What is Epasan?
Epasan 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).
Epasan is used to treat gastric reflux (the regurgitation of stomach acid into the esophagus), which is usually experienced as heartburn.
Epasan may also be used for purposes not listed in this medication guide.
Epasan indications
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 Epasan in details
Epasan 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]).
Epasan description
In many countries (including Canada) Epasan has been either withdrawn or has had its indications limited due to reports about long QT syndrome due to Epasan, which predisposes to arrhythmias. The FDA issued a warning letter regarding this risk to health care professionals and patients.
Epasan 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.
Epasan interactions
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What other drugs will affect Epasan?
Epasan 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 Epasan was taken in conjunction with one of the cytochrome P450 3A4 inhibitors, elevated blood Epasan 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 Epasan, which can result in an increase in plasma Epasan 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 Epasan
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 Epasan therapy, with an appropriate adjustment of the anticoagulant dose, if necessary
Antidepressants: In vitro data indicate that nefazodone inhibits the metabolism of Epasan, which can result in an increase in plasma Epasan 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 Epasan, which can result in an increase in plasma Epasan levels and prolongation of the QT interval on the ECG. Human pharmacokinetic data indicate that oral ketoconazole markedly inhibits the metabolism of Epasan, resulting in a mean eight-fold increase in AUC of Epasan. A study in 14 normal male and female volunteers suggests that coadministration of Epasan 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 Epasan, there is no effect on Epasan absorption when it is coadministered with ranitidine. The gastrointestinal absorption of cimetidine and ranitidine is accelerated when they are coadministered with Epasan
Protease Inhibitors: In vitro data indicate that indinavir and ritonavir markedly inhibit the metabolism of Epasan which can result in an increase in plasma Epasan levels and prolongation of the QT interval on the ECG
Other: Coadministration of grapefruit juice with Epasan increases the bioavailability of Epasan and concomitant use should be avoided
Epasan 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 Epasan 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.
Epasan side effects
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What are the possible side effects of Epasan?
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.
Epasan contraindications
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What is the most important information I should know about Epasan?
Serious cardiac arrhythmias including ventricular tachycardia, ventricular fibrillation, torsades de pointes, and QT prolongation have been reported in patients taking Epasan 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 Epasan may lead to elevated Epasan 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).Epasan 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. Epasan 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. Epasan 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. Epasan is contraindicated in patients with known sensitivity or intolerance to the drug.
Active ingredient matches for Epasan:
Cisapride in Greece.
List of Epasan substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Enteropride (Mexico) | |
| Tablet; Oral; Cisapride Monohydrate 5 mg (Janssen-cilag) | |
| Eriken (Mexico) | |
| Esorid (India) | |
| Esorid 10mg TAB / 10 (Sun) | $ 0.46 |
| Esorid 20mg TAB / 10 (Sun) | $ 0.72 |
| ESORID 10MG TABLET 1 strip / 10 tablets each (Sun) | $ 0.52 |
| ESORID 20MG TABLET 1 strip / 10 tablets each (Sun) | $ 0.74 |
| Esorid 10mg Tablet (Sun) | $ 0.05 |
| Esorid 20mg Tablet (Sun) | $ 0.07 |
| Etacril (Argentina) | |
| Ethiprid (Indonesia) | |
| Ethiprid 5 mg x 2 x 10's (Ethica) | $ 5.39 |
| Expril (Mexico) | |
| Fabrapride (Argentina) | |
| Fisiogastrol (Spain) | |
| G Pride | |
| G Pride 10 mg Tablet (Gracure Pharmaceuticals Ltd.) | $ 0.05 |
| Gasprid (Colombia, Poland) | |
| Gastronax (Poland) | |
| Gastropen DT | |
| Gastropen DT 5 mg Tablet (Morepen Laboratories Ltd.) | $ 0.02 |
| Gastropen MPS | |
| Gastropen MPS 10+125 Tablet (Morepen Laboratories Ltd.) | $ 0.04 |
| Gastropride (Bahrain, Iraq, Lebanon, Libya, Nigeria, Saudi Arabia, Somalia, Sudan, Yemen) | |
| Ge Rui Xi (China) | |
| Guarposid (Indonesia) | |
| Guarposid 5 mg x 5 x 10's (Guardian) | $ 13.64 |
| Guptro | |
| Isaprid (Venezuela) | |
| Kaudalit | |
| Kelosal (Spain) | |
| Kinestase (Mexico) | |
| Suspension; Oral; Cisapride Monohydrate 5 mg / 5 ml (Liomont) | |
| Tablet; Oral; Cisapride Monohydrate 10 mg (Liomont) | |
| Tablet; Oral; Cisapride Monohydrate 5 mg (Liomont) | |
| Kinet (Spain) | |
| Kinetizine (Argentina) | |
| Kinussen (Greece) | |
| Lamafer (Greece) | |
| Lasapride (Greece) | |
| Lirebin (Greece) | |
| Lornakin | |
| Tablet; Oral; Cisapride 10 mg | |
| Lycalin (Greece) | |
| Mai Sai De (China) | |
| Man Sai De (China) | |
| Maprilex (Mexico) | |
| Marovil (Chile) | |
| Mavisid (Mexico) | |
| Minsk (Greece) | |
See 262 substitutes for Epasan | |
References
- PubChem. "cisapride". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "cisapride". http://www.drugbank.ca/drugs/DB00604 (accessed September 17, 2018).
- MeSH. "Serotonin Receptor Agonists". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Epasan are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Epasan. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
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Information checked by Dr. Sachin Kumar, MD Pharmacology
