactions with the following drugs:
  • abametapir
  • azithromycin
  • chloroquine
  • citalopram
  • clozapine
  • dasatinib
  • degarelix
  • hydrocortisone
  • hydroxychloroquine sulfate
  • levoketoconazole
  • lopinavir
  • mifepristone
  • ponesimod
  • saquinavir
  • tipranavir
  • tucatinib
• Cisapride has moderate interactions with the following drugs:
  • atogepant
  • bosutinib
  • capecitabine
  • desflurane
  • desipramine
  • deutetrabenazine
  • dolasetron
  • donepezil
  • efavirenz
  • finerenone
  • isavuconazonium sulfate
  • rucaparib
  • selpercatinib
• Cisapride has minor interactions with the following drugs:
  • isavuconazonium sulfate
  • ribociclib
  • ruxolitinib topical

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Serious cardiac arrhythmias (eg, ventricular fibrillation, torsades de pointes, and QT prolongation) were reported in patients taking cisapride with other drugs that inhibit cytochrome CYP3A4 or have additive QT-prolonging effect; some of these events have been fatal
• Patient history or family history of prolonged QT syndrome
• History of renal failure, ventricular arrhythmias, ischemic heart disease, CHF, clinically significant bradycardia, uncorrected electrolyte disorders (eg, hypomagnesemia, hypokalemia), and respiratory failure
• Concomitant drugs are known to prolong QT and increase the risk of arrhythmia (eg, class III antiarrhythmic agents, CYP3A4 inhibitors by elevating cisapride drug levels, drugs that decrease serum levels of potassium or magnesium)
• Upon requesting cisapride through the compassionate use program, a lengthy list of disallowed medications must be reviewed to assure the patient is not taking drugs that may result in serious or life-threatening interactions

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Cisapride?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Cisapride?”

Cautions

• Decrease dose by 50% with liver impairment
• Potential benefits should be weighed against risks prior to initiating therapy in patients that may develop prolongation of cardiac conduction intervals, especially QTc
• Serious cardiac arrhythmias, tachycardia, ventricular fibrillation, torsade de pointes, and QT prolongation were reported in patients taking CYP3A4 inhibitors
• Not for use in patients that might experience a rapid reduction of plasma potassium as those resulting from potassium wasting diuretics and/or insulin in acute settings

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risk during pregnancy
• Lactation
  • Enters breast milk; use with caution (American Academy of Pediatrics committee states that drug is compatible with nursing)