Medical Editor: John P. Cunha, DO, FACOEP
Propulsid (cisapride) is a "prokinetic" agent that increases muscle contractions of the lower esophagus and the lower esophagus sphincter used to treat gastric reflux (the regurgitation of stomach acid into the esophagus), which is usually experienced as heartburn. The brand name Propulsid is no longer available in the U.S. Generic versions may be available. Common side effects of Propulsid (cisapride) include:
- abdominal pain,
- increased frequency of urination,
- runny or stuffy nose,
- viral infection,
- upper respiratory tract infection,
- urinary tract infection,
- joint pain,
- vision problems,
- vaginal infection,
- sore throat,
- chest pain,
- back pain,
- dehydration, and
- muscle pain.
The starting dose of cisapride is one 10 mg tablet or 10 ml of the suspension 4 times daily at least 15 minutes before meals and at bedtime. Cisapride may interact with antibiotics, antidepressants, antifungal medications, phenothiazines, antihistamines, blood pressure medications, heart medications, HIV medications, clidinium, dicyclomine, hyoscyamine, belladonna, propantheline, cimetidine, warfarin, or benzodiazepines. Tell your doctor all medications you use. During pregnancy, cisapride should be taken only if prescribed. Cisapride passes into breast milk. It is unknown if this drug will harm a nursing infant. Consult your doctor before breastfeeding.
Our Propulsid (cisapride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In the U.S. clinical trial population of 1728 patients (comprising 506 with gastroesophageal reflux disorders, and the remainder with other disorders) the following adverse experiences were reported in more than 1% of patients treated with cisapride and at least as often on cisapride as on placebo. (See TABLE 1.)
|System/Adverse Events||Cisapride N=1042||Placebo N=686|
|Central & Peripheral Nervous Systems|
Upper respiratory tract infection
|Body as a Whole|
|Skin & Appendages|
The following adverse events also reported in more than 1% of cisapride patients were more frequently reported on placebo: dizziness, vomiting, pharyngitis, chest pain, fatigue, back pain, depression, dehydration, and myalgia.
Diarrhea, abdominal pain, constipation, flatulence, and rhinitis all occurred more frequently in patients using 20 mg of cisapride than in patients using 10 mg.
In other U.S. and international trials and in postmarketing experience, there have been rare reports of seizures and extrapyramidal effects. Also reported have been tachycardia, elevated liver enzymes, hepatitis, thrombocytopenia, leukopenia, aplastic anemia, pancytopenia, and granulocytopenia. The relationship of cisapride to the event was not clear in these cases.
Cardiac arrhythmias, including ventricular tachycardia, ventricular fibrillation, torsades de pointes, and QT prolongation, in some cases resulting in death, have been reported. (See CONTRAINDICATIONS, WARNINGS, PRECAUTIONS, and DRUG INTERACTIONS.)
In addition to the cardiovascular adverse events, the following events have been identified during post-approval use of cisapride in clinical practice. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These events have been chosen for inclusion in this product information due to a combination of their seriousness, frequency of reporting, or potential causal connection to cisapride: allergic reactions, including bronchospasm, urticaria, and angioedema; possible exacerbation of asthma; psychiatric events, including confusion, depression, suicide attempt, and hallucinations; extrapyramidal effects including akathisia, Parkinson-like symptoms, dyskinetic and dystonic reactions; gynecomastia, female breast enlargement, urinary incontinence, hyperprolactinemia, and galactorrhea.
The Following Events Were Specifically Reported in the Pediatric Population: Antinuclear antibody (ANA) positive, anemia, hemolytic anemia, methemoglobinemia, hyperglycemia, hypoglycemia with acidosis, unexplained apneic episodes, confusion, impaired concentration, depression, apathy, visual changes accompanied by amnesia, and severe photosensitivity reaction.
There have been rare cases of sinus tachycardia reported. Rechallenge precipitated the tachycardia again in some of those patients.
Read the entire FDA prescribing information for Propulsid (Cisapride (Removed from US Market))