Cisapride
Also known as: Propulsid
- **Administration:** Give exactly as prescribed, ideally **15 to 30 minutes before a meal** for maximum effectiveness. - **Sourcing:** This medication is no longer commercially manufactured and must be specially made by a veterinary compounding pharmacy. - **Side Effects:** Generally very safe for pets. Watch for mild stomach upset, vomiting, or diarrhea. Report any unusual lethargy or abnormal behavior to your veterinarian. - **Interactions:** Inform your vet about *all* medications and supplements your pet is taking, as cisapride has many significant drug interactions that can be dangerous.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- For chronic constipation (e.g., megacolon)
- For chronic constipation (e.g., megacolon)
- For chronic constipation (e.g., megacolon)
- For chronic constipation (e.g., megacolon)
- For gastric stasis
- To reduce the risk for esophageal stricture formation in cases of esophagitis
- As a promotility agent (Foals with periparturient asphyxia)
- Promotility (Mice, Rats, Gerbils, Hamsters, Guinea pigs, Chinchillas)
- For ileus if GI tract not obstructed in Guinea pigs, chinchillas
- GI stasis (Rabbits)
- For gastric stasis in rabbits
- As a promotility agent
How it is given
Possible side effects
- Vomiting
- Diarrhea
- Abdominal discomfort
- Prolonged QT intervals or cardiac arrhythmias (very rare in veterinary patients)
Cautions & contraindications
- Gastrointestinal perforation
- Gastrointestinal obstruction
- Gastrointestinal hemorrhage
- Hypersensitivity to cisapride
- Use with caution in pregnant or nursing animals; high doses caused embryotoxicity and fetotoxicity in lab animals. Dosage may need to be decreased in patients with severe hepatic impairment. Avoid concurrent use with CYP3A4 inhibitors or QT-prolonging drugs due to the risk of severe cardiac arrhythmias.
Drug interactions
- Anticholinergic agents: May diminish the prokinetic effects of cisapride.
- Benzodiazepines: Cisapride may enhance the sedative effects of benzodiazepines.
- Warfarin: Cisapride may enhance anticoagulant effects; additional monitoring and dosage adjustments may be required.
- Oral drugs with a narrow therapeutic index: Cisapride decreases GI transit times, potentially altering the absorption of other oral drugs. Serum levels may need closer monitoring.
- CYP3A4 Inhibitors (Amiodarone, Ketoconazole, Itraconazole, Fluconazole, Chloramphenicol, Cimetidine, Fluvoxamine, Grapefruit juice, Macrolides except azithromycin): Inhibit cisapride metabolism, leading to increased cisapride levels and an increased risk for cisapride cardiotoxicity.
- QT-prolonging drugs (Amiodarone, Clarithromycin, Moxifloxacin, Procainamide, Quinidine, Sotalol, Tricyclic Antidepressants): May increase the risk of QT interval prolongation and fatal arrhythmias when used concurrently with cisapride.
Frequently asked questions
What is Cisapride used for in pets?
- **Administration:** Give exactly as prescribed, ideally **15 to 30 minutes before a meal** for maximum effectiveness. - **Sourcing:** This medication is no longer commercially manufactured and must be specially made by a veterinary compounding pharmacy. - **Side Effects:** Generally very safe for pets. Watch for mild stomach upset, vomiting, or diarrhea. Report any unusual lethargy or abnormal behavior to your veterinarian. - **Interactions:** Inform your vet about *all* medications and supplements your pet is taking, as cisapride has many significant drug interactions that can be dangerous.
Is Cisapride safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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