diltiazem and Cisapride Interactions

Interactions between diltiazem and Cisapride (cisapride)

diltiazem and cisapride (Major Drug-Drug)

GENERALLY AVOID: Coadministration with drugs that are inhibitors of CYP450 3A4 may increase the plasma concentrations of cisapride, which is primarily metabolized by the isoenzyme. High plasma levels of cisapride have been associated with prolongation of the QT interval on the ECG; ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes; cardiac arrest; and sudden death.

MANAGEMENT: Given the potential for serious and life-threatening adverse cardiac events associated with increased plasma levels of cisapride, the concomitant use with potent CYP450 3A4 inhibitors (e.g., azole antifungal agents, protease inhibitors, certain macrolide antibiotics, nefazodone) is considered contraindicated. Use with other agents known to inhibit CYP450 3A4 should generally be avoided if possible.