Propulsid

Generic Name: cisapride (oral) (SISS a pride)

What is cisapride?

Cisapride 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).

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

Cisapride may also be used for purposes other than those listed in this medication guide.

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

Do not take cisapride if you have heart disease or hardening of the arteries; heart failure; an irregular heartbeat or a history of irregular heartbeats; a history of prolonged QT intervals; a family history of congenital long QT syndrome; a slow heart rate that is considered a medical condition; a structural heart defect; heart block or other conduction disturbances; severe dehydration (loss of water), vomiting, malnutrition, an eating disorder; or kidney failure. These conditions may increase the risk of irregular heartbeats, heart attack, and death while taking cisapride. Do not take cisapride with any of the following drugs: antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tab, E.E.S., E-Mycin, others), troleandomycin (TAO), and sparfloxacin (Zagam); antidepressants such as amitriptyline (Elavil), maprotiline (Ludiomil), and nefazodone (Serzone); antifungal medications such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); phenothiazines such as prochlorperazine (Compazine, others) and promethazine (Phenergan, others); antihistamines such as astemizole (Hismanal); blood pressure medications such as bepridil (Vascor); heart medications such as procainamide (Procan SR, Procanbid, Pronestyl) and quinidine (Quinidex, Quinaglute); and HIV medications such as indinavir (Crixivan) and ritonavir (Norvir). Taken with any of these drugs, cisapride may cause irregular heartbeats that could lead to death. This is not a complete list of drugs that may interact with cisapride and cause heart problems. Talk to your doctor or pharmacist before taking any other medications. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking cisapride. Use other medications cautiously during treatment with cisapride to avoid harming yourself or others. Excessive drowsiness may result if benzodiazepines such as alprazolam (Xanax), diazepam (Valium), chlordiazepoxide (Librium), and temazepam (Restoril) are taken during treatment with cisapride. Do not consume grapefruit or grapefruit juice while taking cisapride. Grapefruit products may increase amount of cisapride available in your body, which could lead to dangerous side effects.

What should I discuss with my healthcare provider before taking cisapride?

Do not take cisapride if you

have bleeding, an injury, or an obstruction in your stomach;

have heart disease or hardening of the arteries;

have heart failure;

have an irregular heartbeat or a history of irregular heartbeats;

have a history of prolonged QT intervals;

have a family history of congenital long QT syndrome;

have a slow heart rate that is considered a medical condition;

have a structural heart defect;

have heart block or other conduction disturbances;

have severe dehydration (loss of water), vomiting, malnutrition, an eating disorder;

have severe lung problems or advanced cancer.

The conditions listed above may increase the risk of dangerous side effects including irregular heartbeats, heart attack, and death while taking cisapride.

Do not take cisapride with any of the following drugs:

antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tab, E.E.S., E-Mycin, others), troleandomycin (TAO), and sparfloxacin (Zagam);

antidepressants such as amitriptyline (Elavil), maprotiline (Ludiomil), and nefazodone (Serzone);

antifungal medications such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral);

phenothiazines such as prochlorperazine (Compazine, others) and promethazine (Phenergan, others);

antihistamines such as astemizole (Hismanal); blood pressure medications such as bepridil (Vascor);

heart medications such as procainamide (Procan SR, Procanbid, Pronestyl) and quinidine (Quinidex, Quinaglute); or

HIV medications such as indinavir (Crixivan) and ritonavir (Norvir).

Taken with any of the drugs listed above, cisapride may cause irregular heartbeats that could lead to death. This is not a complete list of drugs that may interact with cisapride and cause heart problems. Talk to your doctor or pharmacist before taking any other medications.

Before taking cisapride, tell your doctor if you have kidney or liver disease. You may not be able to take cisapride, or you may require a lower dose or special monitoring during treatment. Cisapride is in the FDA pregnancy category C. This means that it is not known whether cisapride will harm an unborn baby. Do not take cisapride without first talking to your doctor if you are pregnant. Cisapride passes into breast milk. It is not known whether cisapride will harm a nursing infant. Do not take cisapride without first talking to your doctor if you are breast-feeding a baby.

How should I take cisapride?

Take cisapride exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Shake the liquid well before measuring a dose.

To ensure that you get a correct dose, measure the liquid form of cisapride with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Cisapride is usually taken four times a day, at least 15 minutes before meals and at bedtime. Follow your doctor’s instructions.

Do not consume grapefruit or grapefruit juice while taking cisapride. Grapefruit products may increase amount of cisapride available in your body, which could lead to dangerous side effects. Store cisapride at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a cisapride overdose include nausea, vomiting, rumbling noises in the stomach, flatulence, diarrhea, urinary frequency, tremors, seizures, and weakness.

What should I avoid while taking cisapride?

Do not take cisapride with any of the following drugs: antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tab, E.E.S., E-Mycin, others), troleandomycin (TAO), and sparfloxacin (Zagam); antidepressants such as amitriptyline (Elavil), maprotiline (Ludiomil), and nefazodone (Serzone); antifungal medications such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); phenothiazines such as prochlorperazine (Compazine, others) and promethazine (Phenergan, others); antihistamines such as astemizole (Hismanal); blood pressure medications such as bepridil (Vascor); heart medications such as procainamide (Procan SR, Procanbid, Pronestyl) and quinidine (Quinidex, Quinaglute); and HIV medications such as indinavir (Crixivan) and ritonavir (Norvir). Taken with any of these drugs, cisapride may cause irregular heartbeats that could lead to death. This is not a complete list of drugs that may interact with cisapride and cause heart problems. Talk to your doctor or pharmacist before taking any other medications. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking cisapride. Use other medications cautiously during treatment with cisapride to avoid harming yourself or others. Excessive drowsiness may result if benzodiazepines such as alprazolam (Xanax), diazepam (Valium), chlordiazepoxide (Librium), temazepam (Restoril) are taken during cisapride therapy. Do not consume grapefruit or grapefruit juice while taking cisapride. Grapefruit products may increase amount of cisapride available in your body, which could lead to dangerous side effects.

Cisapride side effects

If you experience any of the following serious side effects, stop taking cisapride and seek emergency medical attention or notify your doctor immediately:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

fainting; or

fast or irregular heartbeats.

Other, less serious side effects may be more likely to occur. Continue to take cisapride and talk to your doctor if you experience

abdominal pain, nausea, or diarrhea; or

increased frequency of urination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect cisapride?

Do not take cisapride with any of the following drugs: antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tab, E.E.S., E-Mycin, others), troleandomycin (TAO), and sparfloxacin (Zagam); antidepressants such as amitriptyline (Elavil), maprotiline (Ludiomil), and nefazodone (Serzone); antifungal medications such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); phenothiazines such as prochlorperazine (Compazine, others) and promethazine (Phenergan, others); antihistamines such as astemizole (Hismanal); blood pressure medications such as bepridil (Vascor); heart medications such as procainamide (Procan SR, Procanbid, Pronestyl) and quinidine (Quinidex, Quinaglute); and HIV medications such as indinavir (Crixivan) and ritonavir (Norvir). Taken with any of these drugs, cisapride may cause irregular heartbeats that could lead to death. This is not a complete list of drugs that may interact with cisapride and cause heart problems. Talk to your doctor or pharmacist before taking any other medications.

The effects of cisapride may be decreased by drugs such as clidinium (Quarzan), dicyclomine (Bentyl), hyoscyamine (Levsin, Cystospaz, Anaspaz), belladonna (Donnatal), and propantheline (Pro-Banthine).

Cimetidine (Tagamet, Tagamet HB) may increase the level of cisapride in your body. Talk to your doctor before taking cimetidine during treatment with cisapride.

Warfarin (Coumadin) may have increased effects during treatment with cisapride. This could lead to bleeding. Your doctor may need to make adjustments to your warfarin dosage.

Use other medications cautiously during treatment with cisapride to avoid harming yourself or others. Excessive drowsiness may result if benzodiazepines such as alprazolam (Xanax), diazepam (Valium), chlordiazepoxide (Librium), and temazepam (Restoril) are taken during cisapride therapy.

Drugs other than those listed here may also interact with cisapride. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.