Cisapride

What is cisapride?

Cisapride (brand names: Prepulsid®, Propulsid®) is a medication used to enhance the movement of the gastrointestinal (GI) system to treat conditions such as stasis, reflux, and constipation/megacolon (in cats). In North America, commercially produced forms of this medication are not available, and this medication must be compounded.

Its use in cats, dogs, and other small mammals to treat various gastrointestinal conditions is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their direction may be significantly different from those on the label.

 

How is cisapride given?

Cisapride is given by mouth in the form of a compounded tablet, capsule, or liquid. It may be given with or without food, but if your pet vomits when dosed on an empty stomach, give future doses with food or a treat. Measure liquid forms of this medication carefully.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

 

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

 

Are there any potential side effects?

Side effects are uncommon but vomiting, diarrhea, or gastrointestinal discomfort may occur. More serious side effects include incoordination, excessive drooling, muscle twitches, agitation, abnormal behavior, increased body temperature, and seizures; these signs may indicate doses are too high.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

 

Are there any risk factors for this medication?

Cisapride should not be used in pets that are allergic to it or in pets with conditions that may be worsened by increased gastrointestinal movement, such as GI perforation, obstruction, or bleeding. It should not be used during pregnancy unless the benefits significantly outweigh the risks and should be used cautiously in lactating pets or pets with severe liver disease or abnormal heart rhythms.

 

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with cisapride: anticholinergic agents, benzodiazepines, cyclosporine, warfarin, oral drugs with a narrow therapeutic index, amiodarone, antifungals, chloramphenicol, cimetidine, fluvoxamine, macrolide antibiotics (except azithromycin), clarithromycin, fluoroquinolones, procainamide, quinidine, sotalol, and tricyclic antidepressants.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

 

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor for serious side effects.

 

How do I store cisapride?

Follow the instructions on the container for storage instructions. If unknown, store tablets or capsules at room temperature away from light and moisture.

 

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

This client information sheet is based on material written by: Rania Gollakner, BS, DVM

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