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Brand Name :
Propulsid
Synonyms :
cisapride
Class :
Prokinetic Agents
Brand Name :
Propulsid
Synonyms :
cisapride
Class :
Prokinetic Agents
Dosage forms and strengths Â
Oral tabletÂ
20 mgÂ
10 mgÂ
SuspensionÂ
(1 mg/mL)Â
Gastroesophageal Reflux Disease (GERD)Â
10 mg taken orally four times daily, specifically 15 minutes prior to meals and before going to bed
If necessary, the dosage may be maximized up to 20 mg per dose
Dosage forms and strengthsÂ
Oral tabletÂ
20 mgÂ
10 mg Â
Suspension Â
(1 mg/mL)Â
Gastroesophageal Reflux Disease (GERD)Â
Age>1 year: The oral dosage is 0.2 to 0.3 mg/kg/ dose, to be administered 3 to 4 times daily
The maximum dose per administration should not exceed 10 mg
Refer adult dosingÂ
may have an increased QTc-prolonging effect when combined with cisapride
may have an increased QTc-prolonging effect when combined with cisapride
may have an increased QTc-prolonging effect when combined with cisapride
may have an increased QTc-prolonging effect when combined with cisapride
may have an increased QTc-prolonging effect when combined with cisapride
may enhance the concentration of serum when combined with cisapride
may enhance the concentration of serum when combined with cisapride
may enhance the concentration of serum when combined with cisapride
may enhance the concentration of serum when combined with cisapride
may enhance the concentration of serum when combined with cisapride
cisapride: they may enhance the serum concentration of CYP3A Inhibitors
cisapride: they may enhance the serum concentration of CYP3A Inhibitors
cisapride: they may enhance the serum concentration of CYP3A Inhibitors
cisapride: they may enhance the serum concentration of CYP3A Inhibitors
cisapride: they may enhance the serum concentration of CYP3A Inhibitors
may increase cisapride's ability to cause irregular heartbeats
may enhance cisapride's serum concentration
may enhance cisapride's serum concentration
cisapride's toxicity is increased by azithromycin's effect on the QTc interval
cisapride's toxicity is increased by chloroquine’s effect on the QTc interval
clozapine together with cisapride lead to an elevation of the QTc interval
dasatinib together with cisapride lead to an elevation of the QTc interval
degarelix together with cisapride lead to an elevation of the QTc interval
it may reduce the therapeutic effect of gastrointestinal agents
it may reduce the therapeutic effect of gastrointestinal agents
it may reduce the therapeutic effect of gastrointestinal agents
The potential for increased CNS depression risk or seriousness occurs when cisapride is used together with pinazepam
when ajmaline is used together with cisapride, the risk or seriousness of QTc prolongation is enhanced
The potential for increased CNS depression risk or seriousness occurs when cisapride is used together with pipecuronium
When cisapride is used together with bromisoval, the risk or seriousness of CNS depression is enhanced
When captodiame is used together with cisapride, there is a risk or seriousness of CNS depression is enhanced
When cisapride is used together with medazepam, the risk or seriousness of CNS depression is enhanced
The potential for CNS depression may enhanced when cisapride is used together with fencamfamin
Combining tegafur with cisapride can reduce tegafur’s metabolism
When cisapride is used together with niaprazine, the risk or seriousness of CNS depression is enhanced
When cisapride is used together with levosulpiride, the risk or seriousness of CNS depression is enhanced
When encainide is used together with cisapride, this leads to a reduction in the encainide’s metabolism
When cisapride is used together with melitracen, this leads to enhanced risk or seriousness of CNS depression
When ponesimod is used together with cisapride, this leads to enhanced risk or seriousness of bradycardia
When cisapride is used together with adenosine, this leads to enhanced risk or seriousness of QTc prolongation
When cisapride is used together with givinostat, this leads to enhanced risk or seriousness of Qtc prolongation
When emylcamate is used together with cisapride , this leads to enhanced risk or seriousness of CNS depression
When acepromazine is used together with cisapride, this leads to enhanced risk or seriousness of CNS depression
When indisulam is used together with cisapride, this leads to a reduction in cisapride metabolism
When cisapride is used together with oleandomycin, this leads to enhanced concentration serum of cisapride
When cisapride is used together with patupilone, this leads to enhanced concentration serum of cisapride
When cisapride is used together with ridaforolimus, this leads to enhanced concentration serum of cisapride
the metabolism of cisapride may decrease when piperine is combined with it
cisapride: it may increase the central nervous system depressant activities of tolperisone
It may reduce the therapeutic effect of gastrointestinal agents
It may reduce the therapeutic effect of gastrointestinal agents
It may reduce the therapeutic effect of gastrointestinal agents
It may reduce the therapeutic effect of gastrointestinal agents
It may reduce the therapeutic effect of gastrointestinal agents
it may decrease the levels of serum concentration of Fosfomycin
it may decrease the levels of serum concentration of Sirolimus
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
cisapride has the potential to enhance the absorption of clotiazepam
bosutinib together with cisapride lead to an elevation of the QTc interval
capecitabine together with cisapride lead to an elevation of the QTc interval
desflurane together with cisapride lead to an elevation of the QTc interval
desipramine together with cisapride lead to an elevation of the QTc interval
donepezil together with cisapride lead to an elevation of the QTc interval
efavirenz together with cisapride lead to an elevation of the QTc interval
deutetrabenazine together with cisapride lead to an elevation of the QTc interval
Actions and SpectrumÂ
Action:Â
The primary action of cisapride is to enhance gastrointestinal motility by stimulating the release of acetylcholine, a neurotransmitter that promotes muscle contractions in the gastrointestinal tract. Â
Spectrum:Â
drug primarily targets the gastrointestinal system, specifically the esophagus, stomach, and intestines. It increases the motility and coordination of the smooth muscle in these areas, which can help in conditions such as GERD and gastroparesis.Â
Frequency defined Â
>10%Â
DiarrheaÂ
HeadacheÂ
1-10%Â
Extrapyramidal effectsÂ
SomnolenceÂ
NauseaÂ
ConstipationÂ
AnxietyÂ
TachycardiaÂ
InsomniaÂ
SinusitisÂ
Abdominal painÂ
RashÂ
FatigueÂ
<1%Â
ApneaÂ
Psychiatric disturbancesÂ
SeizureÂ
GynecomastiaÂ
MethemoglobinemiaÂ
BronchospasmÂ
HyperprolactinemiaÂ
Black Box Warning:Â Â
Cardiovascular complications such as severe cardiac arrhythmias like ventricular tachycardia, ventricular fibrillation, torsades de pointes, and QT prolongation have been observed.  Â
contraindications with several medications, particularly those known to induce QT prolongation (such as tricyclics and specific antipsychotics) or CYP450 3A4 inhibitors (such as fluconazole, ketoconazole, and itraconazole)Â
Contraindication/Caution:Â Â
Known hypersensitivity: The drug should not be used in individuals with a known hypersensitivity or allergic reaction to cisapride or any of its components. Allergic reactions can range from mild skin rashes to severe symptoms like difficulty breathing, facial or throat swelling, or anaphylaxis.Â
Concomitant use with drugs that may increase cisapride levels: drug is primarily metabolized by an enzyme called CYP3A4 in the liver. Medications that inhibit this enzyme, such as certain antifungal agents (e.g., ketoconazole, itraconazole), macrolide antibiotics (e.g., erythromycin, clarithromycin), and HIV protease inhibitors (e.g., ritonavir, saquinavir), can significantly increase the blood levels of cisapride. Â
History of cardiac arrhythmias: cisapride has been associated with an increased risk of cardiac arrhythmias, particularly torsades de pointes. Therefore, individuals with a history of cardiac arrhythmias, including ventricular arrhythmias or long QT syndrome, should avoid using cisapride.Â
Hypokalemia: hypokalemia can increase the risk of developing cardiac arrhythmias. Drug can further prolong the QT interval on the electrocardiogram (ECG), which can increase the risk of arrhythmias. Therefore, individuals with hypokalemia or conditions predisposing them to it should not use this drug.Â
Pregnancy warnings:    Â
Pregnancy category: CÂ
Lactation: Excreted into human milk is knownÂ
Pregnancy Categories:        Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology:Â Â
cisapride belongs to a class of drugs known as prokinetic agents or gastrointestinal motility stimulants. It acts by enhancing the release of acetylcholine, a neurotransmitter, from nerve endings in the gastrointestinal tract.Â
Pharmacodynamics:Â Â
drug acts as a prokinetic agent by stimulating the release of acetylcholine, which enhances gastrointestinal motility. It has a selective affinity for 5-HT4 receptors located on smooth muscle cells in the gastrointestinal tract. By activating these receptors, cisapride promotes the rise of acetylcholine secretion, resulting in enhanced peristalsis and improved gastric emptying.  Â
Pharmacokinetics:Â
AbsorptionÂ
Drug is well absorbed after oral administration. It undergoes extensive first-pass metabolism in the liver, resulting in low systemic bioavailability (approximately 33%). The absorption of drug can be affected by food, with a high-fat meal decreasing its rate and extent of absorption.Â
DistributionÂ
Drug is widely distributed throughout the body. It has a high volume of distribution, indicating that it is extensively distributed into tissues. The drug crosses the blood-brain barrier and placenta and is also found in breast milk.Â
MetabolismÂ
Cisapride undergoes extensive metabolism in the liver, primarily through the cytochrome P450 enzyme system, specifically the CYP3A4 isoenzyme. The main metabolite of cisapride is norcisapride, which is also pharmacologically active. The metabolism of cisapride can be affected by drugs that inhibit or induce CYP3A4, potentially leading to drug interactions.Â
Excretion and Elimination Â
cisapride and its metabolites are primarily excreted in the feces, with minimal amounts in urine. The elimination half-life of cisapride is relatively short, ranging from 6 to 10 hours in healthy individuals. However, the half-life may be prolonged in patients with impaired liver function or those taking drugs that inhibit CYP3A4.Â
Administration: Â
It is crucial to follow your healthcare provider’s instructions and ask them for specific guidance regarding administration.Â
Before providing dosing instructions, they will consider your medical history, condition, and potential drug interactions.Â
Patient information leafletÂ
Generic Name: cisaprideÂ
Why do we use cisapride? Â
Gastroesophageal Reflux Disease (GERD): Gastroesophageal reflux disease (GERD) is disease characterized by the backward flow of stomach acid into the esophagus, resulting in symptoms such as difficulty swallowing, heartburn and regurgitation.Â
Gastroparesis: Gastroparesis leads to symptoms such as nausea, bloating, and early satiety. Drug was sometimes prescribed to enhance stomach emptying and relieve these symptoms.Â
Functional Dyspepsia: Functional dyspepsia refers to recurring indigestion without an apparent cause. drug was occasionally used to manage the symptoms of functional dyspepsia, including stomach pain, fullness, and bloating.Â
Constipation: In some cases, drug was prescribed to alleviate constipation by promoting coordinated movement and contractions of the digestive system, facilitating bowel movements.Â
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