Cisapride Side Effects
Applies to cisapride: oral suspension, oral tablet
Generally cisapride is well tolerated. Many of the side effects reported in clinical trials occurred with similar frequency in the placebo groups.[Ref]
Gastrointestinal side effects are often due the pharmacologic actions of cisapride. These effects appear to be dose-related, as 20 mg doses are associated with an increased incidence of diarrhea, abdominal pain, and flatulence compared to 10 mg doses.
In a study of 1500 patients, approximately 2.5% discontinued cisapride therapy, usually due to abdominal pain and intolerable diarrhea.[Ref]
Gastrointestinal side effects have been reported the most frequently. These have included diarrhea or loose stools (14.2%), abdominal cramping (10.2%), nausea (7.6%), flatulence (3.5%), borborygmi (rumbling bowel sounds), and dry mouth.[Ref]
While cisapride lacks antidopaminergic properties, extrapyramidal effects have been reported to the manufacturer. However, the incidence of cisapride-induced movement disorders would be expected to be significantly less than with metoclopramide, an antidopaminergic, gastrokinetic agent.
In addition, somnolence and fatigue are reported with lesser frequency during cisapride therapy (1.6%) than with metoclopramide (15.2%).
Worsening of tremor has been reported in two patients with parkinsonism who were treated with cisapride.[Ref]
Cardiovascular effects have reported rarely. These have included palpitations, tachycardia, and edema. Rare but potentially serious cardiac arrhythmias, including ventricular arrhythmias and torsades de pointes have also been reported.[Ref]
Syncope associated with QT interval prolongation and nonsustained ventricular tachycardia occurred in a 64-year-old male taking cisapride 40 mg by mouth four times a day for diabetic gastroparesis. A baseline electrocardiogram was normal 6 days earlier. Gradual reduction in dosage to 5 mg four times a day resolved the prolonged QT interval. High dosages of cisapride may lead to a risk of ventricular arrhythmia and torsades de pointes.[Ref]
Hepatic side effects have included elevations in liver function test results, and hepatitis.[Ref]
Urinary symptoms usually begin within 48 hours of starting treatment with cisapride. Urinary frequency and incontinence generally resolve completely upon withdrawal of therapy and may recur during rechallenge with the drug.[Ref]
Ocular side effects have included visual changes (1.4%).[Ref]
Endocrine side effects have been rarely reported. These have included gynecomastia in males, female breast enlargement, hyperprolactinemia, and galactorrhea.[Ref]
1. Bennett JR "How safe and acceptable is cisapride?" Scand J Gastroenterol Suppl 165 (1989): 59-61
2. McCallum RW, Prakash C, Campoli-Richards DM, Goa KL "Cisapride. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use as a prokinetic agent in gastrointestinal motility disorders." Drugs 36 (1988): 652-81
3. Wiseman LR, Faulds D "Cisapride - an updated review of its pharmacology and therapeutic efficacy as a prokinetic agent in gastrointestinal motility disorders." Drugs 47 (1994): 116-52
4. Castell DO, Sigmund C, Patterson D, Lambert R, Hasner D, Clyde C, Zeldis JB "Cisapride 20 mg b.i.d. provides symptomatic relief of heartburn and related symptoms of chronic mild to moderate gastroesophageal reflux disease." Am J Gastroenterol 93 (1998): 547-52
5. "Product Information. Propulsid (cisapride)." Janssen Pharmaceutica, Titusville, NJ.
6. Richter JE, Long JF "Cisapride for gastroesophageal reflux disease: a placebo-controlled, double-blind study." Am J Gastroenterol 90 (1995): 423-30
7. Sempere AP, Duarte J, Cabezas C, Claveria LE, Coria F "Aggravation of parkinsonian tremor by cisapride." Clin Neuropharmacol 18 (1995): 76-8
8. Bucci KK, Haverstick DE, Abercrombie SA "Dystonic-like reaction following cisapride therapy." J Fam Pract 40 (1995): 86-8
9. Bran S, Murray WA, Hirsch IB, Palmer JP "Long QT syndrome during high-dose cisapride." Arch Intern Med 155 (1995): 765-8
10. Hill SL, Evangelista JK, Pizzi AM, Mobassaleh M, Fulton DR, Berul CI "Proarrhythmia associated with cisapride in children." Pediatrics 101 (1998): 1053-6
11. Gray VS "Syncopal episodes associated with cisapride and concurrent drugs." Ann Pharmacother 32 (1998): 648-51
12. Lewin MB, Bryant RM, Fenrich AL, Grifka RG "Cisapride-induced long QT interval." J Pediatr 128 (1996): 279-81
13. Pillans PI, Wood SM "Cisapride increases micturition frequency." J Clin Gastroenterol 19 (1994): 336-8
14. Boyd IW, Rohan AP "Urinary disorders associated with cisapride." Med J Aust 160 (1994): 579-80
15. Pillans P "Bronchospasm associated with cisapride." BMJ 311 (1995): 1472
16. Nolan P, Phillips M, Williamson B "Cisapride and brittle asthma." Lancet 336 (1990): 1443
Some side effects of cisapride may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
More about cisapride
- Side Effects
- During Pregnancy or Breastfeeding
- Drug Interactions
- Support Group
- 1 Review – Add your own review/rating
- Drug class: GI stimulants
Other brands: Propulsid
Related treatment guides
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.