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Cisapride is a prokinetic agent which restores motility of the gastrointestinal tract in conditions of decreased bowel transit. It may also alter the absorption of coadministered drugs.
The absorption of morphine, diazepam, cyclosporin, alcohol (ethanol) and levodopa are increased. Initial absorption of Cimetidine and raniditine is also increased, but overall absorption is lower due to increased bowel transit. The absorption of digoxin, propranolol and the anticoagulants warfarin and phenprocoumon appears unaffected by cisapride, although increase thrombotest values were seen with acenocoumarol (nicoumalone).
Drug interactions leading to increased plasma concentrations of cisapride may produce an increase in adverse effects. The most important of these is QT interval prolongation and ventricular arrhythmias.
Phenytoin does not appear to affect protein binding of cisapride. Cisapride metabolism is inhibited by the antifungals ketoconazole, fluconazole, itraconazole and miconazole, and by the antibacterials erythromycin, troleandomycin and clarithromycin. Cisapride should not be coadministered with these drugs.
Cimetidine produces a small increase in cisapride plasma concentrations, which may be due to inhibition of metabolism. Cisapride absorption is unaffected by other antacids. Atropine may reverse the cisapride-induced increase in peristalsis.
Prescribers should remain vigilant to the presence of these and other, as yet unreported, reactions.
- Wiseman LR, Faulds D. Cisapride: an updated review of its pharmacology and therapeutic efficacy as a prokinetic agent in gastrointestinal motility disorders. Drugs 1994; 47: 116–52 CrossRef
- McCallum RW, Prakash C, Campoli-Richards DM, et al. Cisapride: a preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use as a prokinetic agent in gastrointestinal motility disorders. Drugs 1988; 36: 652–81 CrossRef
- Craig DA, Clarke DE. Pharmacological characterisation of a neuronal receptor for 5-hydroxytryptamine in guinea pig ileum with properties similar to the 5-hydroxytryptamine 4 receptor. J Pharmacol Exp Ther 1990; 252: 1378–86
- Rowbotham DJ, Milligan K, McHugh P. Effect of cisapride on morphine absorption after oral administration of sustained-release morphine. Br J Anaesth 1991; 67: 421–55 CrossRef
- Rowbotham DJ, Parnacott S, Nimmo WS. No effect of cisapride on paracetamol absorption after oral simultaneous administration. Eur J Clin Pharmacol 1992; 42: 235–6 CrossRef
- Rowbotham DJ, Nimmo WS. Effect of cisapride on morphine-induced delay in gastric emptying. Br J Anaesth 1987; 59: 536–9 CrossRef
- Rowbotham DJ, Bamber PA, Nimmo WS. Comparison of the effect of cisapride and metoclopramide on morphine-induced delay in gastric emptying. Br J Clin Pharmacol 1988; 26: 741–6 CrossRef
- Kluger MT, Plummer JL, Owen H. The influence of rectal cisapride on morphine-induced gastric stasis. Anaesth Intensive Care 1991; 19: 346–50
- Bateman DN. The action of cisapride on gastric emptying and the pharmacokinetics of oral diazepam. Eur J Clin Pharmacol 1986; 30: 205–8 CrossRef
- Finet L, Westeel PF, Hary L, et al. Effects of cisapride on the intestinal absorption of cyclosporine in renal transplant recipients [abstract]. Gastroenterology 1991; 100 (5 Pt 2): A209
- Galmiche JP, Brandstätter G, Evereux M, et al. Combined therapy with cisapride and Cimetidine in severe reflux oesophagitis: a double-blind controlled trial. Gut 1988; 29: 675–81 CrossRef
- Kirch W, Janisch HD, Ohnhaus EE, et al. Cisapride-cimetidine interaction: enhanced cisapride bioavailability and accelerated Cimetidine absorption. Ther Drug Monit 1989; 11(4): 411–4
- Rowbotham DJ, Milligan K, McHugh P. Effect of single doses of cisapride and ranitidine administered simultaneously on plasma concentrations of cisapride and ranitidine. Br J Anaesth 1991; 67: 302–5 CrossRef
- Castelli G, van Peer A, Gasparini R, et al. Cisapride-ranitidine interaction. Janssen Pharmaceuticals, 1986. Report No.: N49374
- Kirch W, Janisch HD, Santos SR, et al. Effect of cisapride and metoclopramide on digoxin bioavailability. Eur J Drug Metab Pharmacokinet 1986; 11: 249–50 CrossRef
- Idzikowski C, Welburn P. An evaluation of possible interactions between ethanol and cisapride. Janssen Pharmaceuticals, 1986. Report No.: N49087
- Roine R, Heikkonen E, Salaspuro M. Cisapride enhances alcohol absorption and leads to high blood alcohol levels [abstract]. Gastroenterology 1992; 102 (4 Suppl.): PA507
- Daneshmend TK, Mahida YR, Bhaskar N, et al. Does cisapride alter the anticoagulant effect of warfarin? A pharmacodynamic assessment [abstract]. The World Congress of Gastroenterology: 1990 Aug 26–31; Sydney, PD169
- Möenig H, Wesermeyer D, Gaska T, et al. The effect of metoclopramide and cisapride on the pharmacokinetics of phenprocoumon [abstract]. Eur J Clin Pharmacol 1989; 36 Suppl.: PA117
- Jonker JJC. The effect of cisapride on anticoagulant treatment with acenocoumarol. Janssen Pharmaceuticals, Aug 1985. Clinical Research Report No.: R51619-NL
- Neira WD, Sanchez V, Mena MA, et al. The effects of cisapride on plasma L-Dopa levels and the clinical response in Parkinson’s disease. Mov Disord 1995; 10: 66–7 CrossRef
- Van der Kleijn E, Van Mameren C. Effect of cisapride on the plasma concentrations of a delayed formulation of propranolol and on its clinical effects on blood pressure in mildly hypertensive patients. Janssen Pharmaceuticals, 1989. Report No.: N46957
- Kuroda T, Yoshihara Y, Nakamura H, et al. Effects of cisapride on gastrointestinal motor activity and gastric emptying of disopyramide. J Pharmacobiodyn 1992; 15: 395–402 CrossRef
- Davies DS, Mills FJ, Welburn PJ. Cisapride has no effect on antipyrine clearance [letter]. Br J Clin Pharmacol 1988; 26: 808–9 CrossRef
- Olsson S, Edwards R. Tachycardia during cisapride treatment. BMJ 1992; 305: 748–9 CrossRef
- Cisapride. Data Sheet. Janssen Pharmaceuticals 1995
- Bran S, Murray WA, Hirsch IB, et al. Long QT syndrome during high-dose cisapride. Arch Intern Med 1995; 155: 765–8 CrossRef
- Roberts GW, Kowalski SR, Calabretto JP. Lack of effect of cisapride on phenytoin free fraction. Ann Pharmacother 1992; 26: 1016–7
- Verlinden M, Van Peer A, Gasparini R, et al. Unaltered oral absorption of cisapride on coadministration of antacids. Janssen Pharmaceuticals, 1986. Report No.: N49374
- Corazziari E, Bontempo I, Anzini F, et al. Effect of cisapride on oesophageal motor activity before and after atropine administration. First International Cisapride Investigators’ Meeting; 1985 Dec 2–3: Brussels. Digestion 1986; 34: 137–60 CrossRef
- Jones MJ, Mitchell RWD, Hindocha N. Effects on the lower oesophageal sphincter of cisapride given before the combined administration of atropine and neostigmine. Br J Anaesth 1989; 62: 124–8 CrossRef
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