Cisapro Uses

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What is Cisapro?

Cisapro increases the rate at which your esophagus, stomach, and intestines move during digestion. It also increases the rate at which your stomach empties into your intestines and increases the strength of your lower esophageal sphincter (the muscle between your stomach and your esophagus).

Cisapro is used to treat gastric reflux (the regurgitation of stomach acid into the esophagus), which is usually experienced as heartburn.

Cisapro may also be used for purposes not listed in this medication guide.

Cisapro indications

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The symptomatic management of gastrointestinal motility disorders including: gastroesophageal reflux disease; gastroparesis, idiopathic or associated with diabetic neuropathy; and intestinal pseudo-obstruction. Also for the prophylaxis o gastroesophageal reflux disease.

Uses of Cisapro in details

Cisapro is used in adults in the treatment of night-time heartburn that occurs when stomach contents reflux in to the food pipe (gastro esophageal reflux disease [GERD]).

Cisapro description

In many countries (including Canada) Cisapro has been either withdrawn or has had its indications limited due to reports about long QT syndrome due to Cisapro, which predisposes to arrhythmias. The FDA issued a warning letter regarding this risk to health care professionals and patients.

Cisapro dosage

Usual Adult Dose for Gastroesophageal Reflux Disease:

10 mg orally 4 times a day 15 minutes before meals and at bedtime.

May be increased to 20 mg per dose if necessary.

Usual Adult Dose for Gastroparesis:

10 mg orally 4 times a day 15 minutes before meals and at bedtime.

May be increased to 20 mg per dose if necessary.

Usual Adult Dose for Dyspepsia:

5 mg orally 3 times a day 15 minutes before meals.

May be increased to 10 mg per dose if necessary.

Usual Pediatric Dose for Gastroesophageal Reflux Disease:

>1 year: 0.2 to 0.3 mg/kg/dose orally 3 to 4 times a day.

Maximum: 10 mg per dose.

Cisapro interactions

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What other drugs will affect Cisapro?

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Cisapro is metabolized mainly via the cytochrome P450 3A4 enzyme. In some cases where serious ventricular arrhythmias, QT prolongation, and torsades de pointes have occurred when Cisapro was taken in conjunction with one of the cytochrome P450 3A4 inhibitors, elevated blood Cisapro levels were noted at the time of the QT prolongation

Antibiotics: In vitro and/or in vivo data show that clarithromycin, erythromycin, and troleandomycin markedly inhibit the metabolism of Cisapro, which can result in an increase in plasma Cisapro levels and prolongation of the QT interval on the ECG

Anticholinergics: Concurrent administration of certain anticholinergic compounds, such as belladonna alkaloids and dicyclomine, would be expected to compromise the beneficial effects of Cisapro

Anticoagulants (Oral): In patients receiving oral anticoagulants, the coagulation times were increased in some cases. It is advisable to check coagulation time within the first few days after the start and discontinuation of Cisapro therapy, with an appropriate adjustment of the anticoagulant dose, if necessary

Antidepressants: In vitro data indicate that nefazodone inhibits the metabolism of Cisapro, which can result in an increase in plasma Cisapro levels and prolongation of the QT interval on the ECG

Antifungals: In vitro and/or in vivo data indicate that fluconazole, itraconazole, and oral ketoconazole markedly inhibit the metabolism of Cisapro, which can result in an increase in plasma Cisapro levels and prolongation of the QT interval on the ECG. Human pharmacokinetic data indicate that oral ketoconazole markedly inhibits the metabolism of Cisapro, resulting in a mean eight-fold increase in AUC of Cisapro. A study in 14 normal male and female volunteers suggests that coadministration of Cisapro and ketoconazole can result in prolongation of the QT interval on the ECG

H2 Receptor Antagonists: Cimetidine coadministration leads to an increased peak plasma concentration and AUC of Cisapro, there is no effect on Cisapro absorption when it is coadministered with ranitidine. The gastrointestinal absorption of cimetidine and ranitidine is accelerated when they are coadministered with Cisapro

Protease Inhibitors: In vitro data indicate that indinavir and ritonavir markedly inhibit the metabolism of Cisapro which can result in an increase in plasma Cisapro levels and prolongation of the QT interval on the ECG

Other: Coadministration of grapefruit juice with Cisapro increases the bioavailability of Cisapro and concomitant use should be avoided

Cisapro should not be used concomitantly with other drugs known to prolong the QT interval: certain antiarrhythmics, including those of Class IA (such as quinidine and procainamide) and Class III (such as sotalol); tricyclic antidepressants (such as amitriptyline); certain tetracyclic antidepressants (such as maprotiline); certain antipsychotic medications (such as sertindole); astemizole, bepridil, sparfloxacin, and terodiline. The preceding lists of drugs are not comprehensive

The acceleration of gastric emptying by Cisapro could affect the rate of absorption of other drugs. Patients receiving narrow therapeutic ratio drugs or other drugs that require careful titration should be followed closely; if plasma levels are being monitored, they should be reassessed.

Cisapro side effects

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What are the possible side effects of Cisapro?

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may cause extrapyramidal symptoms (usually acute dystonic reactions); these are more common in children and young adults, especially if female, and at daily doses above 500 micrograms/kg. Parkinsonism and tardive dyskinesia have occasionally occurred, usually during prolonged treatment in elderly patients.

Other adverse effects include restlessness, drowsiness, and diarrhoea. Hypotension, hypertension, dizziness, headache, and depression may occur and there are isolated reports of blood disorders, hypersensitivity reactions (rash, bronchospasm), and neuroleptic malignant syndrome. Disorders of cardiac conduction have been reported with intravenous metoclopramide.

it may also

stimulates prolactin secretion and may cause galactorrhoea or related disorders. Transient increases in plasma-aldosterone concentrations have been reported.

Cisapro contraindications

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What is the most important information I should know about Cisapro?

Serious cardiac arrhythmias including ventricular tachycardia, ventricular fibrillation, torsades de pointes, and QT prolongation have been reported in patients taking Cisapro with other drugs that inhibit cytochrome P450 3A4. Some of these events have been fatal. Concomitant oral or intravenous administration of the following drugs with Cisapro may lead to elevated Cisapro blood levels and is contraindicated. Antibiotics:

Oral or IV erythromycin, clarithromycin (Biaxin), troleandomycin (TAO). Antidepressants: Nefazodone (Serzone). Antifungals:

Oral or IV fluconazole (Diflucan), itraconazole (Sporanox), oral ketoconazole (Nizoral). Protease Inhibitors: Indinavir (Crixivan), ritonavir (Norvir).Cisapro is Also Contraindicated for Patients With: History of prolonged electrocardiographic QT intervals or known family history of congenital long QT syndrome; renal failure; history of ventricular arrhythmias, ischemic heart disease, and congestive heart failure; clinically significant bradycardia; uncorrected electrolyte disorders (hypokalemia, hypomagnesemia); respiratory failure; and concomitant medications known to prolong the QT interval and increase the risk of arrhythmia, such as certain antiarrhythmics, certain antipsychotics, certain antidepressants, astemizole, bepridil, sparfloxacin, and terodiline. The preceding lists of drugs are not comprehensive. Cisapro should not be used in patients with uncorrected hypokalemia or hypomagnesemia or who might experience rapid reduction of plasma potassium such as those administered potassium-wasting diuretics and/or insulin in acute settings. Cisapro should not be used in patients in whom an increase in gastrointestinal motility could be harmful, e.g., in the presence of gastrointestinal hemorrhage, mechanical obstruction, or perforation. Cisapro is contraindicated in patients with known sensitivity or intolerance to the drug.



Active ingredient matches for Cisapro:

Cisapride in India.


Unit description / dosage (Manufacturer)Price, USD
Cisapro 5mg TAB / 10$ 0.24
Cisapro 10mg TAB / 10$ 0.48
Cisapro 20mg TAB / 10$ 0.60
Cisapro 1mg/mL TAB / 30ml$ 0.22
Cisapro 5 mg Tablet$ 0.02
Cisapro 10 mg Tablet$ 0.05
Cisapro 30 ml Suspension$ 0.01
Cisapro 20 mg Tablet$ 0.06

List of Cisapro substitutes (brand and generic names):

Cisar 10 mg Tablet (Hamax Pharmaceuticals)$ 0.03
Cisaride 5 mg x 25 x 10's (Pharmasant)
Cisariv 10 mg Tablet (East African (I) Remedies Pvt Ltd)$ 0.06
Cisarose 10 mg Tablet (Medi Rose)$ 0.04
Cisawal 10mg TAB / 10 (Wallace Pharmaceuticals Ltd.)$ 0.37
Cisawal 10 mg Tablet (Wallace Pharmaceuticals Ltd.)$ 0.04
CISAWAL 10MG TABLET 1 strip / 10 tablets each (Wallace Pharmaceuticals Ltd.)$ 0.38
Cisawal 10mg Tablet (Wallace Pharmaceuticals Ltd.)$ 0.04
Cispel 10mg TAB / 10 (Panacea Biotec Ltd)$ 0.43
Cispel 10mg/5mL SYR / 60ml (Panacea Biotec Ltd)$ 0.30
Cispel 5 mg Tablet (Panacea Biotec Ltd)$ 0.02
Cispel 10 mg Tablet (Panacea Biotec Ltd)$ 0.04
Cispel 60 ml Suspension (Panacea Biotec Ltd)$ 0.04
Ciszy 10 mg Tablet (Zee Laboratories Ltd)$ 0.04
Ciza 5mg TAB / 10 (Intas Laboratories Pvt Ltd)$ 0.30
Ciza 10mg TAB / 10 (Intas Laboratories Pvt Ltd)$ 0.72
Ciza 20mg TAB / 10 (Intas Laboratories Pvt Ltd)$ 0.92
Ciza 1mg/mL SUSP / 30ml (Intas Laboratories Pvt Ltd)$ 0.44
Ciza 5 mg Tablet (Intas Laboratories Pvt Ltd)$ 0.03
Ciza 10 mg Tablet (Intas Laboratories Pvt Ltd)$ 0.07
Ciza 20 mg Tablet (Intas Laboratories Pvt Ltd)$ 0.11
Ciza 30 ml Suspension (Intas Laboratories Pvt Ltd)$ 0.01
Ciza 60 ml Suspension (Intas Laboratories Pvt Ltd)$ 0.01
CIZA 20MG TABLET 1 strip / 10 tablets each (Intas Laboratories Pvt Ltd)$ 1.13
Ciza 20mg Tablet (Intas Laboratories Pvt Ltd)$ 0.11
Cizap 10mg TAB / 10 (Reliance Formulation Pvt Ltd)$ 0.41
Cizap 10 mg Tablet (Reliance Formulation Pvt Ltd)$ 0.04
Disflux 5 mg x 50's (Corsa)$ 8.18
Suspension; Oral; Cisapride Monohydrate 5 mg / 5 ml (Janssen-cilag)
Tablet; Oral; Cisapride Monohydrate 10 mg (Janssen-cilag)
Tablet; Oral; Cisapride Monohydrate 5 mg (Janssen-cilag)

References

  1. PubChem. "cisapride". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  2. DrugBank. "cisapride". http://www.drugbank.ca/drugs/DB00604 (accessed September 17, 2018).
  3. MeSH. "Serotonin Receptor Agonists". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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