CISAPRIDE

Information extract from Plumb’s, fifth edition:

  • Oral GI prokinetic agent used for GI stasis, reflux eosophagitis and megacolon/constipation in cats
  • Contraindicated in GI perforation/obstruction, haemorrhage and hypersensitivity
  • Caution in pregnancy
  • Minimal adverse effects in cats

Prescription required for this medication.

Stenlake Compounding Chemist expects prescribers to have applied an appropriate risk assessment before prescribing cisapride to their patients.

This medication as Prepulsid tablets and oral suspension were supplied in Australia under the Special Access Scheme to patients with gastroparesis unresponsive to other therapies, from 2004 until March 2014.

Cisapride has the potential to cause cardiac arrhythmias in humans. In 1996, the Australian Drug Reaction Advisory Committee (ADRAC) reported nine cases of cardiac arrhythmia associated with cisapride. Five described palpitations or tachycardia, one described atrial fibrillation and one bradychardia. In June 1998 the FDA reported there had been 38 deaths potentially attributable to cisapride from 1993-98 in the USA. A similar trend had not been noted in Australia. Cisapride was removed from the US market in 2000, but remained available on the Australian market until 2004. During that time, the PBS restriction was for ‘the treatment of gastroparesis where the diagnosis has been made or confirmed by a consultant physician’.

Two groups of patients were identified at higher risk. The first is patients who have predisposing conditions such as prolonged QT interval, renal failure, ventricular arrhythmias, ischaemic heart disease, heart failure, electrolyte disturbances, respiratory failure and medications which prolong the QT interval (eg. Tricyclic antidepressants, sotalol, quinidine, phenothiazines). The second group is patients taking medications that inhibit the metabolism of cisapride (eg. Clarithromycin, erythromycin, fluconazole, indinavir, itraconazole, ketoconazole, nefazodone, ritonavir).

Click below for the full monograph from AUSDI 2nd edition: AUSDI entry CISAPRIDE

This medication, as Cisapride capsules, is also used for felines. Consult your veterinarian.